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2012 DIGILAW 731 (RAJ)

Bhanwar Singh Chouhan v. State of Rajasthan

2012-03-22

DINESH MAHESHWARI

body2012
Hon'ble MAHESHWARI, J.—The learned counsel for the parties have made a mention and have been heard finally. 2. The petitioner, working on the post of Booking Clerk with the respondent Rajasthan State Road Transport Corporation ('RSRTC') at its Jodhpur Depot, has filed this petition for being aggrieved against denial of reimbursement of the medical expenses, said to have been incurred by him in the procedure of coronary angioplasty of his wife as performed at Sterling Hospital, Ahmedabd. 3. It is submitted that the petitioner’s wife had been to Ahmedabad for attending a family function when, in the night intervening 5th-6th October 2006, she felt severe angina pain and was, therefore, taken to the Sterling Hospital where coronary angiography was carried out that revealed 99% blockage in her right coronary artery; and immediate angioplasty was advised; and, according to the petitioner, such procedure was undertaken in order to meet with her critical condition and to save her life. 4. The petitioner has stated the grievance in the manner that he was required to spend, in all, an amount of Rs. 1,76,879/- on the aforesaid medical procedures and submitted the bills to the employer but reimbursement of such medical bills was declined on the ground that the treatment had been taken in the said hospital at Ahmedabad without the case of the wife of the petitioner having been referred by the Principal and Controller of the Medical College at Jodhpur. 5. While considering this writ petition on 27.03.2008, this Court directed the petitioner to submit the details about the reasons for his wife’s visit to Ahmedabad. The petitioner has filed an additional affidavit dated 27.04.2008 stating, inter alia, that her wife carrying 99% blockage in right coronary artery was not in the knowledge of anyone prior to angiography at Ahmedabad; that the petitioner’ wife went to attend the marriage reception of a close friend of her son; and that after the function, the petitioner’s wife felt severe pain and in those circumstances, she was taken to Sterling Hospital. 6. The respondents have filed a reply contending against the submissions made by the petitioner. 6. The respondents have filed a reply contending against the submissions made by the petitioner. It is submitted, inter alia, that the story about sudden ailment at Ahmedabad without previous knowledge is incorrect and in that regard, the respondents have placed on record the discharge summary of the patient, i.e., the wife of the petitioner as Annex.R/1 wherein the history of the patient has been stated as under:- “A 50-year-old female patient, Mrs. Rajkawar Chauhan, k/c/o hypertension since 5 years, non-diabetic, hypothyroidism since 1 years, had c/o chest pain with gabharaman and dyspnoea on exertion since last 2 months, h/o old inferior wall MI (thrombolysed-2004). He was admitted to Sterling Hospital for further coronary work up.” 7. It is submitted that it had not been a case of sudden emergency and thus, the petitioner is not entitled to claim the expenses incurred for treatment at Ahmedabad in a hospital not duly notified by the respondents. 8. During the course of submissions in this matter on 13.03.2012, the learned counsel for the respondents frankly and fairly submitted that without prejudice to the submissions sought to be made in the writ petition, the respondents were in the process of examining the claim of the petitioner in the light of Rule 6(1) of the Rajasthan Civil Services (Medical Attendance) Rules, 1970 ('the Rules of 1970'), which have been adopted by the respondent RSRTC; and a report was requisitioned from the Superintendent, SMS Hospital, Jaipur. At request, the matter was adjourned to 19.03.2012 and then, for this date. 9. Today, the learned counsel for the respondents submits that after receiving the report from the said Superintending that the requisite procedure was available in the SMS Hospital and the amount of expenditure having been quantified at Rs. 1,16,886/-, the respondents have immediately made the payment of the said sum of Rs. 1,16,886/- to the petitioner by way of Cheque No. 012496 dated 22.03.2012 drawn on ICICI Bank, Jodhpur Sub-Mandi Paota Branch. The learned counsel for the petitioner submits that the said cheque has been received by him without prejudice to the submissions of the petitioner in this writ petition. 10. After having considered the matter in its totality, this Court is unable to uphold the claim of the petitioner for reimbursement to the tune of Rs. 1,76,879/-, the amount said to have spent for the medical procedure at Sterling Hospital, Ahmedabad. 10. After having considered the matter in its totality, this Court is unable to uphold the claim of the petitioner for reimbursement to the tune of Rs. 1,76,879/-, the amount said to have spent for the medical procedure at Sterling Hospital, Ahmedabad. From the material placed on record, it is difficult to accept that the referred ailment spurt up all of a sudden leading to a case of such emergency as to justify the petitioner's wife taking treatment at Ahmedabad while having gone there for the purpose of family function. The history of the patient as distinctly stated in the discharge summary Annexure-R/1 makes it clear, inter alia, that she had been complaining of chest pain with dyspnoea on exertion at least two months before the process; it had been a case of old inferior wall infarction; and she was admitted in Sterling Hospital for further coronary work up. It is an admitted position that the treatment had been taken at Ahmedabad without the case having been referred by the concerned Government Hospital/Medical College. 11. In view of what has been noticed and discussed above, this Court is satisfied that the petitioner was entitled to reimbursement to the extent of such expenditure in the concerned hospital in the State of Rajasthan. Of course, the respondents were expected to have made appropriate calculations and to have made the payment accordingly without much delay. However, and in any case, the respondents have taken corrective measures and have made payment before final decision of this writ petition. This Court is of the view that the said payment ought to be considered full and final payment towards the claim of the petitioner, who is not entitled for any other payment on this count. 12. In view of the above and approving the payment as made by the respondents, there appears no reason to consider issuance of any writ, order or direction in this matter now. 13. With the observations foregoing, the writ petition stands dismissed. No costs.