Sankar Lal Purkayastha, son of Sri Nanda Lal Purkayastha v. State of Tripura
2017-01-19
S.TALAPATRA
body2017
DigiLaw.ai
Judgment and Order : 1. Heard Mr. Somik Deb, learned counsel appearing for the petitioner as well as Mr. S. Chakraborty, learned Addl. G.A. appearing for the respondents. 2. By means of this writ petition, the petitioner has challenged the action of the respondents by refusing reimbursement of the medical bills submitted by the petitioner for treatment of his father namely Nanda Lal Purkayastha. 3. The facts are mostly undisputed by the respondents. The petitioner is borne in the gazetted establishment and is entitled to get the medical reimbursement for the members of his family within the definition of Central Civil Services (Medical Attendance) Rules, 1965 as adopted by the state of Tripura. The petitioner’s father fell ill and was immediately rushed to the Tripura Medical College and Dr. B.R. Ambedkar Teaching Hospital. The patient was advised for coronary angiography which facility was not available in that hospital and such facility was also not available in the Agartala Government Medical College and G.B.P. Hospital. Having situated thus, the petitioner was compelled to take his father to ILS Hospitals, Agartala for coronary angiography. For that reason, the father of the petitioner was admitted in the said hospitals on 11.05.2013 and he was admitted there till 13.05.2013. After conducting the coronary angiography on 12.05.2013, the father of the petitioner was released from the ILS Hospitals, Agartala on 13.05.2013. But the father of the petitioner faced certain complications and he was again admitted in the ILS Hospital on 17.05.2013 and he received treatment there as an indoor patient till 20.05.2013. After making the assessment, the ILS Hospitals made reference to the superior institute for better management of his treatment and accordingly, the petitioner’s was taken to the Medica Super Specialty Hospital, Kolkata. The petitioner’s father was admitted in that hospital from 20.05.2013 to 30.05.2013 and he was discharged after due treatment. 4. The petitioner raised the medical reimbursement bills and submitted those to the Superintendant of Police, Sipahijala district by his communication dated 04.07.2014 Annexure P/2 to the writ petition. The said authority has informed the petitioner that since the petitioner’s father was not referred by the Standing Medical Board, Government of Tripura, he is not entitled to get reimbursement of the medical expenses. The petitioner had submitted a representation on 31.12.2014 having been aggrieved by the decision of the authority, as communicated by the letter dated 04.07.2014.
The said authority has informed the petitioner that since the petitioner’s father was not referred by the Standing Medical Board, Government of Tripura, he is not entitled to get reimbursement of the medical expenses. The petitioner had submitted a representation on 31.12.2014 having been aggrieved by the decision of the authority, as communicated by the letter dated 04.07.2014. But no positive result yielded therefrom. The petitioner has contended that since no facility in respect of the required treatment was available either in the Tripura Medical College and Dr. B.R. Ambedkar Teaching Hospital or in the Agartala Government Medical College and GBP Hospital in order to save the life of his father and that too on referral made by the ILS Hospitals, he had taken his father to a specialist hospital, Kolkata. 5. The respondents by filing their reply have raised the same ground as reflected in the communication dated 04.07.2014 for refusing the reimbursement expenses for treatment of the petitioner’s father. On 23.11.2016, this court passed the order observing interlia as under : “This is a very pertinent issue. Whether such treatment was at all necessary in the hospital outside the State is of paramount importance so far the reimbursement is concerned. Since there is no such documents from the competent authority, this Court finds it apposite to direct the petitioner’s father, namely, Nanda Lal Purkayastha to appear before the Standing Medical Board at Agartala Medical College and GBP Hospital with all medical records including Annexure-A/1 to the additional affidavit. The medical board after scrutinizing all the records and examination of the said person would form their opinion whether his treatment in the Medica Super Specialty Hospital, Mukundapur, Kolkata or any other institution of similar status was required.” 6. The medical board after examination has sent their opinion under a sealed cover which has been handed up to this court by Mr. S. Chakraborty, learned Addl. G.A. on 16.01.2017. From perusal of their report, the following has surfaced : “The members of the Standing Medical Board, Government of Tripura, Agartala Government Medical College & GBP Hospital, Agartala, examined Sri Nandalal Purkayastha 70 yrs, Male who was admitted at Tripura Medical College, Agartala, Tripura on 03.05.2013. His diagnosis was Coronary Arterial Disease with Hypertension.
