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2024 DIGILAW 520 (UTT)

Nidhi Saxena v. State of Uttarakhand

2024-07-30

PANKAJ PUROHIT

body2024
JUDGMENT : Pankaj Purohit, J. By means of this writ petition, petitioner has sought the indulgence of this Court for issuance of a writ of certiorari to quash the order dated 28.06.2021, which was communicated to the petitioner vide letter dated 26.07.2021, whereby, the claim of the petitioner seeking reimbursement of medical bills was rejected being time barred in view of the Government Order dated 28.07.2011 and further a writ of mandamus commanding respondent No.4 to conduct pre-audit and accord approval of the bills submitted by the petitioner in view of recommendations made by respondent Nos.2 & 3 and to pay the medical bill amounting to Rs.6,34,030/- along with interest. 2. The facts of the case shorn-off unnecessary details are that the husband of petitioner was in service as Supply Inspector with Food and Civil Supply Department, Haridwar. Husband of the petitioner fell ill and was undergone treatment w.e.f. 05.08.2016 to 19.08.2016 in Synergy Institute of Medical Sciences, Dehradun. Unfortunately, the life of petitioner’s husband could not be saved and he expired during treatment on 19.08.2016. After death of her husband, petitioner submitted claim for medical reimbursement of the amount spent on the treatment of her husband along with the bills and vouchers to respondent No.3. The amount of medical reimbursement, which was demanded by the petitioner, was Rs.6,34,030/-. Respondent No.3, in view of the Government Order No 679@fp0&3&2006&437@2002 dated 04.09.2006, submitted those bills and vouchers to respondent No.4-Director General, Medical Health and Family Welfare, vide its letter dated 28.02.2017. The said bills and vouchers submitted by the petitioner through its department to the respondent No.4 was returned unpaid to the department by respondent No.4, on the ground that in view of Government Order dated 04.09.2006 read with Government Order dated 16.05.2016, the maximum time for raising claim for reimbursement of medical bills was six months, and, since, the claim of the petitioner was raised after the period of six months, the claim was time barred and accordingly, the same was returned back to the department vide order dated 16.07.2018 (Annexure No.5 to the writ petition). After several correspondences made between the department and the respondent No.4, respondent No.4 refused to approve the bills for the same reason that the claim raised by the petitioner was time barred, and, finally, vide impugned order dated 28.06.2021, communicated to petitioner through letter dated 26.07.2021, the claim was rejected, relying upon the Government Order dated 28.07.2011 (Annexure No.1 to the writ petition). 3. It is the contention of the petitioner that the petitioner, being a widow, was unaware of the time limit to raise the claim for reimbursement, therefore, due to unavoidable circumstances, i.e. untimely death of her husband and burden of raising her minor children, delay occasioned in submitting the bills and raising the claim for reimbursement of the medical expenses incurred in the treatment of her husband. It is the case of the petitioner that the bills were genuine and were duly examined and verified and forwarded by the Competent Authority of the department of the petitioner’s husband to respondent No.4 on three occasions. Merely on the ground of delay, the claim of the petitioner cannot be denied. 4. A counter affidavit has been filed by respondent Nos.2, 3 & 4. The ground which is taken by respondent No.4 for not entertaining the claim and payment of the medical reimbursement, have been pleaded in Para 3 of its counter affidavit. The same is quoted below:- “Para 3: It is pertinent to state here that the petitioner i.e. Smt. Nidhi Saxena, w/o Late Vijay Prakash Saxena has submitted the claim of medical reimbursement of her husband for the expenditure of his treatment from 05-08-2016 to 19-08-2016 after the expiry of more than one year through her application dated 21.08.2017 in the office of the deponent. Pursuant to which vide letter no. 1463@ft0iw0v0 dated 28th October, 2017 of District Supply Office, Haridwar, the claim of medical reimbursement bills has been sent for countersign to the Directorate, Medical Health & Family Welfare, Uttarakhand, Dehradun. In pursuance thereof, the Directorate, Medical Health & Family Welfare, Uttarakhand, Dehradun vide his letter no. 19i@708@2017@16407 dated 16.07.2018 returned the medical reimbursement bills under the provisions contained in the Government Order No. 679@fp0&3&2006&437@2002 dated 04.09.2006 and amended Government Order No.679(1)XXVIII-03-2011-437/ 2002 T.C. dated 28.07.2011 inasmuch as the same are presented belatedly as per the provisions of aforesaid Government Orders after the expiry of 01 years.” 