Gujarat High Court

Gujarat State Road Transport ... vs Sureshchandra Keshavlal Vyas on 5 August, 2025

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                           C/SCA/10198/2025                                      JUDGMENT DATED: 05/08/2025

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                                    IN THE HIGH COURT OF GUJARAT AT AHMEDABAD

                                     R/SPECIAL CIVIL APPLICATION NO. 10198 of 2025


                      FOR APPROVAL AND SIGNATURE:


                      HONOURABLE MRS. JUSTICE M. K. THAKKER

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                                   Approved for Reporting                       Yes           No
                                                                                              ✔
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                                   GUJARAT STATE ROAD TRANSPORT CORPORATION
                                                     Versus
                                        SURESHCHANDRA KESHAVLAL VYAS
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                      Appearance:
                      MR HS MUNSHAW(495) for the Petitioner(s) No. 1
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                         CORAM:HONOURABLE MRS. JUSTICE M. K. THAKKER

                                                            Date : 05/08/2025

                                                           ORAL JUDGMENT

1. The present petition is filed under Articles 226 and 227

of the Constitution of India, challenging the award

passed by the learned Labour Court, Rajkot, in Recovery

C-2 Application No. 7 of 2020, whereby the petitioner

has been directed to pay an amount of ₹1,19,585/-

towards medical reimbursement for treatment availed at

a hospital not recognized by the petitioner..

2. It is the case of the present petitioner that the

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respondent had availed medical treatment at CIMS

Hospital, where he was admitted on 20.06.2011, and

subsequently submitted a bill amounting to ₹1,19,585/-

for reimbursement. However, the said claim was denied

by the petitioner on the ground that, as per General

Standing Order No. 1125 of 2003 dated 25.11.2003,

CIMS Hospital is not included in the list of recognized

hospitals. Aggrieved by the denial, the respondent filed a

recovery application, which came to be allowed by the

learned Labour Court, directing the petitioner to pay the

aforesaid amount along with 6% interest from

20.02.2020. The said order is the subject matter of

challenge in the present petition.

3. Heard learned advocate Mr.H.S.Munshaw for the

petitioner.

4. Learned advocate Mr. Munshaw submits that, as per the

prevailing Government policy, CIMS Hospital is not

included in the list of recognized hospitals. Accordingly,

the medical reimbursement bill submitted by the

respondent was declined. Learned advocate Mr.

Munshaw submits that, the learned Labour Court has

passed the impugned award without properly

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appreciating this aspect of the matter. Therefore, the

impugned award deserves to be quashed and set aside

by allowing the present petition.

5. Having considered the submissions advanced by the

learned advocate and upon perusal of the reasons

assigned by the learned Recovery Court, it emerges that

the respondent was serving as a Conductor for a period

of 34 years and retired upon attaining the age of

superannuation on 31.05.2011. It is the case of the

respondent that he experienced severe headache and,

upon consultation with a Neurosurgeon, he was advised

to undergo surgery, which was performed at CIMS

Hospital on 20.06.2011. The respondent has further

contended that prior to seeking admission at CIMS

Hospital, he had approached various hospitals

recognized by the petitioner-employer; however, due to

the complexity of the required surgery, all such hospitals

declined to undertake the operation. In these compelling

circumstances, the respondent was constrained to get

admitted to CIMS Hospital, where the surgery was

successfully performed. Consequently, he incurred

medical expenses to the tune of ₹1,19,585/-, which he

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submitted for reimbursement. The petitioner, however,

rejected the claim on the ground that CIMS Hospital is

not included in the list of recognized hospitals. At this

stage, reference is required to be made to the decision

rendered by this Court in Letters Patent Appeal No. 553

of 2023, wherein the Division Bench has held as under:-

3. Noticing at the outset the basic facts, the prayer of the petitioner to set aside the order dated 7.7.2016 and to direct the respondents to reimburse the medical expenditure was on the premise that on 29.2.2016, the petitioner suffered a sudden severe cardiac attack. At that time, the petitioner was in a marriage function. The petitioner immediately rushed to Sai Shradha hospital at Nadiad, where he received primary treatment. As petitioner's condition deteriorated, he was required to be shifted for further treatment to Zydus hospital, Anand, which was the nearest superspecialist hospital from Nadiad. The petitioner who was Assistant Sub-Inspector came to be given intensive care treatment at Zydus hospital, Nadiad, and came to be discharged thereafter.

