Gujarat High Court
Yogesh Mafatlal Barot vs State Of Gujarat on 27 November, 2025
Author: Bhargav D. Karia
Bench: Bhargav D. Karia
NEUTRAL CITATION
C/LPA/1263/2025 JUDGMENT DATED: 27/11/2025
undefined
IN THE HIGH COURT OF GUJARAT AT AHMEDABAD
R/LETTERS PATENT APPEAL NO. 1263 of 2025
In
R/SPECIAL CIVIL APPLICATION NO. 19207 of 2022
FOR APPROVAL AND SIGNATURE:
HONOURABLE MR. JUSTICE BHARGAV D. KARIA
and
HONOURABLE MR.JUSTICE L. S. PIRZADA
==========================================================
Approved for Reporting Yes No
✓
==========================================================
YOGESH MAFATLAL BAROT
Versus
STATE OF GUJARAT & ORS.
==========================================================
Appearance:
MR LAKSHIT V PATEL FOR MR HB CHAMPAVAT(6149) for the
Appellant(s) No. 1
MR HS MUNSHAW(495) for the Respondent(s) No. 2
MS SHRUTI DHRUVE, AGP for the Respondent(s) No. 1
==========================================================
CORAM:HONOURABLE MR. JUSTICE BHARGAV D. KARIA
and
HONOURABLE MR.JUSTICE L. S. PIRZADA
Date : 27/11/2025
ORAL JUDGMENT
(PER : HONOURABLE MR. JUSTICE BHARGAV D. KARIA)
1. Heard learned advocate Mr. Lakshit V. Page 1 of 28 Uploaded by RAGHUNATH R NAIR(HC00196) on Mon Dec 01 2025 Downloaded on : Mon Dec 01 21:01:36 IST 2025 NEUTRAL CITATION C/LPA/1263/2025 JUDGMENT DATED: 27/11/2025 undefined Patel for learned advocate Mr. H.B. Champavat for the petitioner, learned advocate Mr. H.S. Munshaw for respondent no.2 and learned Assistant Government Pleader Ms. Shruti Dhruve for the respondent State.
2. Having regard to the controversy involved which is in a narrow compass, With the consent of the learned advocates for the respective parties, the matter is taken up for hearing at the admission stage. Hence, Admit. Learned advocate Mr. H.S. Munshaw waives service of notice of rule on behalf of the respondent no.2 Corporation and learned Assistant Government Pleader Ms. Shruti Dhruve waives service of notice of rule on behalf of the respondent State.
Page 2 of 28 Uploaded by RAGHUNATH R NAIR(HC00196) on Mon Dec 01 2025 Downloaded on : Mon Dec 01 21:01:36 IST 2025
NEUTRAL CITATION C/LPA/1263/2025 JUDGMENT DATED: 27/11/2025 undefined
3. Brief facts of the case are that the appellant-original petitioner was working with the respondent Corporation and suffered heart problem due to which he was admitted to Hetal Heartcare Hospital wherein after treatment, he was discharged on 02.06.2016. It is the case of the appellant-petitioner that he was advised for angiography and bypass as the future course of action by the concerned doctor.
4. The appellant accordingly got admitted in U.N. Mehta hospital on 07.06.2016 and angiography was performed and was discharged on 09.06.2016 with a report of block artery.
5. Subsequently, the appellant petitioner got admitted to SAL hospital, Ahmedabad on Page 3 of 28 Uploaded by RAGHUNATH R NAIR(HC00196) on Mon Dec 01 2025 Downloaded on : Mon Dec 01 21:01:36 IST 2025 NEUTRAL CITATION C/LPA/1263/2025 JUDGMENT DATED: 27/11/2025 undefined 15.06.2016 for bypass surgery.
6. The appellant petitioner therefore, incurred Rs.22,914/- for the medical treatment at Hetal Heartcare Hospital, Rs.7,868/- for treatment at U.N. Mehta Hospital and Rs.1,83,108/- for bypass surgery at SAL Hospital, totalling to Rs.2,13,890/-.