5. 19i@708@2017@16407 dated 16.07.2018 returned the medical reimbursement bills under the provisions contained in the Government Order No. 679@fp0&3&2006&437@2002 dated 04.09.2006 and amended Government Order No.679(1)XXVIII-03-2011-437/ 2002 T.C. dated 28.07.2011 inasmuch as the same are presented belatedly as per the provisions of aforesaid Government Orders after the expiry of 01 years.” 5. The gravamen of the submission of respondent No.4 is that the claim of reimbursement of medical expenses were presented by the petitioner after the expiry of one year, and, therefore, the same was returned to the petitioner by respondent No.4 vide letter dated 16.07.2018 pursuant to the Government Order dated 04.09.2006 (Annexure No. CA-3 to the counter affidavit) and amended Government Order No. 679(1)XXVIII-03-2011-437/ 2002 T.C. dated 28.07.2011 (Annexure No.CA-4 to the counter affidavit). 6. The petitioner filed rejoinder affidavit, wherein, it supported and reiterated the case which was raised in the writ petition. It is contended in the rejoinder affidavit that due to shock and untimely demise of her husband, she could not raise the claim for medical reimbursement immediately. It is further contended in Para 7 of the rejoinder affidavit that the objection raised by the Medical Department, i.e. respondent No.4, does not hold good as it was for the employer to approve or disapprove the bills and once the employer has decided to reimburse the medical bills, the Health Department has no say in the matter. It is further averred in the said Para 7 of the rejoinder affidavit that the role of Medical Department is limited only to assess and verify the bills because medical bills include fee of doctor, cost of medicine etc., which can only be assessed and verified by the Health Department so that public exchequer may not be siphoned off by unscrupulous persons. 7. Heard learned counsel for the parties. 8. The arguments advanced by the learned counsel for the petitioner are the same as reiterated in the pleadings. It is contended by learned counsel for the petitioner that mere on a technical ground, the claim for medical reimbursement has been rejected. It is also contended by learned counsel for the petitioner that the purpose of sending the medical bills and vouchers to the respondent-Medical Department is only to verify them and the main role of payment of medical reimbursement is with the employer-department. 9. It is also contended by learned counsel for the petitioner that the purpose of sending the medical bills and vouchers to the respondent-Medical Department is only to verify them and the main role of payment of medical reimbursement is with the employer-department. 9. It is also submitted by learned counsel for the petitioner that there is no dispute with regard to the genuineness of the medical bills and vouchers submitted by the petitioner, the claim was only rejected and returned for being time barred, as the same, having been raised after a period of six months. 10. Learned State Counsel only argued that the claim for medical reimbursement was raised after a prescribed period of six months in view of the Government Orders dated 04.09.2006 and 28.07.2011, and, belatedly after expiry of 1 year, therefore, the same has been not found favour with the respondent No.4 and was returned accordingly to the department. 11. Having heard learned counsel for the parties and from perusal of the record, particularly, the Government Orders dated 04.09.2006 and 28.07.2011, this Court is of the opinion that the claim of the petitioner cannot be rejected only on the ground of delay. There is no denying of this fact that the husband of the petitioner was entitled for the medical reimbursement. It is also not denied that the husband of the petitioner was under treatment before his death and he died during treatment on 19.08.2016. The only dispute is that the petitioner submitted her claim for medical reimbursement of her husband after six months contrary to the Government Order dated 04.09.2006, which was amended by a subsequent Government Order dated 28.07.2011. Clause 6(i) of the Government Order dated 04.09.2006 is quoted herein below:- 12. The Government Order dated 04.09.2006 prescribes that the bills and vouchers shall be produced within three months to the Head of the Department or Office and subsequently, Clause 6(ii) provides that