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2007 DIGILAW 270 (GAU)

Imphalbench Angom Sushila Devi v. State of Manipur and Ors.

2007-04-05

T.NANDA KUMAR SINGH

body2007
T. N. K. Singh, J.:- 1. By this writ petition, the petitioner is pray­ing for a direction to the respondents to reim­burse the medical bill for her treatment at Mallya Hospital, Bangalore on the refusal by the respondents to reimburse the medical bill only on the ground that the said hospital was a private hospital. The point called for deci­sion in the present writ petition is no more res integra. The decision of the Apex Court in Surjit Singh Vs. State of Punjab & Ors. reported in (1996) 2SCC 336 and the deci­sion of this Court in Gouri Sengupta Vs. State of Assam reported in 1999 (3) GLT 601 had already answered the point called for decision in the present writ petition. 2. The petitioner is a State Government employee serving as Additional Public Prosecutor-cum-Additional Government Advo­cate (District) and undisputedly the petitioner is a Class-I Officer of the Government of Manipur. 3. On 27.08.2005, the petitioner left Imphal for Bangalore for her son's admission at Dayananda Sagar of Dental Science, Ban­galore and she was on earned leave for a period of 15 days commencing from 27.8.2005 to 10.9.2005 under the Manipur Civil Service (Leave) Rule 1979. Unfortu­nately, while she was at Bangalore for her son's admission she suddenly fell ill and ad­mitted at Kidwai Institute of Oncology, Bangalore-29, Department of Pathology on 2.9.2005 vide Registration No. 14774. On initial examination, the concerned doctor (specialist) suspected that she was suffering from Cancer of her right breast and thyroid lobe. The attending doctor (specialist) after preliminary examination further advised her for histological evaluation of the case by way of lumpectomy and biopsy. It is said that due to non-availability of bed in the said Kidwai Memorial Hospital, Bangalore, she was re­ferred to Mallya Hospital, Bangalore. In sup­port of her case, petitioner annexed the pho­tocopy of the registered receipt of the OPD having registration No. 14774 Unit GDD Di­agnosis dated 2.9.2005 wherein the con­cerned doctor made a noting on 4.9.2005 that "refer to Mallya Hospital for shortage of bed" to the present writ as Annexure-A-1. The petitioner also undergone many tests and found that the illness of the petitioner was of serious nature and required immediate inter­vention. She was also further subjected vari­ous medical tests at Mallya Hospital, Banga­lore as per advice of the attending doctors. The attending doctor (specialist) Dr. The petitioner also undergone many tests and found that the illness of the petitioner was of serious nature and required immediate inter­vention. She was also further subjected vari­ous medical tests at Mallya Hospital, Banga­lore as per advice of the attending doctors. The attending doctor (specialist) Dr. Vishwanath Hiremath advised her to undergo medical test like needle aspiration cytology, thyroid scan, mammography routine, aspira­tion, complete hemogram test, HIV rapid as­say, hepatitis etc. After the medical report of the said test highly suspicious to be suffering from thyroid left malignancy fnac breast (RT) lump suspicious of malignancy (complex cyst). Accordingly, she was admitted to Mallya Hospital, Bangalore on 22.9.2005 and was operated on the next following day on 23.9.2005 and was finally diagnosed as Left Lobe Follicular Adenoma with Atypical Pap­illary Hyperplasia and Fibrocystic disease with Lobular Hyperplasia Right Breast (mildatypia). After completion of the operation she was discharged from hospital on 28.9.2005. The photocopies of the medical tests receipts along with medical reports and discharged summary reports are also enclosed as An-nexure-A/2(Colly) 4. After arrival at her home town at Imphal, the petitioner applied to the Public Prosecu­tors (Districts), Government of Manipur un­der whom the petitioner is serving for seek­ing permission to the Medical Directorate, Health Services, Manipur for grant of Ex-Post Facto Sanction for medical reimbursement of the actual expenditure incurred in her medical treatment in a private hospital which is not a referable hospital/recognized Hospital of the Government of Manipur and also a sanction for further periodical check up. The petitioner's application dated 28.12.2005 addressed to the Public Prosecutor (Districts) was submitted along with the application and the necessary documents such as duly filled in Form 97-A, Form 97-B along with the original bills and medical reports. The said application of the petitioner dated 28.12.2005 was forwarded to the Secretary (Law), Gov­ernment of Manipur by the Director of Pros­ecution vide its letter No.3/27/90-DP (Ext-S (pt) dated 7.2.2006 for grant of Ex-post Facto Sanction from the Medical Board as the medical treatment of the petitioner was obtained during her earned leave at Mallya Hospital, Bangalore. The total expenditure incurred as the costs of the medical treatments, hospital charges, doctors fees, costs of medi­cines, dietary, laboratory, bed