7. The appellant petitioner submitted the bills for reimbursement with the respondent corporation. However, the respondent partially cleared the bill on 02.09.2016 for meager amount of Rs. 69,925/- and amount of Rs. 1,45,965/- was not cleared and paid to the appellant.
8. The appellant thereafter due to his ill-health gave application for voluntary Page 4 of 28 Uploaded by RAGHUNATH R NAIR(HC00196) on Mon Dec 01 2025 Downloaded on : Mon Dec 01 21:01:36 IST 2025 NEUTRAL CITATION C/LPA/1263/2025 JUDGMENT DATED: 27/11/2025 undefined retirement after completion of notice period and by office order dated 30.11.2016, the application for voluntary retirement was accepted and the appellant was deemed retired from 30.11.2016 onwards.
9. Thereafter, it is the case of the appellant that several oral requests were made for clearing the outstanding amount of Rs. 1,45,965/-. However, the respondent Corporation did not clear the same. Therefore, notice dated 1.06.2017 was issued through advocate calling upon the respondent corporation to pay the remaining amount of medical bills submitted by the appellant.
10. The appellant thereafter preferred Page 5 of 28 Uploaded by RAGHUNATH R NAIR(HC00196) on Mon Dec 01 2025 Downloaded on : Mon Dec 01 21:01:36 IST 2025 NEUTRAL CITATION C/LPA/1263/2025 JUDGMENT DATED: 27/11/2025 undefined Recovery Application No.48/2017 before the Labour Court at Mehsana under section 33C(2) of the Industrial Disputes Act, 1947 for recovery of Rs. 1,45,965/- with interest at the rate of 18% per annum from the respondent authority.
11. The Labour Court after considering the documents placed on record and providing opportunity of hearing to both the sides, by order dated 21.04.2022 rejected the Recovery Application No. 48/2017.
12. The appellant therefore, being aggrieved preferred Special Civil Application before this Court challenging the order of the Labour Court as the Labour Court has relied upon resolution dated 20.12.2005 issued by the respondent Page 6 of 28 Uploaded by RAGHUNATH R NAIR(HC00196) on Mon Dec 01 2025 Downloaded on : Mon Dec 01 21:01:36 IST 2025 NEUTRAL CITATION C/LPA/1263/2025 JUDGMENT DATED: 27/11/2025 undefined corporation for rejecting the recovery claim made by the appellant.
13. Learned Single Judge by the impugned judgment and order dated 31.01.2025 dismissed the petition on the ground that the respondent corporation has followed its policy for reimbursement of the medical expenses and as per various decisions of Hon'ble Apex Court, scope of judicial review while examining the policy of the Government is very limited and the policy can be interfered if it violates the fundamental rights of the citizen or is opposed to provision of the Constitution or is opposed to any statutory provision or is manifestly arbitrary.
Page 7 of 28 Uploaded by RAGHUNATH R NAIR(HC00196) on Mon Dec 01 2025 Downloaded on : Mon Dec 01 21:01:36 IST 2025
NEUTRAL CITATION C/LPA/1263/2025 JUDGMENT DATED: 27/11/2025 undefined
14. Being aggrieved, this appeal under clause 15 of the Letters Patent is filed by the appellant original petitioner.
15. Learned advocate Mr. Lakshit V. Patel for learned advocate Mr. H.B. Champavat for the appellant original petitioner submitted that the respondent corporation has not disputed that the appellant has availed the treatment for his bypass surgery from SAL hospital which is admittedly a recognised hospital in the approved list of the respondent Corporation.
16. It was submitted that the reliance placed by the respondent Corporation on the policy dated 20.12.2005 in the year 2016 is unreasonable and the amount of Page 8 of 28 Uploaded by RAGHUNATH R NAIR(HC00196) on Mon Dec 01 2025 Downloaded on : Mon Dec 01 21:01:36 IST 2025 NEUTRAL CITATION C/LPA/1263/2025 JUDGMENT DATED: 27/11/2025 undefined Rs. 60,000/- stated in the said policy cannot be applied in the year 2016 when the appellant took the treatment in SAL hospital for which medical bill of Rs. 1,83,108/- is issued by the Hospital which is not in dispute.
