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2025 DIGILAW 1735 (RAJ)

Jawanaram Chouhan, S/o. Pekaram v. State Of Raj. Through The Principal Secretary, Medical, Health & Family Welfare Department

2025-11-07

FARJAND ALI

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ORDER : FARJAND ALI, J. 1. The present writ petition has been instituted by the petitioner under Article 226 of the Constitution of India, with a prayer for issuance of an appropriate writ, order or direction to the respondents to reimburse the medical expenses incurred by the petitioner towards the treatment of his wife, along with interest at the rate of 12% per annum from the date of incurrence of expenditure till the date of actual payment by the respondents. 2. Briefly stated the facts of the case are that the petitioner is serving as a Patwari under the Government of Rajasthan. His wife, Smt. Sunder Devi, had gone to Surat along with their son to assist her brother engaged in business there. During her stay, she developed a severe renal ailment and was admitted to Mahaveer General Hospital, Sangrampura, Surat in a critical condition. Upon receiving information, the petitioner reached Surat, where the attending doctors informed him that both kidneys of his wife had failed, necessitating urgent surgery and continued dialysis twice a week. 2.1. The petitioner incurred medical expenses amounting to Rs. 80,992/- up to 01.09.2005 and, due to the continued treatment requirements, submitted an application to the District Collector (Land Records), Jalore, seeking reimbursement and allocation of a special budget. The Tehsildar (Land Records), Jalore, recommended reimbursement and further allotment of funds vide letter dated 01.09.2005. The District Collector accordingly forwarded the case to the Additional Registrar (Finance & Accounts), Board of Revenue, Ajmer, on 20.09.2005. 2.2. The Additional Registrar raised certain queries, which were duly clarified by the District Collector and the petitioner through successive correspondences dated 25.11.2005 and 09.05.2006. Meanwhile, the petitioner’s wife succumbed to her illness on 04.04.2006. The Collector recommended reimbursement of Rs. 2,29,465/– towards the total treatment expenditure. 2.3. Vide communication dated 15.06.2006, the Additional Registrar requested the Deputy Secretary, Revenue (Group–II), Government of Rajasthan, Jaipur, to sanction reimbursement by granting relaxation in rules. The District Collector, Jalore, reiterated through letter dated 04.12.2006 that the petitioner was entitled to full reimbursement under the Rajasthan Civil Services (Medical Attendance) Rules, 1970 (hereinafter referred as ‘the Rules of 1970). 2.4. The Revenue Department, however, sought a valuation from the S.M.S. Hospital, Jaipur, for an equivalent treatment cost. The hospital assessed the amount at Rs. 50,000/–. Acting on this, the petitioner furnished an undertaking dated 19.04.2007, agreeing to accept Rs. 2.4. The Revenue Department, however, sought a valuation from the S.M.S. Hospital, Jaipur, for an equivalent treatment cost. The hospital assessed the amount at Rs. 50,000/–. Acting on this, the petitioner furnished an undertaking dated 19.04.2007, agreeing to accept Rs. 50,000/– as per the S.M.S. Hospital’s estimation. The Collector forwarded the same to the Board of Revenue for budgetary sanction. 2.5. Despite repeated communications between the year 2007 and 2008 from the District Collector, Jalore, and the Board of Revenue to the Finance Department and Revenue (Group–II) Department, the reimbursement was never sanctioned. After a lapse of two years and no disbursement, the petitioner withdrew his undertaking vide letter dated 17.07.2009. 2.6. The petitioner contends that treatment at Mahaveer General Hospital, Surat was necessitated by an emergent medical situation, and as held in various judgments of the Hon’ble High Courts and the Hon’ble Supreme Court, medical reimbursement cannot be denied merely because treatment was undertaken outside the State or in a private hospital during an emergency. 2.7. The petitioner’s total claim of Rs. 2,25,000/– remains unpaid. Even the partial amount of Rs. 50,000/–, to which he had consented earlier, was never sanctioned. Consequently, he served a legal notice upon the respondents, which was duly acknowledged, but no further action was taken till now, hence the instant Writ Petition. 