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2016 DIGILAW 140 (PNJ)

Rajesh Modi v. State of Punjab

2016-01-13

RITU BAHRI

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JUDGMENT : RITU BAHRI , J. Petitioner has approached this Court by way of instant writ petition filed under Articles 226/227 of the Constitution of India, seeking a writ in the nature of mandamus for issuance of direction to the respondents to reimburse the medical expenses of Rs.2,19,506/-incurred while undergoing treatment in the PGI along with minimum interest @ 18% Petitioner is legal heir of of Smt. Kanta Modi w/o Shri B.M. Modi, Judicial Officer (Retd.) (now deceased). Her mother got her both knees joint replaced at P.G.I Chandigarh and was admitted in the PGI on 24.01.1993 and was discharged on 31.05.1993 and father of the petitioner was pensioner of Punjab Government, who retired as Sub Judge, 1st Class, Samrala, District Ludhiana. On the basis of instruction issued by the Punjab Government, the petitioner is entitled for the medical expenses incurred by her mother. The father of the petitioner died on 29.03.1995 and mother of the petitioner died on 20.05.1995. The details of the bills amounting to Rs.2,19,506/-reads as under:- Cost of 2 knees component - Rs.93475/- PGI Charges - Rs.80580/- Medicines, Injections etc - Rs.45501/- TOTAL - Rs.2,19,506/- The Sessions Judge, Ludhiana forwarded the claim of the petitioner to the High Court, who further forwarded on 20.11.1993 to respondent No. 1 and the claim was received in the Department of Home on 22.11.1993 for sanction but no claim was received by the petitioner. A representation dated 15.09.1994 (P-1) was made by father of petitioner to Chief Minister, Punjab and to respondent No. 1. On notice, a written statement has filed by respondent No. 1 and took a stand that a medical bill of Rs.2,19,506.54 was received on 22.11.1993 which remained under process in various departments and was finalised in October, 1995 sanctioning an amount of Rs.40,000/-as replacement of two knees including other allied expenditure incurred for the purpose i.e cost of medicines, injections, hospital charges and Rs.70,400/-as room rent excluding other allied expenditure incurred for the purpose i.e A.C. Charge, Diet Charge etc, as per instructions dated 18.01.1990 and 01.01.1992 issued by the Punjab Government. Thus, the total amount of Rs.1,10,400/-was reimbursed vide letter dated 04.10.1995. Reference has been made to a Division Bench judgment of this Court in a case of Waryam Singh vs. State of Punjab and others, 1996(4) SLR 177 (2) DB whereby reference has been made to letter dated 08.01.1996 and held as under:- 22. Thus, the total amount of Rs.1,10,400/-was reimbursed vide letter dated 04.10.1995. Reference has been made to a Division Bench judgment of this Court in a case of Waryam Singh vs. State of Punjab and others, 1996(4) SLR 177 (2) DB whereby reference has been made to letter dated 08.01.1996 and held as under:- 22. Some of these instructions have become subject matter of interpretation by this Court in large number of cases. In Sadhu R. Pall v. State of Punjab 1994 (1) RSJ 335, a Division Bench made reference to the Circulars dated 25.1.1991 and 8.10.1992 and held that a person, who has undergone by-pass surgery at Escort Heart Institute and Research Centre, New Delhi, cannot be denied reimbursement only on the ground that the institute was not recognised for the purpose of reimbursement and the petitioner had ignored the channel of Government Medical Institutions. The Division Bench held:- "There is no reason nor any has been pointed out to restrict the right of the petitioner to get the best Medical treatment available in the country from an Institute recognised by the State Government. Since provision of free medical treatment or reimbursement in lieu thereof is a beneficial act of the welfare State for its employees, the rules/instructions have to be construed liberally in favour of the employees, for granting them the relief, rather than adopting a wooden attitude to deprive a person of his due. The respondents appear to have patently used excuses in refusing full reimbursement, when the factum of treatment and the urgency for the same has been accepted by the respondents by reimbursing the petitioner the expenses incurred by him, which he would have incurred in the A.I.I.M.S., New Delhi, We cannot loose sight of factual situation in the A.I.I.M.S., New Delhi, i.e. with respect to the number of patients received there for heart problems. In such an urgency, one cannot sit at home and think in a cool and calm atmosphere for getting medial treatment at a particular hospital or wait for admission in some Government medical institute. In such a situation decision has to be taken forthwith by the person or his attendants if precious life has to be saved." The Division Bench further held:- "In view of the observations made above, we do not find force in the contention raised by the respondents. In such a situation decision has to be taken forthwith by the person or his attendants if precious life has to be saved." The Division Bench further held:- "In view of the observations made above, we do not find force in the contention raised by the respondents. It is ridiculous to suggest that for a disease like heart trouble, particularly in the facts and circumstances of this case, the petitioner should have first appeared before the Medical Board and got their prior approval for treatment from a recognised institute. The very defence put forth by the respondents in view of the fact is frivolous. Taking the State's contention to its logical end, it would mean that a person who suffers a heart attack, should first get recommendation from the Medical Broad by appearing before it personally etc. before getting himself treated he should first get an approval for treatment from the medical board. In such circumstances as revealed in the instant petition, the petitioner would have never made it to the Medical Board as he in all probability would have died before the medical board could meet and examine him. In such diseases and situations timely medical aid is of paramount consideration. We are of the considered view, by reading the instructions dated 8.10.1991 in pith and substance that the instructions do not authorise the respondents to refuse reimbursement as suggested by them. The instructions are meant for human being s and have to be read liberally and with an object to serve the purpose and the persons for whom they are meant. The defence taken by the respondents is nothing else but a frivolous defence which cannot be sustained in the eye of law. The very act of the respondents is arbitrary and an attempt at defeating justice." 