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2007 DIGILAW 815 (RAJ)

Sita Ram v. State of Rajasthan

2007-04-18

H.R.PANWAR

body2007
JUDGMENT 1. - By the instant writ petition under Article 226 of the Constitution of India, the petitioner seeks a direction to the respondents to reimburse all the expenses incurred by him on account of an accident suffered by him, along with interest. 2. The facts and circumstances giving rise to the instant writ petition are that the petitioner is a retired Government servant and he is a pensioner having P.P.O. No. 603326. He went on pilgrimage at Rameshwaram where he fell down from the roof in the evening of 5.6.1998 and suffered numerous injuries, as a result of which he became unconscious. With the help of some surrounded persons at Rameshwaram, the petitioner was immediately taken and admitted in Meenakshi Mission Hospital & Research Centre, Madhurai (Tamil Nadu) and underwent emergency treatment. The said hospital is a recognised hospital for treatment of Central Government Employees under the CS (MA) Rules, 1994 vide No. S.1421/5/96 dated 3.8.1997 issued by the Ministry of Family & Health Welfare, Government of India, New Delhi vide Annexure-2. The petitioner suffered very severe head injury and became unconscious and underwent various tests like CT SCAN of brain etc. There was right temporal communized fracture and haemorrhage as also four to ten multiple ribs were fractured on the right side to cardiological disorderness and suffered cardiological disease. He remained hospitalized in the emergency ward in an unconscious and coma state for nearly two months and underwent various kind of treatments. He suffered head injury IGCS-8/15 and multiple ribs-fractures (right 4th to 10th) and fracture of right clavical, acute lung injury, haemothrac (left) and Haemopneumothorzx (right), Bilateral IC was done immediately. His arterial blood gas report showed severe hypoxaemia with inadequate gas exchange across the Alveolocapillary membrane. He was placed on Mechanical Ventilatory support after awake Nasotracheal Intubation. ICD were removed after few days. Lungs expanded well with BIPAP Ventilation, Serial ABG's reflected Poor Oxygenation and inadequate gas exchange. He was conscious, oridenated (oriented ?), interacting veaning from the ventilator was attempted frequently but it was unsuccessful as he had classical presentation of A.R.D.S. The petitioner showed significant improvement clinically, Radiologically and ABG-wise after change of mode of Ventilation (BIPAP with IRV). The petitioner had been treated with Broad Spectrum Abtibiotics. Pulmonary Vasodilators. Initially intermittent weaning was attempted but his blood gases reports were not encouraging. The petitioner had been treated with Broad Spectrum Abtibiotics. Pulmonary Vasodilators. Initially intermittent weaning was attempted but his blood gases reports were not encouraging. The petitioner did not go for Multiple Organ dysfunction syndrome (MODS) fortunately. Petitioner was on Mechanically Ventilatory support for 16 days and was extubated after 18 days. He was on continuous 02 Supplementation with venti-Mas, FI 02 was reduced gradually. He co-operated well for deep breathing exercises (with incentive spirometery) and made ambulatory. Selective active Chest Psiotherapy (left) and limb physiotherapy was given to him. Radiologically clearance was seen on Serial Chest X-ray's. Arterial Blood gas values normalized by the time of his discharge. Recouping therefrom, the petitioner was discharged from the said hospital after a long treatment on 1.7.1998 vide Annexure 5. On arrival to Rajasthan, the petitioner submitted the medical reimbursement bills to the respondents for medical treatments and other expenses incurred by him on various tests etc. amounting to Rs. 2,20,000/- vide Annexure-6. A Medical Board was constituted and the medical report was prepared vide Annexure-11. There had been some communications between the Treasury Officer, Bikaner and the District Collector, Bikaner vide Annexure-7 to Annexure-10. The medical claim of the petitioner was returned to him vide Annexure-9 by the Treasury Officer, Bikaner noticing certain shortcomings in the bills. Thereafter vide Annexure-12, respondent No. 3 the District Collector, Bikaner approached the respondent No. 2 the Director, Pension and Pensioners' Welfare, Rajasthan, Jaipur for consideration of petitioner's case under Rule 4 of the Rajasthan State Pensioners Medical Concession Scheme (for short, "the Scheme" hereinafter). However, vide order Annexure R-1, the Sub-Committee of the Board of Trustees, in its meeting held on 14.2.2000, rejected the claim of the petitioner on the ground that the treatment was taken by the petitioner in Meenakashi Mission Hospital, Madhurai which is not a recognised hospital by the State Government and also on the ground that the petitioner did not have a renewed medical diary at the time of his treatment. Hence this writ petition. 3. I have heard learned counsel for the parties.It is contended by the learned counsel for the petitioner that the petitioner is a retired Government servant and entitled for medical reimbursement under the provisions of the Scheme. Hence this writ petition. 