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2021 DIGILAW 2223 (RAJ)

Jal Singh v. State of Rajasthan

2021-11-25

REKHA BORANA

body2021
JUDGMENT The present writ petition has been filed by the petitioner for reimbursement of his medical expenses amount of Rs.33,906/- incurred for a surgery of right eye at All India Institute of Medical Science (AIIMS), New Delhi. The petitioner was a Government Doctor, who retired on 31.08.2006. In the present petition petitioner stated that he suffered in his right eye an ailment named Mecular Hole and the diagnosis was Pseudophahia c Idipathic FTMH Stage 2. An emergency arose when he was with his son at Delhi and because of the emergent situation he was rushed to All India Institution of Medical Science (AIIMS), New Delhi, wherein he was admitted and operated for the ailment. He remained hospitalized from 07.05.2011 to 11.05.2011 and for the said complete period of hospitalization and surgery an amount of Rs. 33,906/- was incurred of which he claimed the reimbursement. The said claim of the petitioner was allegedly returned by the Directorate of the Pension & Pensioners Welfare Department on the ground that: firstly, the treatment of the petitioner had been undertaken in a private hospital outside the State of Rajasthan; secondly, there was no certificate of any emergent situation having been arisen and thirdly, that there was no certificate of reference to the AIIMS, New Delhi. When called upon by the respondent, petitioner submitted an affidavit clarifying the emergent situation of disease and the treatment thereof. But the reimbursement was not made by the respondents and hence the present petition has been preferred. In the reply, it has been stated by the respondents that in terms of Rule 10 (1) and 10(3) of the Rules of Rajasthan Civil Services (Medical Attendance) Rules, 2008 (hereinafter referred as Rules of 2008), the petitioner had not produced any certificate showing emergency of treatment taken by him. It has also been averred that the petitioner has failed to produce any certificate issued by Competent Authority regarding non-availability of such treatment in any Medical College of the State of Rajasthan and further that petitioner had not submitted any document of his reference to the AIIMS Hospital for treatment. Controverting the facts as stated by the respondents, vide rejoinder the petitioner stated that the document Annexure-2 annexed with the petition was a certificate fulfilling the essential requirements as mentioned under Rule 10 (3) of the Rules of 2008. Controverting the facts as stated by the respondents, vide rejoinder the petitioner stated that the document Annexure-2 annexed with the petition was a certificate fulfilling the essential requirements as mentioned under Rule 10 (3) of the Rules of 2008. So far as the certificate pertaining to emergency is concerned, the same was also furnished by the petitioner when called upon. Heard counsel for both the parties and perused the material available on record. A bare perusal of Annexure-2 issued by AIIMS, New Delhi makes it clear that the petitioner was treated for the disease in an urgent situation and his condition was deteriorating. The certificate has also been issued by the treating Doctor with specific details which read as under:- "I Dr. Atul Kumar/ Dr. Bhavin Shah hereby certify that the patient named above has been under treatment at Dr. R.P. Centre for Ophthalic Sciences A.I.I.M.S. under my care and that the undermentioned Drugs/Lab tests/ X Ray needed in this connection were essential for the recovery/prevention of serious deterioration in the consideration of the patient. The medicines are not stocked in the centre for supply to the patient." So far as the averment of the respondents that the petitioner was treated in a private hospital is concerned, by no terms AIIMS can be termed to be a private hospital. It has been admitted by the respondents in the reply too that AIIMS was a referral hospital under the Rules and therefore too, rejection of the petitioner's claim for reimbursement cannot be treated to be valid. It has been specifically averred by the petitioner that the treatment of disease from which he suffered, was not available in any hospital in Rajasthan to which no specific reply has been furnished by the respondents which concludes the fact that no specific denial of the same was made. Counsel for the petitioner relied upon the judgments of Division Bench of this Court passed in DB Special Appeal (Writ) No. 1015/2007 (The State of Rajasthan & Ors. v. Raghuveer Sharan Sharma) and also other judgments of this court passed in SB Civil Writ Petition No. 2266/2018 (Radhe Shyam Dhand v. State of Rajasthan) decided on 01.05.2018 and Civil Writ Petition No. 11578/2009 (Liyakat Ali Khan v. State of Rajasthan) decided on 16.03.2016. v. Raghuveer Sharan Sharma) and also other judgments of this court passed in SB Civil Writ Petition No. 2266/2018 (Radhe Shyam Dhand v. State of Rajasthan) decided on 01.05.2018 and Civil Writ Petition No. 11578/2009 (Liyakat Ali Khan v. State of Rajasthan) decided on 16.03.2016. In Raghuveer Sharan Sharma's (supra) case Division Bench of this Court while relying upon the earlier judgments of this Court as well of Hon'ble Apex Court in the case of Surjit Singh v. State of Punjab and Others ( AIR 1996 SC 1388 ) held as under:- "Government cannot insist upon an employee to get himself treated at recognized government institution. All that the Government in these circumstances can do is to reimburse the concerned employee at the rates that may be applicable in the recognized government institutions. Before we may part with this order, we would like to mention that the government cannot insisite upon an employee to get himself treated at recognized government institution. All that the government in these circumstances can do is to reimburse the concerned employee at the rates that may be applicable in the recognized government institutions Reference in this connection may be made to the judgment of the Supreme Court in Surjit Singh v. State of Punjab and Others ( AIR 1996 SC 1388 ) and State of Punjab and Others v. Mohan Lal Jindal (2001) 9 SCC 217 . The preliminary objections raised by the State as have been noted above need to be straightaway rejected. Delay in this case has actually been caused by the State in refusing a justified claim despite repeated recommendations made by this Court. In so far as right of petitioner for reimbursement of mediclaim is concerned, it could not be disputed during the course of arguments that a government employee is entitled to the same. Simply because the right of a government employee for medical reimbursement may not be a fundamental right it cannot be said that the writ petition would not be competent. Simply because the right of a government employee for medical reimbursement may not be a fundamental right it cannot be said that the writ petition would not be competent. Once such a right is recognized, denial thereof would certainly entitle a citizen to invoke jurisdiction of this Court under Article 226 of the Constitution of India." In view of the above authoritative pronouncements of this Court as well as Hon'ble Apex Court rejection/denial of the reimbursement of the medical bills of the petitioner by the Department cannot be held to be a valid in the eye of law. It is also to be noted that it is not the case of the respondents that the bills as raised by the petitioner were not in consonance with the rates applicable to the recognised government institutions. In the result, the writ petition is allowed. The respondents are directed to reimburse the sum of medical expenses amounting to Rs. 33,906/- to the petitioner within a period of one month from the date of receipt of copy of this order. All pending applications, if any, stand disposed of.