23. The same issue was again considered in Ravi Mohan Duggal v. State of Punjab and other 1995 (3) RSJ 399 , and it has been held:-"Once the Escort Heart Institute, new Delhi and Apollo Hospital, Madras are recognised institutions and the Government has authorised the Government servant to go for treatment to these Institutions, the State cannot refuse reimbursement of the expenditure incurred by a Government servant for it is the bona fide duty of the Government to pay for the beneficial act of an employee as it is Welfare State. All the rules and regulations are to be considered in favour of the Government employee liberally and to the benefit of the Government employee and the State is not permitted to have an iron heart in such matters. The State has admitted the full expenditure to have been incurred by the petitioner in both the hospitals. The treatment and urgency for the same has been accepted by the respondents. They no where claimed that such an amount has not been incurred by the petitioner for his treatment. Once the petitioner was suffering from a serious heart attack he could not consult the doctor in Government hospital and sit at his home or wait for the permission of the Government to seek the treatment in a recognised hospital lest that would cause danger to his life and in many cases it could even cause death. In such a situation it was quite justified for the petitioner to take treatment in a recognised hospital and save his life." Thereafter, in concluding para, it has been observed as under:- 35. Now the question which needs determination is whether the petitioners are entitled to be paid interest. In most of the cases decided earlier, this Court has awarded interest to the petitioners. This is because the Court has taken the view that the Government and its functionaries have unjustifiably withheld the reimbursement. We do not find any reason to deviate from the earlier decisions. In addition to the reasons given to the decisions to which reference has been made above, we deem it necessary to add that it is extremely agonising for a person to wait for months and years to receive reimbursement of the expenses incurred by him for treatment. The very nature of ailment like heart disease changes the life style of a human being and if he is under mental strain of paying back the amount incurred for medical treatment and the Government, it only increases risk to his life in future. Wholly unjustifiable approach on the part of the Government forcing these persons to approach the Court cannot also be ignored. One can reasonably assume that three months' time is sufficient for the Government to make an inquiry into the genuineness of the bill submitted by an employee for reimbursement. Wholly unjustifiable approach on the part of the Government forcing these persons to approach the Court cannot also be ignored. One can reasonably assume that three months' time is sufficient for the Government to make an inquiry into the genuineness of the bill submitted by an employee for reimbursement. Therefore, it would be just and proper to direct the payment of interest with effect from expiry of three months' of the submission of the application for reimbursement. 36. We also feel that after having taken note of the pendency of large number of cases involving claims of the employee for reimbursement of the medical expenses and having given notice to the Government of this issue, it would be appropriate to issue general directions to the Government to settle the pending claims of reimbursement within a specified time frame so that the employees are not compelled to move this Court for similar relief. 37. We, therefore, allow the writ petitions and direct that:- 1. The petitioners except Gurmail Singh Bhogal and D.S. Sandhu are directed to be paid the amount of reimbursement incurred by them within a period of three months of the submission of certified copy of this order. Petitioner Gurmail Singh Bhogal is also directed to be paid amount equivalent to the amount which are normally incurred for open heart by-pass surgery at the Escorts Heart Institute, New Delhi. This payment is also to be made within three months. 2. All the petitioners shall get interest at the rate of 15% per annum. This interest shall be paid for the period between a date, commencing from expiry of three months of the submission of the application for reimbursement till the date of payment. 3. All cases of reimbursement of medical expenses pending in all the departments of the Government shall be taken up by the concerned departmental authorities and the competent authorities are directed to make payment in the following manners : i) Where the amount of reimbursement claimed by the employee is less than Rs. 1,000/-, the payment shall be made by the concerned departmental authority within one month from today. ii) Where the amount of reimbursement exceeds Rs. 1,000/-but is less than Rs. 10,000/-, they payment shall be made by the departmental authority within a period of two months ; and iii) Where the amount exceeds Rs. 10,000/-the payment shall be made within three months. ii) Where the amount of reimbursement exceeds Rs. 1,000/-but is less than Rs. 10,000/-, they payment shall be made by the departmental authority within a period of two months ; and iii) Where the amount exceeds Rs. 10,000/-the payment shall be made within three months. The Government of Punjab is directed to send a report to this Court about the compliance of these directions within four months and the matter shall be placed before the Court on 16.8.1996 for perusal of the report and for issue of other directions, if any, required. The case of the petitioner is identical to CWP No. 14120 of 1995 mentioned in Waryam Singh's case and in para 40, it has been observed as under:- “This petition has been filed for reimbursement of the expenses incurred by the petitioner for the replacement of knee joint of his wife, Smt. Rajinder Kaur. It is alleged in the writ petition that his wife remained an indoor patient at Post Graduate Institute of Medial Science and Research, Chandigarh, from 2.9.1993 to 31.10.1993 for replacement of knee joints. It is further stated that a sum of Rs. 1,33,657.25 was incurred on her treatment. The petitioner submitted his bills and by the time of filing of the writ petition, the Government had sanctioned only a sum of Rs. 40,000/-. The petitioner made representation against the denial of total medical reimbursement. During the pendency of the writ petition, learned Government Advocate made a statement that the total amount of expenses incurred by the petitioner for treatment of his wife has been sanctioned.” Applying the ratio of the above said judgments to the facts of the present case, the present writ petition is allowed and respondents are directed to pay the amount mentioned below, to the legal heir's of the petitioner - Cost of 2 knees component - Rs.70000/- PGI Charges - Rs.80580/- Medicines, Injections etc - Rs.45501/- TOTAL - Rs.1,96,081/- The amount of Rs. 156,081/-(196081-40000) be paid to the legal heirs of the petitioner @ 9% per annum w.e.f the date commencing from expiry of three months of the submission of the application for reimbursement till the date of the payment.