charges and miscellaneous expenditures is Rs. 52,050.31 (Rupees fifty-two thousand fifty and paisa thirty one) only. The total expenditure incurred as the costs of the medical treatments, hospital charges, doctors fees, costs of medi­cines, dietary, laboratory, bed charges and miscellaneous expenditures is Rs. 52,050.31 (Rupees fifty-two thousand fifty and paisa thirty one) only. The Deputy Secretary (Law) to the Government of Manipur vide his letter No.7/23/95-GA/L dated 24.6.2006 informed the Director of Prosecution, Manipur that the medical reimbursement of the petitioner as claimed could not be reimbursed under C.S. (M.A.) Rules 1944 after having examined by the State Medical Board on 14.6.2006 on the sole ground that the medical treatment of the petitioner was obtained in the private hos­pital. A copy of the said letter dated 24.6.2006 is annexed as Annexure-A/7 to the present writ petition. On 3.6.2006, the petitioner re­ported to the Regional Institute of Medical Sciences (RIMS in short) for her follow up medical check up vide C.R. No. 2000606022021 being OPD registration card. The petitioner was advised by the con­cerned Associate Professor of RIMS to attend the Mallya Hospital, Bangalore on the ground that the RJMS does not have the de­tails of her surgery or/treatment available with the Mallya Hospital where the petitioner had been operated. Having no alternative, the petitioner after obtaining leave went to Mallya Hospital for follow up medical check up on 21.6.2006 by flight from Imphal via Kolkata to Bangalore and returned from Bangalore via Kolkata to Imphal by flight. During the fol­low up medical treatment, she got clinically examined on 1.7.2006 and 3.7.2006 respec­tively. The total amount incurred for the fol­low up medical check up as the costs of in­vestigation and the clinical test and the costs of journey is Rs. 22,890/- (Rupees twenty two thousand eight hundred and ninety) only. As stated above, the petitioner being ag­grieved by the refusal to grant as post facto sanction for treatment of the petitioner in the Mallya Hospital, Bangalore by the State Medical Board and also refusal to reimburse the said amount of medical bill i.e. Rs. 74,940.31 (Rupees seventy four thousand nine hundred forty and thirty one paisa) only on the ground that her treatment was at pri­vate hospital filed the present writ petition. 5. The respondents also filed their affidavit-in-opposition. 74,940.31 (Rupees seventy four thousand nine hundred forty and thirty one paisa) only on the ground that her treatment was at pri­vate hospital filed the present writ petition. 5. The respondents also filed their affidavit-in-opposition. In the affidavit-in-opposition, the respondents are not denying that the petitioner had the medical treatment at Mallya Hospital, Bangalore and also had the follow up medical check up at Mallya Hospital and the total expenditure incurred by the petitioner for her treatment was Rs. 74,940.31 (Rupees seventy four thousand nine hundred forty and thirty one paisa) only but the respondents in their affidavit-in-opposition stated that the Mallya Hospital, Bangalore is not recognized by the State Government as the same is not included in the list of the recognized institutes/hospitals for the purpose of medical treatment of the State Government employees and their family members vide Government order No. 5/1/98-M dated 26.08.2006. It is also stated in their affidavit that any reimbursement of expenditure incurred for medical treatment if the amount exceeds Rs.2,000/- required ap­proval of the State Medical Board which is the final authority irrespective of the nature of medical treatment either emergency or nor­mal and the said restriction has been imposed by a policy decision of the Government of Manipur in view of the acute financial crunch in the State. 6. From the case of the respondents made out in their affidavit-in-opposition, it is clear that the respondents are denying to reimburse the medical expenditure incurred by the peti­tioner only on the two grounds- 1. The said Mallya Hospital, Bangalore is a private hospital. 2. The petitioner did not obtain the sanc­tion of the State Medical Board for her medical treatment at Mallya Hospital, Bangalore. 7. It also appeared that the respondents also had taken another ground for refusing to reimburse the bill for medical treatment of the petitioner in their affidavit that there is no emergency for treatment of the petitioner at Mallya Hospital, Bangalore. 8. The Apex Court in the case of State of Punjab & Ors. Vs. Mohinder Singh Chawla & Ors. reported in (1997) 2 SCC 83 ob­served that it is now settled law that right to health is integral to the right to life. Govern­ment has a constitutional obligation to pro­vide health facilities. 