3. I have heard learned counsel for the parties.It is contended by the learned counsel for the petitioner that the petitioner is a retired Government servant and entitled for medical reimbursement under the provisions of the Scheme. Learned counsel submits that Rule 16 of the Scheme provides that the Board of Trustees may grant to a pensioner any concession relating to medical treatment or attendant which is not provided in this scheme in individual cases of extreme hardship on merits. Learned counsel fairly conceded that the case of the petitioner does not fall under any of the categories enumerated in Rule 4 of the said Scheme and, therefore, the petitioner seeks medical reimbursement by invoking the provisions of Rule 16 of the Scheme. In support of his contention, learned counsel for the petitioner has relied on the decisions of this Court in Smt. Nirmala Kumari Raizada v. Director Pensions and Pensioners Welfare and others, 170, RLR 2001(1) Raj. 539 and Laxman Taneja v. State of Rajasthan and others, 2005(3) SCT 464 : 2005(3) WLC (Raj.) 451. It has further been contended by the learned counsel for the petitioner that the petitioner went on pilgrimage to Ramseshwaram (Tamil Nadu) and accidentally fell down from the roof and suffered numerous injuries, as noticed above, became unconscious and went in coma. He was immediately taken by the surrounding persons, who were even not known to the petitioner, for treatment to the Meenakshi Mission Hospital & Research Centre, Madhurai (Tamil Nadu), where he was admitted in an unconscious state for a long period of 25 days from the date of the accident and underwent various types of treatments and tests. At such a distant place from Rajasthan, it was not possible for the petitioner either to seek permission for treatment at the place out-side the State of Rajasthan or to get his case referred to a hospital situated outside the State of Rajasthan. It has been contended that the medical claim of the petitioner has been denied by the respondents on the ground that he took the treatment out-side the State without having been referred, the said hospital at Madhurai is not a recognised hospital by the Government of Rajasthan and at the time of undertaking the treatment, the petitioner was not having a renewed medical diary. 4. 4. It is not in dispute that the medical diary is renewable when it is fully utilised and subsequently it has been renewed by the respondents themselves, therefore, in my view, denial of medical reimbursement on the ground of non- renewal of medical diary at the time of undertaking the treatment at Madhurai cannot be sustained. 5. So far as taking treatment by the petitioner out-side the State of Rajasthan is concerned, the facts and circumstance noticed above clearly go to indicate that while on pilgrimage to Rameshwaram (Tamil Nadu), accidentally the petitioner fell down from the roof of a building and suffered numerous serious injuries, as a result of which he became unconscious and went in coma. He was taken by some surrounding persons known (unknown ?) to the petitioner to the nearest aforesaid hospital at Madhurai and, in those circumstances, it could not have been possible for any one to seek prior permission for undertaking the medical treatment at the place out-side the State of Rajasthan, or to get his case referred for treatment. In the given circumstances, it was not within the domain of the petitioner, as he was unconscious and in a coma state for nearly 25 days, to seek prior permission or get his case referred to a place out-side the State of Rajasthan. His life could be saved only on taking him immediately to the aforesaid nearest hospital at Madhurai by some surrounding persons who were even not known to the petitioner. In these circumstances, the petitioner underwent his treatment at Madhurai. 6. In Smt. Nirmala Kumari Raizada v. Director Pensions and Pensioners Welfare and others, 170 (supra), this Court held that the provisions of the Scheme should be liberally construed in the benefit of retired employees. When a retired Government employee had gone out of the State and in emergency in order to save his life had to take medical treatment at a big hospital outside the State, then he should be given the benefit of the Scheme by invoking Rule 16 of the Scheme and in such a case of emergency, it is not expected of a person to ask the Principal, SMS Medical College or Director, Medical & Health for constituting the Medical Board and for recommending his case for getting medical treatment from outside the State. In that case, it was held that the respondents acted in violation of Articles 14 and 21 of the Constitution of India in refusing reimbursement of medical bills. 7. In Laxman Taneja v. The State of Rajasthan and others (supra), a coordinate Bench of this Court held that to preserve health and obtain medical aid in furtherance of self-preservation is part of right of life under Article 21 of the Constitution of India and in the given circumstances, it was held that the petitioner therein is also entitled for reimbursement of medical expenses, irrespective of the place where the treatment has been received. It was held that denial of reimbursement on technical grounds is nothing but an arbitrary, unreasonable and unjust action of the respondents. It was further held that when a person explains reasons for getting the treatment in a private hospital in emergent circumstances, the reimbursement should not be denied only on some hyper-technical grounds and the Government must give relaxation in such matters. 8. Keeping in view the peculiar facts and circumstances of the case that the petitioner, under the emergency and compelling circumstances, took treatment at Madhurai, which was the nearest hospital from pilgrim Rameshwaram where he suffered injuries on account of accidental fall and taken to the hospital in an unconscious condition by the surrounding persons, where he was admitted and remained unconscious and in a coma state for nearly 25 days and discharged from there nearly after two months, in my view, the case of the petitioner for medical reimbursement deserves to be considered under Rule 16 of the Scheme. 9. In the result, the respondent No. 2, who is also the Member Secretary of the Board of Trustees, is directed to reconsider the case of the petitioner sympathetically for reimbursement of the medical bills submitted by the petitioner keeping in view the decisions of this Court in Smt. Nirmala Kumari Raizada v. Director Pension & Pensioners Welfare and others, 170 (supra) and not to entertain the technicalities as referred in Annexure R-1, by relaxing Rule 16 of the Scheme. This exercise be completed within two months and make payment of the amount which arises on reconsideration by the Medical Board.With these directions, the writ petition stands disposed of. There shall be no order as to costs.Petition allowed. *******