17. In support of his submissions, reliance was placed on the following decisions of Hon'ble Supreme Court as well as this Court:
1) In case of Shiva Kant Jha v. Union of India reported in (2018) 16 Supreme Court Cases 187.
2) In case of Chandrakant Kantilal Dave v. State of Gujarat reported in 2019(1) GLR 653.Page 9 of 28 Uploaded by RAGHUNATH R NAIR(HC00196) on Mon Dec 01 2025 Downloaded on : Mon Dec 01 21:01:36 IST 2025
NEUTRAL CITATION C/LPA/1263/2025 JUDGMENT DATED: 27/11/2025 undefined
3) In case of KP Singh v. Union of India reported in (2001) 10 SCC 167.
18. Per contra, learned advocate Mr. H.S. Munshaw appearing for the respondent Corporation reiterated the submissions made before the learned Single Judge to emphasize that as the policy suggests that for the heart problem, the rules provide medical reimbursement upto Rs.60,000/-, and therefore, respondent Corporation following such policy has cleared such amount and paid to the appellant. It was submitted that the respondent corporation is bound by its own policy and therefore, could not pay the amount of actual medical expenses incurred by the appellant petitioner because as per the circular dated 20.12.2005, the appellant was Page 10 of 28 Uploaded by RAGHUNATH R NAIR(HC00196) on Mon Dec 01 2025 Downloaded on : Mon Dec 01 21:01:36 IST 2025 NEUTRAL CITATION C/LPA/1263/2025 JUDGMENT DATED: 27/11/2025 undefined entitled to Rs. 60,000/- only which is released towards Coronary Artery Bypass Grafting treatment. It was submitted that the respondent corporation has also sanctioned the bill for medicines and accordingly, sum of Rs.67,925/- is paid to the appellant.
19. It was submitted that learned Single Judge has not committed any error in view of decision of the Hon'ble Supreme Court in case of Ugar Sugar Works Ltd. v. Delhi Administration and others reported in (2001) 3 Supreme Court Cases 635 wherein it is held that in exercise of powers under Articles 226 and 227 of the Constitution, the Courts would not ordinarily interfere in the policy matters and in view of decision in case of Directorate of Film Festivals and others Page 11 of 28 Uploaded by RAGHUNATH R NAIR(HC00196) on Mon Dec 01 2025 Downloaded on : Mon Dec 01 21:01:36 IST 2025 NEUTRAL CITATION C/LPA/1263/2025 JUDGMENT DATED: 27/11/2025 undefined v. Gaurav Ashwin Jain and others reported in (2007) 4 Supreme Court Cases 737 as referred to and relied upon by the learned Single Judge. It was therefore, submitted that no interference is called for in the impugned judgment and order passed by learned Single Judge dismissing the petition filed by the petitioner upholding the order of the Labour Court in Recovery Application No.48/2017.
20. Having heard the learned advocates for the respective parties and considering the facts of the case, it is not in dispute that the appellant petitioner has undergone the bypass surgery in the month of June, 2016 after suffering heart attack on getting preliminary treatment on 02.06.2016 at Mehsana from Hetal Heartcare Page 12 of 28 Uploaded by RAGHUNATH R NAIR(HC00196) on Mon Dec 01 2025 Downloaded on : Mon Dec 01 21:01:36 IST 2025 NEUTRAL CITATION C/LPA/1263/2025 JUDGMENT DATED: 27/11/2025 undefined Hospital. The appellant thereafter has undergone angiography at U.N. Mehta hospital and bypass surgery at SAL hospital, as both the hospitals are recognised and approved by the respondent corporation for reimbursement of the medical expenses.
21. The respondent corporation has also not disputed the veracity of the medical bills of Rs.2,13,890/- submitted by the appellant petitioner.
22. Therefore, the questions which arise for consideration by this Court is whether the respondent corporation could have referred to and relied upon the policy of 20.12.2005 in the year 2016 and whether reliance on such policy would be a Page 13 of 28 Uploaded by RAGHUNATH R NAIR(HC00196) on Mon Dec 01 2025 Downloaded on : Mon Dec 01 21:01:36 IST 2025 NEUTRAL CITATION C/LPA/1263/2025 JUDGMENT DATED: 27/11/2025 undefined reasonable criteria for clearing the medical bills by denying the actual reimbursement of the medical expenses incurred by the appellant petitioner for bypass surgery in the year 2016.
