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2022 DIGILAW 471 (JK)

Union Territory of J&K v. Sudesh Kumar Raina

2022-09-06

SINDHU SHARMA, TASHI RABSTAN

body2022
JUDGMENT Tashi, J. - This Letters Patent Appeal is directed against the judgment dated 23.07.2019 delivered by the learned Single Bench in SWP No.911/2014, whereby the learned Single Judge while allowing the writ petition directed the respondents, appellants herein, to settle the medical reimbursement claim of writ petitioner, respondent herein, and disburse him the claim along with interest at the rate of 6% per annum to be paid with effect from 25.02.2014 till it is actually paid. 2. Today, when the matter was taken up for hearing, none appeared on behalf of respondent. On the last date of hearing, i.e., 29.07.2022 it was specifically observed by the Court that if the learned counsel for respondent fails to appear on the next date of hearing, the matter would be considered on merits in his absence. 3. Accordingly, matter was taken up today; heard learned counsel appearing for appellants and perused the file. 4. The contention of learned counsel for appellants is that it was incumbent upon the respondent to have referral of his son from the competent medical authority of the State. Since the respondent had failed to comply with the prescribed procedure, as such his case for reimbursement of his medical claim came to be rejected. It was further contended that the son of respondent had already been suffering from the same problem a year ago; as such the respondent could have easily got a referral from the J&K State Medical Authorities. The further contention of learned counsel for appellants is that in terms of Rule 6 of J&K Civil Services (Medical Attendance and Allowance) Rule, 1990, neither the respondent nor his family was temporarily residing outside the State in Delhi nor they have got the requisite certificate from the Directorate Health Services, as such, on this score too, the respondent is not entitled to for reimbursement of medical claim. 5. Admittedly, the medical reimbursement claim of the respondent came to be rejected owing to the fact that the treatment of the minor son of respondent from Sir Ganga Ram Hospital at Delhi was in violation of Circular dated 06.07.2011 issued by the Finance Department, which provided that if a person takes treatment outside the State on its (his) own without referral from the prescribed competent Medical Authority of the State, it shall be presumed to have been done on his own in violation of the prescribed procedure. 6. 6. A perusal of the appeal reveals that the appellants have themselves admitted that when the son of respondent was operated at Sir Ganga Ram Hospital, New Delhi on 12.11.2012, he, as per the medical record, was already suffering from the same problem a year ago and had been admitted in Government Medical College, Jammu; meaning thereby the appellants cannot question the genuineness or emergent situation of the son of respondent. Otherwise too, the Medical Reimbursement Verification Committee of the Directorate of Health Services had also observed that the treatment received by the patient was genuine. Further, Director Agriculture in his recommendation had clearly indicated that the treatment of the son of respondent at Sir Ganga Ram Hospital was due to sudden illness of his son, Director Agriculture, thus, recommended that the case of respondent be settled under Rule 8 of the Rules of 1990. Even the appellants herein in their objections to the writ petition have not denied the genuineness of the claim of respondent nor did they deny that it was under an emergent situation the respondent had to get his son treated at Sir Ganga Ram Hospitaln New Delhi, but have justified the rejection on the strength of Circular dated 6.7.2011. The appellants have failed to understand that apart from the power of the Government to relax the rigors of the Rules in appropriate cases, in terms of Rule 8(ii) of the Rules, the medical treatment by Government servant in a hospital outside the State, is not altogether barred. The Government servant is, however, liable to demonstrate that there was emergency and the same ought to be certified by the competent authority. 7. In the present case, the appellants have not denied that it was under emergent situation the respondent had to get his son treated at Sir Ganga Ram Hospital, New Delhi. Further, the Medical Reimbursement Verification Committee of the Directorate of Health Services also observed that the treatment received by the patient was genuine. Further, keeping in view the observation of learned Single Judge that the effective medical treatment for operation of bleb in the left lower lobe of the lung of respondent's son was not available in the Medical Colleges of the State, nothing further requires to be adjudicated upon. 8. Further, keeping in view the observation of learned Single Judge that the effective medical treatment for operation of bleb in the left lower lobe of the lung of respondent's son was not available in the Medical Colleges of the State, nothing further requires to be adjudicated upon. 8. In a somewhat similar case, claim of an Assistant Surgeon in the Health Department, claiming medical reimbursement for treatment of his son at United Kingdoms, was considered by a Division Bench of this Court in the decision reported in 2004 (3) JKJ 412 , State of J&K vs. Sakhi Willayat, and it was held that the rules cannot be interpreted to operate harshly in medical treatment cases and in the said case the government gracefully accepted the judgment of the Division Bench and conceded to consider the eligible medical claim within a period of four months. 9. Therefore, in view of what has been discussed above, we do not find any merit in the appeal and the same is, accordingly, dismissed.