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2012 DIGILAW 1280 (RAJ)

Raghuveer Prasad Saini v. State of Rajasthan

2012-05-16

M.N.BHANDARI

body2012
JUDGMENT 1. - The matter is listed on an application seeking early listing of the writ petition, however, with the consent of learned counsel for both the parties, the matter is heard finally. 2. It is case where medical bills of petitioner have not been reimbursed by the respondents as treatment was taken in private hospital. 3. Learned counsel for the petitioner submits that under an emergent situation, treatment was taken in private hospital and in any case, petitioner limits his claime at par with the rates prescribed by the Government for similar treatment in Government hospital. 4. Learned counsel for respondents opposed the prayer on the ground that treatment was not taken from a recognised private hospital and even petitioner was not referred for such treatment to Santokba Durlabhji Hospital as similar treatment was available in SMS Medical Hospital. Thus, he is not entitled to the benefit of reimbursement contrary to Scheme. A reference of judgment of Hon'ble Supreme Court in the case of State of Rajasthan v. Mahesh Kumar Sharma reported in (2011) 4 SCC 257 has been given to indicate that reimbursement of medical bills can be as per the terms of Scheme and not contrary to it. 5. I have considered the submissions made by learned counsel and perused the record. 6. It is a case where petitioner underwent neurosurgery in Santokba Durlabhji Hospital in the given circumstances mentioned in the writ petition. The question now comes as to whether petitioner is entitled to reimbursement of entire medical bills or it can be at the rate prescribed for similar treatment in the Government hospital. 7. So far as the issue regarding admissibility of claim is concerned, any treatment taken from private recognised hospital cannot result in reimbursement of medical bills at par with the rates prescribed in Government hospital for similar treatment. It is in view of judgments of Division Bench and Hon'ble Supreme Court. Accordingly, an employee is entitled for reimbursement of medical bills at par with the rates prescribed by the State Government for similar treatment, thus reimbursement is restricted and not permissible beyond the rate prescribed by the Government. 8. The question now comes as to whether treatment taken from private hospital attracts the Scheme. 9. The judgment in the case of Mahesh Kumar Sharma (supra) does not bar reimbursement of medical bills if treatment is taken from private hospital. 8. The question now comes as to whether treatment taken from private hospital attracts the Scheme. 9. The judgment in the case of Mahesh Kumar Sharma (supra) does not bar reimbursement of medical bills if treatment is taken from private hospital. It only refers to the admissibility of claim as per the Scheme. The controversy as raised herein was not before the Hon'ble Apex Court, thus judgment of the Hon'ble Apex Court has to be read in reference of the controversy raised. This is moreso when, consistently this Court is granting relief of reimbursement of medical bills to the employees if they have taken treatment from private hospital, however, restricting their claim at par with the rates provided for similar treatment in Government hospital. Thus, similar issue was considered and decided by this Court in the case of Niranjan Audichya v. State of Rajasthan & Anr. reported in 2007 WLC (Raj.) UC 507 wherein judgment of Division Bench was also considered. Therein, treatment was taken from a private unrecognized hospital though in the present case, Santokba Durlabhji Hospital is now one of the recognised hospital, accordingly, I am inclined to accept this writ petition. The reason to accept claim is that if employee would have taken treatment from the Government hospital then also same amount would have incurred, thus to that extent, he is entitled to the reimbursement. 10. In the light of the discussion made above, the writ petition is allowed. The respondents are directed to reimburse the medical bills of the petitioner at the rates prescribed for similar treatment in Government hospital. It is would obviously be at the rates prescribed by the Government at the relevant time when treatment was taken.Writ petition allowed. *******