3. Learned counsel for the petitioner contended that the respondents’ refusal to reimburse the petitioner’s medical claim of Rs. 2,25,000/– incurred for the treatment of his deceased wife at Mahaveer General Hospital, Surat, is arbitrary, illegal, and contrary to the Rules of 1970. Despite the petitioner’s full compliance with procedural requirements, the authorities, adopting a mechanical approach, failed to process his claim, compelling him even to furnish an undertaking to accept Rs. 50,000/–, which too remains unpaid. 3.1. It was urged that treatment undertaken in an emergency cannot be denied reimbursement merely because it occurred in a private or non-recognized hospital, as the right to medical relief is integral to Article 21 of the Constitution. The respondents’ inaction, it was argued, reflects administrative apathy, violates Articles 14, 16, and 21, and frustrates the object of the welfare scheme. The petitioner, having suffered prolonged financial and mental distress for over nine years, thus seeks full reimbursement with interest. 4. Learned counsel for the respondents submitted that the petitioner’s grounds are mere reiterations of earlier contentions already dealt with in the reply. The petitioner, having suffered prolonged financial and mental distress for over nine years, thus seeks full reimbursement with interest. 4. Learned counsel for the respondents submitted that the petitioner’s grounds are mere reiterations of earlier contentions already dealt with in the reply. The impugned action is lawful, justified, and in conformity with the applicable rules. Under the the Rules of 1970, reimbursement of actual expenses incurred in a private hospital is impermissible, except to the extent admissible at recognized rates. Reliance is placed on B.L. Verma v. State of Rajasthan decided on 20.05.2008 , wherein this Hon’ble Court held that reimbursement is limited to rates prescribed for recognized institutions. 4.1. It is further urged that the petitioner cannot claim benefits de hors the rules, circulars, or judicial precedents, nor raise new grounds during arguments without affording rebuttal. Hence, the writ petition is devoid of merit and liable to be dismissed with costs. 5. I have heard the learned counsel for the parties and gone through the niceties of the matter as also the material placed on record. 6. Having heard the learned counsel for the parties and upon a meticulous perusal of the record, this Court finds that the controversy pivots around a narrow yet significant issue: whether the petitioner is entitled to reimbursement of medical expenses incurred for the treatment of his wife at Mahaveer General Hospital, Surat, a private institution situated outside the State, under the ambit of the Rules of 1970. 6.1 It is trite that the right to medical aid forms an inseparable facet of the right to life guaranteed under Article 21 of the Constitution of India. The State, being a model and welfare employer, is under a constitutional as well as moral obligation to safeguard the health and well-being of its employees and their dependents. Denial of reimbursement merely because treatment was availed at a private or non-recognized institution, particularly during an emergency, is antithetical to the spirit of the welfare State and the mandate of Articles 14, 16, and 21. 6.2 The Hon’ble Division Bench of this Court in State of Rajasthan & Ors. v. Surendra Kumar Kalra [RLW 2008 (3) Raj. 1953] has lucidly enunciated that in cases of emergent medical exigency, the government cannot rigidly insist that its employees obtain treatment solely from government-recognized institutions. 6.2 The Hon’ble Division Bench of this Court in State of Rajasthan & Ors. v. Surendra Kumar Kalra [RLW 2008 (3) Raj. 1953] has lucidly enunciated that in cases of emergent medical exigency, the government cannot rigidly insist that its employees obtain treatment solely from government-recognized institutions. The Court held that when immediate medical intervention is imperative for saving life, delay can prove fatal, and hence, reimbursement must be accorded at rates applicable to recognized government hospitals. 6.3 Similarly, the Hon’ble Supreme Court in Suman Rakheja v. State of Haryana [ (2004) 13 SCC 562 ] held that where a patient was admitted in an emergent condition to a non- recognized private hospital, the employee was entitled to full reimbursement at AIIMS rates and 75% of the expenses exceeding such rates. The Apex Court underscored that emergency circumstances override procedural formalities, and the State’s duty to preserve life cannot be diluted by technicalities. 