G.A. on 16.01.2017. From perusal of their report, the following has surfaced : “The members of the Standing Medical Board, Government of Tripura, Agartala Government Medical College & GBP Hospital, Agartala, examined Sri Nandalal Purkayastha 70 yrs, Male who was admitted at Tripura Medical College, Agartala, Tripura on 03.05.2013. His diagnosis was Coronary Arterial Disease with Hypertension. He was advised to attend higher centre for Coronary Angiography by Assistant Professor Tripura Medical College, Department of Medicine as this facility is not available at Tripura Medical College, Agartala, Tripura as per record. The patient was discharged from Tripura Medical College on 10.05.2013 and got admitted at ILS Hospital, Agartala on 17.05.2013, were Coronary Angiography was done. The report of Coronary Angiography shows that he was having severe Triple Vessel Disease. From ILS Hospital, Agartala he was advised to attend higher centre for further management, and got discharged on 20.05.2013 from Tripura Medical College. The patient went to Medica Super speciality Hospital, Kolkata on 20.05.2013, where Coronary Artery bypass grafting operation was done. This is to mention that the treatment of Coronary Artery Disease with severe Triple Vessel Disease is Coronary Artery bypass grafting operation and this facility is not available at Tripura Medical College and Agartala Govt. Medical College, Agartala, Tripura. The patient did not attend the Standing Medical Board of Agartala Govt. Medical College, Agartala for referral before going to Kolkata, which is the procedure. He attended the Medical Board twice on 29.12.2016 and 05.01.2017 and also Cardiology OPD on 29.12.2016 Thursday at 2.00 p.m. after Coronary bypass operation as directed by the Hon’ble High Court.” As such, there cannot be any amount of confusion that the treatment availed by the father of the petitioner outside the state particularly in the Medical Super speciality Hospital was highly necessary inasmuch as there is no dispute that the ILS Hospitals, Agartala by their advice dated 20.05.2013 had asked the patient, the father of the petitioner “to attend higher centre for further management”. It transpires amply clear that there was no other alternative but to refer the petitioner’s father to the speciality institute for better management of his treatment. 7. Mere absence of referral cannot take away the right that flows from the right to life which includes the right to get the life saving medical intervention. This right falls under Article 21 of the constitution.
7. Mere absence of referral cannot take away the right that flows from the right to life which includes the right to get the life saving medical intervention. This right falls under Article 21 of the constitution. Hence, the petitioner is entitled to get reimbursement of the expenses of the treatment of his father, however, that shall be restricted to the amount that would have been incurred if the petitioner was treated in a referral hospital. There is no dispute that at the relevant point of time that Medica Super Speciality Hospital was not in the panel of the referral hospitals, however on 13.01.2014, Medica Super Speciality Hospitals has been empanelled as the referral hospital. 8. Be that as it may, for simplifying the procedure for reimbursement, this court finds it apposite to direct the respondents to restrict the rate of treatment of an empanelled referral hospital where such facility of treatment was available at the relevant point of time. If the Medical Reimbursement Bills were returned by the respondents, the petitioner is directed to resubmit those bills to the competent authority for reimbursement of bills, in terms of this direction. Such reimbursement shall be made within 3 (three) months from today. 9. It is clarified that costs of treatment availed in the TMC and ILS Hospitals be reimbursed according to the rules. It is further clarified that since the petitioner’s father required an escort for the treatment in a hospital outside the state, the competent authority at the time of reimbursement shall also consider the expenses for the escort as per rule. 10. With these observations and direction, this writ petition is allowed to the extent as indicated above. There shall be no order as to costs. A copy of this order be furnished to Mr. S. Chakraborty, learned Addl. G.A. appearing for the respondents.