8. The Apex Court in the case of State of Punjab & Ors. Vs. Mohinder Singh Chawla & Ors. reported in (1997) 2 SCC 83 ob­served that it is now settled law that right to health is integral to the right to life. Govern­ment has a constitutional obligation to pro­vide health facilities. If the government ser­vant has suffered an ailment which requires treatment at a specialized approved hospital and on reference whereat the government servant had undergone such treatment therein, it is but the duty of the State to bear the ex­penditure incurred by the government servant. Expenditure, thus, incurred requires to be re­imbursed by the State to the employee, Right to health life is the constitutional right of every citizen of India. It is an obligation of the State to tone up health services and to give way to the right of the public at large. The Articles 41 and 47 of the Constitution give recogni­tion to this aspect. 9. The Apex Court in Surjit Singh(supra), held that the government employee suffers from serious illness is not required to stand in queue before the Medical Board for obtain­ing necessary sanction and also did not have to stand in queue in the Government Hospital for treatment and could go elsewhere to an alternative hospital but the amount incurred for medical treatment in the private hospital would be limited to the amount chargeable by the approved/referable hospital. The fact in that case was that the appellant Surajit Singh after obtaining leave from his superior from 15.06.1988 to 08.09.1988 went to England to visit his son. While he was in En­gland he fell ill due to heart problem and as an emergency case, was admitted in Dudley Road Hospital, Birmingham. After diagnosis he was suggested treatment at a named alter­native place. Thus to save himself the appel­lant got himself admitted and operated upon in Humana Hospital, Wellngton, London for a bypass surgery. He claimed a sum of Rs. 3 lakhs for medical reimbursement but rejected by the Govt. of Punjab only on two grounds- (i) The appellant while on leave had the bypass surgery at foreign hospital without sanction of the Medical Board and (ii) it was not an emergency case. 10. He claimed a sum of Rs. 3 lakhs for medical reimbursement but rejected by the Govt. of Punjab only on two grounds- (i) The appellant while on leave had the bypass surgery at foreign hospital without sanction of the Medical Board and (ii) it was not an emergency case. 10. The Apex Court in the context of the fact in Surjit Singh (supra) held that the ap­pellant Surjit Singh will get the medical reim­bursement to the extent of medical expendi­ture chargeable by the AIIMS or/government hospital/or referable hospital and also the ap­pellant need not have to stand in queue be­fore the Medical Board for necessary sanc­tion and also when reimbursing the medical bill at the rate of medical expenditure charge­able by a referable/government hospital whether the case is emergency or not is im­material. Para 3 and 12 of Surjit Singh (su­pra) are quoted hereunder- 3. The appellant, Surjit Singh (now retired) while posted as a Deputy Superintendent of Police, Anandpur Sahib, District Ropar, Punjab developed a heart-condition on 22.12.1987 and that very day went on a short leave extending it uptil 10.01.1988 on medical grounds. It remains unclarified on the record of this case as to what steps the appellant took thereafter to meet his ailment. However, six months later he obtained leave from his superiors from 15.06.1988 to 08.09.1988 and went to England to visit his son. It is the case of the appellant that while in England, he fell ill due to his heart problem and as an emer­gency case, was admitted in Dudley Road Hospital, Birmingham. After diagnosis he was suggested treatment at a named alternate place. Thus to save himself the appellant got himself admitted and oper­ated upon in Humana Hospital, Wellington, London for a bypass surgery. He claims to have been hospitalized from 25.07.1988 to 04.08.1988. A sum of Rs. 3 lakhs allegedly was spent on his treat­ment at London, borne by his son. 12. The appellant therefore had the right to take steps in self-preservation. He did not have to stand in queue before the Medical Board, the manning and assem­bling of which, barefacedly, makes its meetings difficult to happen. The appel­lant also did not have to Stand in queue in the government hospital of AIIMS and could go elsewhere to an alternative hos­pital as per policy. He did not have to stand in queue before the Medical Board, the manning and assem­bling of which, barefacedly, makes its meetings difficult to happen. The appel­lant also did not have to Stand in queue in the government hospital of AIIMS and could go elsewhere to an alternative hos­pital as per policy. When the state itself has brought Escorts on the recognized list, it is futile for it to contend that the appel­lant could in no event have gone to Es­corts and his claim cannot on mat basis be allowed, on suppositions. We think to the contrary. In the facts and circumstances, had the appellant remained in India, he could have gone to Escorts like many oth­ers did, to save his life. But instead he has done that in London incurring consider­able expense. The doctors causing his operation there are presumed to have done so as one essential and timely. On that hy­pothesis, it is fair and just that the respon­dents pay to the appellant, the rates ad­missible as per Escorts. The claim of the appellant having been found valid, the question posed at the outset is answered in the affirmative. Of course the sum of Rs. 40,000/- already paid to the appel­lant would have to be adjusted in compu­tation. Since the appellant did not have his claim dealt with in the High Court in the manner it has been projected now in this Court, we do grant him any interest for the intervening period, even though prayed for. Let the difference be paid to the ap­pellant within two months positively. The appeal is accordingly allowed. There need be no order as to costs. 