23. The Hon'ble Apex Court in case of Ugar Sugar Works Ltd.(supra) with regard to policy decision has held as under:
"18. The challenge, thus, in effect, is to the executive policy regulating trade in liquor in Delhi. It is well settled that the Courts, in exercise of their power of judicial review, do not ordinarily interfere with the policy decisions of the executive unless the policy can be faulted on grounds of mala fide, unreasonableness, arbitrariness or unfairness etc. Indeed, arbitrariness, irrationality, perversity and mala fide will render the policy unconstitutional. However, if the policy cannot be faulted on any of these grounds, the mere fact that it would hurt business interests of a party, does not justify Page 14 of 28 Uploaded by RAGHUNATH R NAIR(HC00196) on Mon Dec 01 2025 Downloaded on : Mon Dec 01 21:01:36 IST 2025 NEUTRAL CITATION C/LPA/1263/2025 JUDGMENT DATED: 27/11/2025 undefined invalidating the policy. In tax and economic regulation cases, there are good reasons for judicial restraint, if not judicial deference, to Judgement of the executive. The Courts are not expected to express their opinion as to whether at a particular point of time or in a particular situation any such policy should have been adopted or not. It is best left to the discretion of the State.
xxx
21. In the present case the executive policy regulating the sale of liquor in the territory of Delhi is sought to be challenged by the petitioner on the ground that it is 'unfair' and 'unreasonable' besides being 'authority' and has no nexus with the object sought to be achieved. We are unable to agree.
22. The State has every right to regulate the supply of liquor within its terrotorial jurisdiction to ensure that what is supplied is 'liquor of good quality' in the interest of health, morals and welfare of the people. One of the modes for determining that the quality of liquor is a 'good' is to ascertain whether that particular brand of liquor has been tested and tried Page 15 of 28 Uploaded by RAGHUNATH R NAIR(HC00196) on Mon Dec 01 2025 Downloaded on : Mon Dec 01 21:01:36 IST 2025 NEUTRAL CITATION C/LPA/1263/2025 JUDGMENT DATED: 27/11/2025 undefined extensively elsewhere and has found its acceptability in other States. The manner in which the Government chooses to ascertain the factor of higher acceptability, must in the very nature of things, fall within the discretion of the Government so long as the discretion is not exercised mala fide, unreasonably or arbitrarily. The allegations of mala fide made in the writ petition are totally bereft of any factual matrix and we, therefore, do not detain ourselves at all to consider challenge on that ground. In fairness to learned counsel for the petitioner we may record that challenge to notification on grounds of mala fide was not pressed during arguments. Laying down requirement of achieving minimum sale figures of a particular brand of liquor in other States, as a mode for determination of the "acceptability" of that brand of liquor, is neither irrelevant, nor irrational or unreasonable. It appears that prescription of MSF requirement is aimed at allowing sale of only such brands of liquor which have been tested, tried and found acceptable at large in other parts of the country.
xxx
25. Though, we are not required to test the correctness of the Page 16 of 28 Uploaded by RAGHUNATH R NAIR(HC00196) on Mon Dec 01 2025 Downloaded on : Mon Dec 01 21:01:36 IST 2025 NEUTRAL CITATION C/LPA/1263/2025 JUDGMENT DATED: 27/11/2025 undefined 'reason' for increase of MSF over the previous years' figures, but it is relevant to point out that increase of sale from 60,000 cases to 75,000 cases in respect of 'lowest price tag' brand of liquor does not appear to be arbitrary and on the other hand it appears to have a rational basis. Economic mechanism is a highly sensitive and a complex matter. With inflation every year, it goes without saying, that the brand which has the "lowest price tag"
this year, was perhaps not the brand which had the "lowest price tag last year". It is possible that the brand 'with lowest price tag' this year may not be of that good quality as the brand with identical price tag last year, even though it may conform to ISI standards. It was, therefore, reasonable for the State to find out whether that particular brand with the lowest price tag this year, had been tested and tried elsewhere and had been accepted largely by the public in other parts of India to determine if that particular brand of liquor can be considered to liquor of good quality keeping the health and welfare of the public in view. The impugned notification in our opinion furthers the object of providing good liquor having larger acceptability. The policy Page 17 of 28 Uploaded by RAGHUNATH R NAIR(HC00196) on Mon Dec 01 2025 Downloaded on : Mon Dec 01 21:01:36 IST 2025 NEUTRAL CITATION C/LPA/1263/2025 JUDGMENT DATED: 27/11/2025 undefined is made in the interest of health, welfare and morals to benefit all citizens of Delhi and not the big industrial houses as alleged. Determination of wide scale acceptability on the basis of revised national sales figures (MSF) does not strike us as being unreasonable let alone irrational, arbitrary or unfair. Under these circumstances there is no justifiable reason warranting interference with the impugned notification. The Writ Petition accordingly fails and is dismissed but without any order as to costs."