3.1 Under the Gujarat State Services Medical treatment Medical Rules, 2015, which provides for reimbursement of medical expenditure, the petitioner lodged its claim for Rs. 1,91,729/- The claim was denied by the aforementioned communication dated 7.7.2016 of respondent No.2 on the ground that the treatment taken by the petitioner was not at the hospital which was certified or empanelled by the authorities.

4. Before the learned single Judge, the very contention was raised on behalf of the appellant authority that the treatment was not

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taken at one of the empanelled hospitals, the names of which are specified in notification dated 24.8.2015. According to the stand of the authorities, unless the treatment was at such notified hospitals, the government servant would not be entitled to reimbursement of the expenses incurred towards the medical treatment. Learned single Judge considered the controversy and recorded the admitted facts in paragraph No.8 to observe that the decision reflected in communication dated 7.7.2016 suffers from non-application of mind, "The respondent authorities have not disputed that the petitioner suffered a medical emergency while he was attending the marriage function on 29.02.2016 and he was immediately rushed to the nearest hospital by his friends and relatives and admitted in Sai Shraddha Hospital at Nadiad. They have also not disputed that the petitioner was immediately shifted to Zydus Hospital at Anand, looking to his deteriorating health and critical condition.

The medical certificate issued by Sai Shraddha Hospital dated 09.03.2016 reflects that the petitioner was admitted in that hospital and he was shifted on 27.02.2016. The Discharge Summery of Zydus Hospital also reflects that he was on the very same date admitted at Zydus Hospital, Anand i.e. on 27.02.2016. Thus, the petitioner was taken to the aforesaid hospitals in a medical emergency situation by his friends and relatives. It was not expected from the friends and relatives that they would be having the list of the empanelled hospitals in their pockets and only after verifying that list, such relatives and friends would have thought it fit to admit the petitioner in the empanelled hospital. The impugned communication dated 07.07.2016

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suffers from non-application of mind and the request of the petitioner for claiming medical reimbursement has been reject."

4.1 Learned single Judge relied on the decision of the Supreme Court in Shiva Kant Jha vs. Union of India [(2018) 16 SCC 187], in which the Supreme Court observed inter alia that all government employees even after their retirement are entitled to get the medical facilities and no limits can be placed on their rights, "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 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

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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." (para 13) 4.2 It was highlighted that what was to be seen was whether the employee had taken the actual treatment and that the factum of treatment was fortified by material in that regard. In that case also, the denial of the claim was on the ground that the hospital where the treatment was undertaken, was not included in the government order.

5. Any medical treatment, epecially in the emergent situation, has to be availed without loss of time. An employee who has to rush to the hospital, which is the nearest or where the expert treatment could be availed in immediate medical need, could not be denied reimbursement towards the medical expenses. The cardiac arrest is life threatening. Therefore, if the petitioner employee has taken treatment at a particular hospital having regard to the emergent situation, the reimbursement claim by her of the actual expenses incurred towards medical treatment could not have been denied to her on the technical ground that the hospital was not listed as approved hospital by the authorities. When a government employee seeks emergency treatment, it hardly stands to reason that the authorities to deny the reimbursement on the ground that treatment was not obtained from a particular hospital.

5.1 For the aforesaid considerations, the impugned judgment and

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order of learned single Judge could hardly book any error. It deserves to be upheld."

6. Considering the aforementioned decisions and the facts

of the present case, this Court is of the opinion that

availing medical treatment from a specialized hospital,

on one's own accord, cannot be a ground to deny

reimbursement solely because the hospital is not

included in the list of recognized hospitals. The real test,

before honoring any medical reimbursement claim, must