11. This Court also followed the ratio laid down in Surjit Singh (supra) in the case of Gouri Sengupta(supra) and directed the State respondents to reimburse to the petitioner i.e. Gouri Sengupta for her medical treatment at the private hospital. The fact of the case is spell out in para No. 1 and the operative por­tions of the judgment are mentioned in para No. 3 and are quoted below : 1. This writ application has been filed by a lady and that also by a Matron of the Civil Hospital at Nowgong. But ultimately she herself was ill and she went to Dibrugarh and there she con­sulted Dr. H.N. Sarma, Professor of Obstetrics and Gynaecology, Assam Medical College, Dibrugarh and Doctor Binit Kumar Baruah, Asstt. This writ application has been filed by a lady and that also by a Matron of the Civil Hospital at Nowgong. But ultimately she herself was ill and she went to Dibrugarh and there she con­sulted Dr. H.N. Sarma, Professor of Obstetrics and Gynaecology, Assam Medical College, Dibrugarh and Doctor Binit Kumar Baruah, Asstt. Professor of the same Department. The attending Doctors on preliminary examination advised her Biopsy suspecting that she was suffering from Carcinoma of the uterus and it was found that she was suffering from Carci­noma. Doctor immediately advised her to at­tend an advanced Gynaecological Centre out side the State of Assam for further treatment. It was also advised that the patient should be ac­companied by an escort. She was advised to undergo major abdominal surgery for removal of the uterus. A copy of the reports are annexed to this writ application as Annexures-1,2 and 3. The petitioner went to Calcutta and there she got herself treated in Lans Down Nursing and Research Centre at Calcutta and thereafter she attended the Thakur Pukur Cancer Centre and Welfare Home for Radiotherapy and Brachy Therapy and also took various courses of Ra­diations as advised by the doctors of the said Institution. The petitioner after completion of her treatment returned to Dibrugarh. It is stated herein that the husband of the petitioner ac­companied the petitioner as Escort. Documents regarding her treatment are Annexure-4. The petitioner on her return to Dibrugarh submitted the medical reimbursement bill on 30.1.89 to the Director of Health Services, Hengrabari at Guwahati. Along with the bill, she furnished the relevant vouchers supporting her claim and necessary certificates of the attending Doctors. The total amount of bill comes to Rs. 34,774.19. Certain classifications were called for with re­gard to the claim which she furnished in due course. The bill of the petitioner was not ap­proved by the authority on the ground that the private Nursing Home is not recognized by the State of Assam for the purpose of reimburse­ment of the medical expenses. Hence this writ application. 3. That being the position, this writ application is allowed and the authority is directed to pay the amount of Rs. 34,774.19 within a period of one month from the date of receipt of this order, with interest @ 18% from 31.1.89. The petitioner also shall be paid a cost of Rs. 2500/- Heard Mr. Hence this writ application. 3. That being the position, this writ application is allowed and the authority is directed to pay the amount of Rs. 34,774.19 within a period of one month from the date of receipt of this order, with interest @ 18% from 31.1.89. The petitioner also shall be paid a cost of Rs. 2500/- Heard Mr. A. Roy, learned senior Advocate for the peti­tioner and Mr. K.H. Choudhury, learned Addl. Senior GA, Assam assisted by Mr.B. Goswami, GA, Assam for the respondents." 12. This Court is not burdening itself by citing different decisions of the Apex Court in order to answer the point called for decision by this Court in the present writ petition inas­much as decision of this Court in Gouri Sengupta (supra) and the decision of the Apex Court in Surjit Singh (supra) shall squarely cover this case. In the present case, the re­spondents are not stating that the medical re­imbursement bill claimed by the petitioner are excessive and the more than the medical bill chargeable by the referable hospital or/by the Government hospital. 13. For the reasons discussed above, the respondents are directed to pay the amount of Rs. 74,940.31 to the petitioner within a period of two (2) months from the date of receipt of this order. In the event of failure to pay the said amount within two (2) months from the date of receipt of this order, there shall be interest @ Rs. 14% per annum from the date of delivery of this judgment.