24. On perusal of the above dictum of law as enunciated by the Hon'ble Apex Court we have to examine whether the policy relied upon by the Corporation can be faulted on the ground of unreasonableness or not. Admittedly, the policy is of year 2005 which is applied by the respondent Corporation in the year 2016 and therefore, on face of it, it is unreasonable to apply the rates fixed in Page 18 of 28 Uploaded by RAGHUNATH R NAIR(HC00196) on Mon Dec 01 2025 Downloaded on : Mon Dec 01 21:01:36 IST 2025 NEUTRAL CITATION C/LPA/1263/2025 JUDGMENT DATED: 27/11/2025 undefined the year 2005 in 2016.
25. The Hon'ble Apex Court has further observed that the respondent has every right to regulate and frame the policy, however such policy can be considered only on the ground of unfairness and unreasonableness. It is also pertinent to note that in facts of the case before the Hon'ble Apex Court, the policy of sale of liquor was in question and not a policy of reimbursement of medical expenses which is in nature of a benevolent policy and therefore, reliance placed by the petitioners on the decisions of Hon'ble Apex Court would not be applicable to the facts of the case, which clearly stipulates that when the policy is unreasonable, same can be interfered by the Court. Similarly, in case of Page 19 of 28 Uploaded by RAGHUNATH R NAIR(HC00196) on Mon Dec 01 2025 Downloaded on : Mon Dec 01 21:01:36 IST 2025 NEUTRAL CITATION C/LPA/1263/2025 JUDGMENT DATED: 27/11/2025 undefined Directorate of Film Festivals and others(supra), while considering the scope of judicial review in policy matters, the Hon'ble Apex Court has held as under:
"16. The scope of judicial review of governmental policy is now well defined. Courts do not and cannot act as Appellate Authorities examining the correctness, suitability and appropriateness of a policy. Nor are courts Advisors to the executive on matters of policy which the executive is entitled to formulate. The scope of judicial review when examining a policy of the government is to check whether it violates the fundamental rights of the citizens or is opposed to the provisions of the Constitution, or opposed to any statutory provision or manifestly arbitrary. Courts cannot interfere with policy either on the ground that it is erroneous or on the ground that a better, fairer or wiser alternative is available. Legality of the policy, and not the wisdom or soundness of the policy, is the subject of judicial review. vide :
Asif Hameed V/s. State of J&K, 1989 Supp2 SCC 364; Shri Sitaram Sugar Co. Ltd., V/s. Union of India, 1990 3 SCC 223; Khoday Page 20 of 28 Uploaded by RAGHUNATH R NAIR(HC00196) on Mon Dec 01 2025 Downloaded on : Mon Dec 01 21:01:36 IST 2025 NEUTRAL CITATION C/LPA/1263/2025 JUDGMENT DATED: 27/11/2025 undefined Distilleries V/s. State of Karnataka, 1996 10 SCC 304, Balco Employees Union V/s. Union of India, 2002 2 SCC 333, State of Orissa V/s. Gopinath Dash, 2005 13 SCC 495 and Akhil Bharat Goseva Sangh V/s. State of Andhra Pradesh, 2006 4 SCC 162.