6.4 A Coordinate Bench of this Court, in Kanhaiya Lal Dave v. State of Rajasthan & Ors. [S.B. Civil Writ Petition No. 420/2009] and Gyanendra Kumar Pareek v. State of Rajasthan [2009 (4) WLC (Raj.) 95], reiterated that “emergency knows no law and no procedure,” emphasizing that when human life is imperiled, the State cannot abdicate its responsibility. It was held that reimbursement must be granted even if treatment was obtained at an unrecognized hospital or outside the State without prior reference, subject, however, to the rates prescribed for recognized institutions. 6.5 This legal position was reaffirmed in S.B. Civil Writ Petition No. 5714/2011 – Sohan Lal Sharma v. State Finance Department & Ors., decided on 04.12.2024 , wherein the Coordinate Bench, while drawing upon the aforementioned precedents, observed that reimbursement cannot be withheld merely on account of the treatment having been undertaken in an unrecognized hospital outside the State or without prior permission. The Court directed that reimbursement must be processed strictly in accordance with the prescribed rates, together with interest at 6% per annum after 30 days of submission of bills. 6.6 For ready reference, this Court recalls the following extract from Sohan Lal Sharma (supra) , which draws from the judgments in Kanhaiya Lal Dave and Gyanendra Kumar Pareek “When a family member suffers from a cardiac ailment, the prime objective of the other family member would be to save his/her life. 6.6 For ready reference, this Court recalls the following extract from Sohan Lal Sharma (supra) , which draws from the judgments in Kanhaiya Lal Dave and Gyanendra Kumar Pareek “When a family member suffers from a cardiac ailment, the prime objective of the other family member would be to save his/her life. Emergency knows no law and no procedure, and when human life is at stake, the ultimate responsibility of the State cannot be washed off. The Government cannot insist upon an employee to get himself treated only at a recognized government institution. All that the Government can do in such circumstances is to reimburse the concerned employee at the rates applicable to recognized government hospitals.” The judgment further relied on Surjit Singh v. State of Punjab [ AIR 1996 SC 1388 ] and State of Punjab & Ors. v. Mohan Lal Jindal [ (2001) 9 SCC 217 ], wherein the Supreme Court unambiguously held that reimbursement must be made even if the treatment is undertaken in an unrecognized hospital or outside the State, provided it is emergent in nature. 6.7 In the backdrop of these judicial pronouncements, it is abundantly clear that the petitioner’s case falls squarely within the ambit of an emergent medical situation. His wife was admitted to Mahaveer General Hospital, Surat, in a critical state with renal failure necessitating immediate dialysis and surgical intervention. The petitioner, upon being informed, rushed to Surat and bore substantial medical expenses in good faith and urgency. The authorities themselves acknowledged the genuineness of the claim, having sought a valuation from S.M.S. Hospital, Jaipur, which assessed the admissible amount at Rs. 50,000/–. Yet, even this amount was never disbursed, reflecting administrative apathy and insensitivity. 6.8 This Court, therefore, finds that the denial of reimbursement in such circumstances not only frustrates the object of the Rules of 1970 but also infringes upon the petitioner’s fundamental rights under Article 21. The respondents were expected to act with fairness, empathy, and promptitude, especially when the case pertained to life-saving treatment of a dependent. Their failure to do so for nearly two decades is deplorable and cannot be condoned. 6.9. The respondents were expected to act with fairness, empathy, and promptitude, especially when the case pertained to life-saving treatment of a dependent. Their failure to do so for nearly two decades is deplorable and cannot be condoned. 6.9. Accordingly, this Court reiterates that the petitioner is entitled to reimbursement of the medical expenses incurred for the treatment of his wife at Mahaveer General Hospital, Surat, restricted to the rates applicable to recognized government hospitals in Rajasthan (such as S.M.S. Hospital, Jaipur), as envisaged under Rule 12 of the Rules of 1970. 7. In the result, the writ petition thus succeeds and is hereby allowed to the extent indicated above. No order as to costs. Stay applications and all pending applications, if any, stand disposed of accordingly. 7.1. The respondents are directed to verify the petitioner’s medical bills, process the same in accordance with the prescribed rates, and release the admissible amount after deducting any payment already made. The amount shall carry interest at the rate of 6% per annum from the expiry of 30 days after the submission of bills until the date of actual payment.