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2012 DIGILAW 147 (HP)

Jagat Singh Negi, Ex. MLA, Shillai, Paonta Sahib, District Sirmaur v. Secretary, H. P. Vidhan Sabah, Shimla

2012-03-30

DHARAM CHAND CHAUDHARY

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JUDGMENT Dharam Chand Chaudhary, Judge: 1. The petitioner, who is an Ex. MLA, has approached this Court by filing the present writ petition for quashing the impugned order dated 3.10.2008 Annexure P-2 issued by the 2nd respondent though permitting thereby the petitioner to take treatment from Sir Ganga Ram Hospital, New Delhi, however, restricted his entitlement to reimbursement of the expenses he incurred upon his treatment as per the rates of AIIMS, New Delhi, on the basis of clause 9.7 of the Policy decision dated 21.6.2008 Annexure P-3 being illegal and arbitrary and also for issuing a direction to the respondents to reimburse the entire amount, he actually spent on his treatment. 2. The petitioner had to transplant his kidney and was under treatment in Sir Ganga Ram Hospital, New Delhi. He remained hospitalized during the period from 11.9.2007 to 28.1.2008 and incurred upon an expenditure of Rs. 9,97,348/- on his treatment. The Director Health Services, Himachal Pradesh had allowed him to undergo treatment in Sir Ganga Ram, Hospital. He submitted all the bills for payment to the1st respondent, who in turn referred the matter to the 2nd respondent vide Annexure P-1. The 2nd respondent had conveyed the approval of the Government to the 1st respondent vide Annexure P-2 for reimbursement of the claim in favour of the petitioner in relaxation of Rules subject to the condition that the same shall be restricted to the rates of AIIMS. Thus the 1st respondent had reimbursed only a sum of Rs.4,25,573/- vide Annexure P-5 and a further sum of Rs.88,724/- against his bills amounting to Rs.9,97,348/-. Against the part payment so made to him, he had made a representation for payment of balance amount to the 1st respondent vide Annexure P-6. The 1st respondent, however, had conveyed the petitioner that in view of the approval granted by the Government, he was only held entitled to the reimbursement of Rs.4,25,573 and Rs.88,724/- respectively, vide Annexure P-7, in full and final settlement of his claim and no balance payment on account of this claim was due to him. 3. Feeling aggrieved and dissatisfied therewith, the petitioner has filed the present writ petition with a prayer to strike out clause 9.7 of the Policy in respect of reimbursement of medical claims framed by the respondents and for a direction to the respondents to reimburse the whole amount he spent on his treatment. 4. 3. Feeling aggrieved and dissatisfied therewith, the petitioner has filed the present writ petition with a prayer to strike out clause 9.7 of the Policy in respect of reimbursement of medical claims framed by the respondents and for a direction to the respondents to reimburse the whole amount he spent on his treatment. 4. The 1st respondent has resisted and contested the claim, as laid in the writ petition, on the ground inter alia that Sir Ganga Ram Hospital is not recognized so far as transplantation of Kidney is concerned. Although the permission was granted to the petitioner by the Director, Health Services to undergo the treatment in this Hospital, yet subject to the condition that the reimbursement of the expenses incurred upon such treatment shall be restricted to the rates of the AIIMS, New Delhi, in accordance with instruction/health policy framed by the State Government and inforce at that time. The administrative approval was also conveyed by the Government accordingly and the petitioner has rightly been reimbursed Rs.4,25,573 and Rs.88,724/- towards full and final settlement of the amount he incurred upon his treatment. 5. Respondents No.2 and 3 have also filed reply to the writ petition and contested the claim of the petitioner on the ground that the medical expenses have been reimbursed to the petitioner in accordance with law and as per his entitlement under Section 2(2) of the Himachal Pradesh State Legislative Officers/Minister and Members Medical Facilities Act, 1971 and the Rules framed thereunder. Sir Ganga Ram Hospital was recognized w.e.f. 21.6.2008 whereas the petitioner had undertaken treatment there well before that. The respondent No.1 has considered the claim and accorded the approval for reimbursement of admissible claim in favour of the petitioner in relaxation, vide Annexure P-2. 6. The petitioner in rejoinder to the reply filed by the respondents has reiterated his claim as set out in the writ petition and denied the contentions to the contrary being wrong. 