17. The Government's policy for National Film Awards is to restrict entry to only those films which have been certified by the Board for exhibition, that is films intended for public exhibition. The government is not interested in evaluating or giving an award to a film which may never be seen by the public, or at all events never be seen in an 'uncensored' form. Its object is to select the best from among those which the public can see and enjoy or gain knowledge. The said policy neither relates to nor interferes with the right of a film maker either to make films, or to apply for certificate or to exhibit the films. There is nothing illogical, unreasonable or arbitrary about a policy to select only the best from among films certified for public exhibition.
We cannot, in judicial review, change that policy by requiring the Government to select the best from among 'films made' instead of 'films made and certified for public exhibition'. We, therefore, Page 21 of 28 Uploaded by RAGHUNATH R NAIR(HC00196) on Mon Dec 01 2025 Downloaded on : Mon Dec 01 21:01:36 IST 2025 NEUTRAL CITATION C/LPA/1263/2025 JUDGMENT DATED: 27/11/2025 undefined hold that the requirement that films should have been certified by the Central Board of Film Certification between 1.1.2005 and 31.12.2005 for entry for the 53rd National Film Awards is not an unreasonable restriction of any fundamental right of the respondents or other film makers."
26. In facts of the case before Hon'ble Apex Court, it was found that Film Certification process of the Central Board of Films was not an unreasonable restriction on fundamental rights. In such circumstances, scope of judicial review is described by Hon'ble Apex Court.
27. Learned Single Judge of this Court in case of Chandrakant Kantilal Dave (supra) has also referred to the decision in case of Hon'ble Supreme Court in case of Shiva Kant Jha (supra). In case of Shiva Kant Jha (supra), the Hon'ble Apex Court held Page 22 of 28 Uploaded by RAGHUNATH R NAIR(HC00196) on Mon Dec 01 2025 Downloaded on : Mon Dec 01 21:01:36 IST 2025 NEUTRAL CITATION C/LPA/1263/2025 JUDGMENT DATED: 27/11/2025 undefined as under:
"13. Further, the writ petitioner was admitted in emergency condition with complaint of breathlessness on 11.11.2013 in Fortis Escorts Health Institute, which was a non-empanelled hospital at the relevant time. He underwent angiography on 12.11.2013 which revealed diffused disease in left anterior descending coronary artery 50-60%. He had been implanted the CRT-D device (Combo) as part of cardiac resynchronization therapy (CRT) on 12.11.2013. The hospital charged an amount of Rs. 11,56,293/- for the said treatment, out of which, an amount of Rs. 10,70,000/- was for the cost of the unlisted cardiac implant (CRT-D) and an amount of Rs. 3,19,950/- was paid by the Insurance company directly to the hospital.
14. A Special Technical Committee meeting was held on 29.04.2014 to consider the case of the petitioner. However, on examining the same, the Committee did not find any justification for the implant of CRT-D device of the petitioner. On a further request by the petitioner, the Special Technical Committee again did not find any justification for the implant of CRT-D device on Page 23 of 28 Uploaded by RAGHUNATH R NAIR(HC00196) on Mon Dec 01 2025 Downloaded on : Mon Dec 01 21:01:36 IST 2025 NEUTRAL CITATION C/LPA/1263/2025 JUDGMENT DATED: 27/11/2025 undefined 10.07.2014. On a request for reconsideration by the petitioner, on 15.01.2015, the case of the petitioner was again reconsidered by the Special Technical Committee which denied the claim of CRT-D. xxx
17. It is a settled legal position that the Government employee during his life time or after his retirement is entitled to get the benefit of the medical facilities and no fetters can be placed on his rights. It is acceptable to common sense, that ultimate decision as to how a patient should be treated vests only with the Doctor, who is well versed and expert both on academic qualification and experience gained. Very little scope is left to the patient or his relative to decide as to the manner in which the ailment should be treated.
