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2022 DIGILAW 2453 (RAJ)

Chhagan Lal Mathur v. State Of Rajasthan

2022-09-15

KULDEEP MATHUR

body2022
JUDGMENT Kuldeep Mathur, J. - Briefly stated facts of the case are that the petitioner suffered from a cardiac problem and was taking treatment at Mathura Das Mathur Hospital, Jodhpur admitted on 05.05.2013. Thereafter, he was referred to 'higher centre urgent CABG for needful' and was discharged on 07.05.2013. After being discharged, the petitioner went to Jaipur Heart Institute, wherein he was operated on 08.05.2013 and he remained admitted from 07.05.2013 to 16.05.2013. A sum of Rs. 1,48,179/- was incurred as expenses for the treatment underwent by the petitioner. The petitioner submitted reimbursement claim for medical bills through an application dated 14.11.2013. The respondents pursuant to the petitioner's application for reimbursement, sent a cheque of Rs. 44,000/-. Aggrieved by partial acceptance of the claim, the petitioner has preferred the present writ petition. 2. Learned counsel for the petitioner submitted that the petitioner was referred to 'higher centre urgent CABG for needful' by Mathura Das Mathur Hospital, Jodhpur. Since, the petitioner undertook treatment at an approved hospital as per Appendix-1 of the Rajasthan Civil Services (Medical Attendance) Rules, 2008 (hereinafter referred to as the 'Rules of 2008'), the claim for reimbursement of medical bills ought to have been accepted in toto. Reliance was placed on the judgments rendered by this Court in the cases of Smt. Usha Mehta v. State of Rajasthan & Ors. (S.B. C.W. No. 6401/2006) and State of Rajasthan & Ors. v. Smt. Usha Mehta (D.B. S.A.W. No. 1309/2014) 3. Per contra, learned counsel for the respondents submitted that the claim of the petitioner was partially accepted in consonance with the Rules of 2008. It was further submitted that though the Jaipur Heart Institute is an approved hospital, the reimbursement is to be made on recommendation of Health Benefit Advisory Committee as mandated by circular of the finance department dated 16.12.2009 and Rule 4 of the Rules of 2008. Reliance was placed on the judgment rendered by the Hon'ble Supreme Court in the case of State of Rajasthan v. Mahesh Kumar Sharma reported in 2011 (4) SCC 257 . 4. Heard learned counsels for the parties and perused the material available on record. 5. Reliance was placed on the judgment rendered by the Hon'ble Supreme Court in the case of State of Rajasthan v. Mahesh Kumar Sharma reported in 2011 (4) SCC 257 . 4. Heard learned counsels for the parties and perused the material available on record. 5. Rule 8 of the Rules of 2008 states that a Government servant shall be entitled to medical attendance and treatment in approved hospital within State and the expenditure incurred for treatment in an approved hospital shall be reimbursed to the extent mentioned in sub rule 8 of Rule 8 of the 'Rules of 2008'. 6. In the present case, the claim of the petitioner has been admitted partly but so far as claims pertaining to medicines, drugs, anesthesia and room charges etc. are concerned, no amount qua the same has been reimbursed. 7. The judgments relied upon by the counsel for the petitioner have taken into consideration the provisions of Rajasthan Civil services (Medical Attendance) Rules 1970. The aforesaid rules have been revised by introduction of the Rajasthan Civil services (Medical Attendance) Rules 2008, therefore, the case of the petitioner is required to be considered in light of the provisions of Rajasthan Civil services (Medical Attendance) Rules 2008. 8. The Hon'ble Supreme Court in the case of Mahesh Kumar Sharma (supra) held as under:- "8. In this connection it will be profitable to refer to the judgment of a Bench of three Judges of this Court in State of Punjab and Ors. v. Ram Lubhaya Bagga and Ors. Reported in (1998) 4 SCC 117 where the Bench has laid down that the Government would be justified in limiting the medical facilities to the extent it is permitted by its financial resources. In the instant case, the Government has formulated necessary rules certain situations and upto a certain limit. The Government has been reimbursing the necessary expenditure as permitted by the rules uniformly. It will, therefore, not be proper for a Government employee or for his relatives to claim reimbursement of medical expenses otherwise than what was provided in the Rules." 9. Therefore, in view of the ratio laid down by the Hon'ble Supreme Court and also keeping in view the peculiar facts of the case, the present writ petition is partly allowed. It will, therefore, not be proper for a Government employee or for his relatives to claim reimbursement of medical expenses otherwise than what was provided in the Rules." 9. Therefore, in view of the ratio laid down by the Hon'ble Supreme Court and also keeping in view the peculiar facts of the case, the present writ petition is partly allowed. The respondents are directed to reconsider the claim of the petitioner in light of the provisions contained in Rule 8 of the 'Rules of 2008'. The respondents are further directed to reimburse the amount qua the medicines, drugs, anesthesia, room charges and all other heads as payable in terms of Rules of 2008. The exercise indicated hereinabove shall be completed within a period of eight weeks from the date of receipt of this order. No order as to costs.