Bipinchandra M Bhavsar vs State Of Gujarat
2022 Latest Caselaw 712 Guj

    C/SCA/10873/2019                             JUDGMENT DATED: 20/01/2022




            IN THE HIGH COURT OF GUJARAT AT AHMEDABAD

              R/SPECIAL CIVIL APPLICATION NO. 10873 of 2019


FOR APPROVAL AND SIGNATURE:


HONOURABLE MR. JUSTICE BIREN VAISHNAV

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1    Whether Reporters of Local Papers may be allowed No
     to see the judgment ?

2    To be referred to the Reporter or not ?                  No

3    Whether their Lordships wish to see the fair copyNo
     of the judgment ?

4    Whether this case involves a substantial questionNo
     of law as to the interpretation of the Constitution
     of India or any order made thereunder ?

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                       BIPINCHANDRA M BHAVSAR
                                 Versus
                           STATE OF GUJARAT
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Appearance:
MR ATIT D THAKORE(5290) for the Petitioner(s) No. 1
MR. KURVEN DESAI, ASSISTANT GOVERNMENT PLEADER(1) for the
Respondent(s) No. 1,2,3,4,5
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    CORAM:HONOURABLE MR. JUSTICE BIREN VAISHNAV

                             Date : 20/01/2022

                            ORAL JUDGMENT

1 Heard Mr.Atit Thakore, learned advocate for the petitioner and

Mr.Kurven Desai, learned Assistant Government Pleader for the

respondents-State.

C/SCA/10873/2019 JUDGMENT DATED: 20/01/2022

2 Rule returnable forthwith. Mr.Kurven Desai, learned AGP, waives

service of rule on behalf of the respondents.

3 In this petition under Article 226 of the Constitution of India, the

petitioner has prayed for reimbursement of medical expenses undertaken

for replacement of knee of the petitioner. By the impugned

communication dated 14.08.2018, the respondent has refused

reimbursement on the ground that it does not fall within the Medical

Reimbursement Rules, 2015.

3.1 The case of the petitioner is that he is working as a Plant Operator

with the Civil Hospital. He underwent a surgery of knee replacement at

the Civil Hospital, however, the knee joint which was to be replaced,

since not being available at the hospital, was purchased from one vendor

J.D.Enterprise. The total expenditure incurred by the petitioner was

Rs.1,27,798/-. A Bill was accordingly raised, which was turned down for

reimbursement.

4 Mr.Atit Thakore, learned advocate for the petitioner, would submit

that in a similarly situated case of one Kishorebhai Shite, replacement of

knee surgery expenses were reimbursed.

5 Mr.Kurven Desai, learned AGP for the respondents, would submit

C/SCA/10873/2019 JUDGMENT DATED: 20/01/2022

relying on the policy of the State by virtue of the Resolution dated

24.08.2015 and submit that the resolution specifically provides for

eligibility for reimbursement for artificial implants which is included in

the schedule of the resolution and therefore such expenditure is not

reimbursible.

5.1 Mr.Desai, learned AGP, would further submit that even the Policy

which subsequently came into force on 01.11.2018 provided for

reimbursement post April 2018 which will not govern the case of the

present petitioner.

6 Admittedly, the petitioner was working with the Civil Hospital and

undertook the surgery of knee replacement at the hospital premises, his

employer. Reading of the resolution, particularly the Appendix would

indicate that what is reimbursed are the list of artificial appliances such as

hip joints, unilateral joint, leg braces, knee cage etc. The list runs into

sixty artificial appliances and fourteen implants which are reimbursable.

6.1 Probably finding knee replacement implants to be genuinely left

out, it is only in the year 2018 that the same was made reimbursable. It

may be reasonable for the authorities to contend that such applicability of

reimbursable appliances post 2018 can only be reimbursed. However,

looking to the facts of the present case that the petitioner was an

employee of the Civil Hospital, the authorities could have shown little

C/SCA/10873/2019 JUDGMENT DATED: 20/01/2022

sympathy to the petitioner who was a Plant Operator with the Civil

Hospital.

7 The petition is allowed, accordingly. The order / communication

dated 14.08.2018 is hereby quashed and set aside. The respondents are

directed to reimburse the amount of Rs.1,27,798/- to the petitioner,

preferably within a period of eight weeks from the date of receipt of copy

of this order. Rule made absolute accordingly.

(BIREN VAISHNAV, J) Bimal