7. Learned counsel on both sides have hotly contested the claims/counter-claims as laid down in their respective pleadings. 8. The sole question under determination in the present lis is as to whether the petitioner is entitled to the reimbursement of the whole amount he spent on his treatment in Sir Ganga Ram Hospital, New Delhi. 9. Admittedly, the petitioner had undertaken the treatment in the said hospital during the period w.e.f. 11.9.2007 to 28.1.2008. 8. The sole question under determination in the present lis is as to whether the petitioner is entitled to the reimbursement of the whole amount he spent on his treatment in Sir Ganga Ram Hospital, New Delhi. 9. Admittedly, the petitioner had undertaken the treatment in the said hospital during the period w.e.f. 11.9.2007 to 28.1.2008. The said hospital was recognized by the Government of Himachal Pradesh for the purpose of undergoing treatment of its employees and pensioners etc., in the said hospital vide notification dated 1st November, 2007 Annexure R-2. It is true that this Hospital was not recognized for the purpose of transplantation of Kidneys. The fact, however, remains that the Director, Health Services had permitted the petitioner to undergo treatment in the said hospital may be ex post facto. There is again no dispute that the petitioner had furnished the medical bills amounting to Rs.9,97,318/-. He, however, has been reimbursed only a sum of Rs.4,25,573/- and Rs.88,724/-, at the rates of AIIMS, New Delhi in terms of the Government approval Annexure P-2 conveyed to 1st respondent by the 2nd respondent. In Annexure P-2 there is nothing suggesting as to on what basis such claims have been restricted to the rates prevalent in AIIMS, New Delhi. It may be for the reason that Sir Ganga Ram Hospital is not recognized for the purpose of Kidney Transplantation because had it been so, the whole expenditure incurred upon by the petitioner on his treatment would have been reimbursed to him as per clause 9.7 of the Policy/ Guidelines Annexure P-3 notified by the Government of Himachal Pradesh on 21.6.2008. 10. Irrespective of the provisions qua restricting the medical claim in a situation like the present one while deprecating such practice being followed by the State Government, it has been held by our own High Court in a recent judgment in CWP(T) No.16351 of 2008, titled Sudha Kaisha Vs. State of Himachal Pradesh & Others, decided on 5.5.2010, as under:- “The petitioner is aggrieved by the recovery to the tune of Rs.9175/- sought to be made by the fourth respondent on account of audit objection. The petitioner was granted permission to seek treatment in the Dayanand Medical College, Ludhiana. However, it was clarified that charges would be limited to that of PGI of AIIMS. After treatment, all the bills were cleared and the petitioner was reimbursed actual charges. The petitioner was granted permission to seek treatment in the Dayanand Medical College, Ludhiana. However, it was clarified that charges would be limited to that of PGI of AIIMS. After treatment, all the bills were cleared and the petitioner was reimbursed actual charges. After five years, audit party made objection to the effect that room charges and some other incidental expenses as shown in Annexure A-1 are not permissible in terms of the sanction given to her. 2. We are afraid that the stand taken cannot be appreciated. When the petitioner is permitted to have treatment in the medical college, for the only reason that charges in the Medical College vary from the charges in the PGI or AIIMS, it is highly unreasonable to hold that only the charges that are payable for treatment in PGI or AIIMS would be payable unless there is a case for the respondents that such amounts are spent not for the treatment. That is not the case. It is only a case that the rates are higher than that of PGI or AIIMS. The issue is squarely covered by judgment of the Supreme Court in State of Punjab and others vs. Mohinder Singh Chawla, AIR 1997 SC 1225 .” 11. The Judgment supra clinches the point in controversy in the present writ petition because it is not the case of the respondent that the petitioner has not spent the whole amount on his treatment as per the medical bills he submitted to the 1st respondent. 12. No other point including declaring clause 9.7 of the Health Policy Annexure P-3 notified by the State Government is urged before this Court by either of the parties. Learned counsel has rather abandoned the claim of the petitioner in the writ petition qua setting aside clause 9.7 of the Health Policy being illegal and arbitrary. 13. In view of all the reasons hereinabove this petition succeeds and the same is accordingly allowed. The pending application(s) if any also stand disposed of. No order so as to costs.