the documents and vouchers shall be technically examined by the Medical Department and shall be returned to the Head of the Department/Office of the government servant after countersigning, within a period of one month maximum. Vide Government Order dated 28.07.2011, undisputedly, three months period has been enhanced to six months. Government Order dated 04.09.2006 was amended only to that extent and rest of the terms and conditions of the said Government remained as it was. 13. Vide Government Order dated 28.07.2011, undisputedly, three months period has been enhanced to six months. Government Order dated 04.09.2006 was amended only to that extent and rest of the terms and conditions of the said Government remained as it was. 13. From the pleadings of the parties, it is reflected that husband of the petitioner expired on 19.08.2016 and the claim of medical reimbursement was submitted by the petitioner to Head of Department/Office on 21.08.2017 (Annexure No.3 to the writ petition). The employer raised no objection and forwarded the same to the respondent No.4 for technical examination of the bills and vouchers for its being countersigned vide letter dated 28.10.2017 (Annexure No.4 to the writ petition). The department has never raised any objection on raising the claim for medical reimbursement beyond time, rather, for the first time, the claim for medical reimbursement was returned back to the Head of Department of the petitioner’s husband on 16.07.2018 by respondent No.4 on the ground of its being time barred in view of the Government Order dated 04.09.2006, as the limitation of claim for medical reimbursement was six months. The respondent No.3 wrote a letter to Commissioner, Department of Food, Civil Supply and Consumer Affairs Department on 11.09.2018 detailing therein that the claim for medical reimbursement of the petitioner’s husband was returned by the respondent No.4 as being time barred and sought the sanction of the time barred medical reimbursement and finally, after calling report from the department, the claim of medical reimbursement was again sent to respondent No.4. 14. From the language of the Government Orders dated 04.09.2006 and 28.07.2011, it is clear beyond doubt that the claim should have been submitted to the Head of Department/Office, within six months and it is the Head of department/Office who can raise objection about the delayed submission of claim for medical reimbursement, not the respondent No.4 who has to technically check and examine the bills and vouchers submitted by the petitioner. Once the claim has been submitted by Head of Department/Office of the petitioner’s husband to the respondent No.4, respondent No.4 has no competence or power to raise any objection about the limitation of raising the claim of medical reimbursement. Thus, the order dated 28.06.2021, communicated to petitioner by the respondents-department through letter dated 26.07.2021, is beyond jurisdiction. Once the claim has been submitted by Head of Department/Office of the petitioner’s husband to the respondent No.4, respondent No.4 has no competence or power to raise any objection about the limitation of raising the claim of medical reimbursement. Thus, the order dated 28.06.2021, communicated to petitioner by the respondents-department through letter dated 26.07.2021, is beyond jurisdiction. The objection to the limitation can only be raised by the employer/ department of the petitioner’s husband and not by the respondent No.4. Once the bills and vouchers along with all documents forwarded by the Head of Department/Office of the petitioner’s husband, respondent No.4 should only examine and sent it back to the employer/department for payment. 15. In this view of the matter, writ petition succeeds. Impugned Order dated 28.06.2021 passed by respondent No.4 communicated to petitioner vide letter dated 26.07.2021 is hereby quashed by issuing a writ of certiorari. A writ of mandamus is issued to respondent No.4 to conduct the examination of the bills and vouchers sent by the petitioner through its department, in accordance with law, as the same was submitted by the Head of Department/Office to the respondent No.4 and send it back to the department after countersigning it as per law and the respondent-employer/department is further directed to make the payment of such amount of medical reimbursement of the petitioner’s husband as she is entitled, as early as possible but not later than three months’ from the date of production of certified copy of this order. 16. Accordingly, the writ petition is allowed. 17. Pending application(s), if any, also stands disposed of.