Speciality Hospitals are
established for treatment of
specified ailments and services of Doctors specialized in a discipline are availed by patients only to ensure proper, required and safe treatment. Can it be said that taking treatment in Speciality Hospital by itself would deprive a person to claim reimbursement solely on the ground that the said Hospital is not included in the Government Order. The right to medical claim cannot Page 24 of 28 Uploaded by RAGHUNATH R NAIR(HC00196) on Mon Dec 01 2025 Downloaded on : Mon Dec 01 21:01:36 IST 2025 NEUTRAL CITATION C/LPA/1263/2025 JUDGMENT DATED: 27/11/2025 undefined be denied merely because the name of the hospital is not included in the Government Order. The real test must be the factum of treatment. Before any medical claim is honoured, the authorities are bound to ensure as to whether the claimant had actually taken treatment and the factum of treatment is supported by records duly certified by Doctors/Hospitals concerned. Once, it is established, the claim cannot be denied on technical grounds. Clearly, in the present case, by taking a very inhuman approach, the officials of the CGHS have denied the grant of medical reimbursement in full to the petitioner forcing him to approach this Court.
18. This is hardly a satisfactory state of affairs. The relevant authorities are required to be more responsive and cannot in a mechanical manner deprive an employee of his legitimate reimbursement. The Central Government Health Scheme (CGHS) was propounded with a purpose of providing health facility scheme to the central government employees so that they are not left without medical care after retirement. It was in furtherance of the object of a welfare State, which must provide for such medical care that the scheme was Page 25 of 28 Uploaded by RAGHUNATH R NAIR(HC00196) on Mon Dec 01 2025 Downloaded on : Mon Dec 01 21:01:36 IST 2025 NEUTRAL CITATION C/LPA/1263/2025 JUDGMENT DATED: 27/11/2025 undefined brought in force. In the facts of the present case, it cannot be denied that the writ petitioner was admitted in the above said hospitals in emergency conditions. Moreover, the law does not require that prior permission has to be taken in such situation where the survival of the person is the prime consideration. The doctors did his operation and had implanted CRT-D device and have done so as one essential and timely. Though it is the claim of the respondent-State that the rates were exorbitant whereas the rates charged for such facility shall be only at the CGHS rates and that too after following a proper procedure given in the Circulars issued on time to time by the concerned Ministry, it also cannot be denied that the petitioner was taken to hospital under emergency conditions for survival of his life which requirement was above the sanctions and treatment in empanelled hospitals."
28. In facts of the case before the Hon'ble Apex Court in case of Shiva Kant Jha (supra), medical treatment was taken in emergency condition and thereafter Page 26 of 28 Uploaded by RAGHUNATH R NAIR(HC00196) on Mon Dec 01 2025 Downloaded on : Mon Dec 01 21:01:36 IST 2025 NEUTRAL CITATION C/LPA/1263/2025 JUDGMENT DATED: 27/11/2025 undefined reimbursement was not made citing that the rates mentioned in the Central Government Health Scheme did not permit the payment of the medical bills and in such circumstances, the Hon'ble Apex Court has granted the reimbursement of the medical expenses incurred by the employee.
29. Considering the above conspectus of law, it appears that the respondent Corporation could not have relied upon the policy of 2005 in the year 2016, as it would be absolutely unreasonable on part of the respondent corporation to refer to and rely upon the decade year old policy for limiting the reimbursement of medical treatment. We are of the opinion that in a medical ailment like heart bypass surgery relating to the heart diseases, the Page 27 of 28 Uploaded by RAGHUNATH R NAIR(HC00196) on Mon Dec 01 2025 Downloaded on : Mon Dec 01 21:01:36 IST 2025 NEUTRAL CITATION C/LPA/1263/2025 JUDGMENT DATED: 27/11/2025 undefined respondent corporation is required to revise its policy so as to reimburse the entire medical expenses incurred by its employees.
30. In facts of the present case, the appeal is allowed directing the respondent corporation to pay the remaining amount of medical bills amounting to Rs.1,45,965/- within a period of 90 days from the date of receipt of a copy of this order, failing which, the interest at the rate of 6% shall be paid to the appellant by the respondent corporation.
(BHARGAV D. KARIA, J) (L. S. PIRZADA, J) RAGHUNATH R NAIR Page 28 of 28 Uploaded by RAGHUNATH R NAIR(HC00196) on Mon Dec 01 2025 Downloaded on : Mon Dec 01 21:01:36 IST 2025