Gopal Chandra Mahato vs M/S. Bharat Coking Coal Ltd.
2021 Latest Caselaw 3320 Jhar

               IN THE HIGH COURT OF JHARKHAND AT RANCHI
                                      W.P.(S). No. 5247 of 2018
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Gopal Chandra Mahato, son of Bishu Mahato, resident of village Maheshpur, P.O. Maheshpur, P.S. Madhuban, District Dhanbad.

                                                        .........         Petitioner.
                                              Versus

1. M/s. Bharat Coking Coal Ltd., through Chief Managing Director- cum-General Manager, Koyla Nagar, P.O. Saraidhela, P.S. Saraidhela, Dist. Dhanbad.

2. Incharge Chief Medical Services, M/s. Bharat Coking Coal Ltd., Koyla Bhawan, Koyla Nagar, P.O. Saraidhela, P.S. Saraidhela, Dist. Dhanbad.

3. The Employer in relation to the Management of Govindpur Area- III of M/s. Bharat Coking Coal Ltd. Dhanbad, P.O. Govindpur, P.S. Govindpur, Dist. Dhanbad.

4. Project Officer, Maheshpur Colliery, M/s. Bharat Coking Coal Ltd., P.O. Tundoo, P.S. Sonardih, Dist. Dhanbad.

5. Personnel Manager, Maheshpur Colliery, M/s. Bharat Coking Coal Ltd., P.O. Tundoo, P.S. Sonardih, Dist. Dhanbad.

6. Finance Manager, Mahespur Colliery, M/s. Bharat Coking Coal Ltd., P.O. Tundoo, P.S. Sonardih, Dist. Dhanbad.

7. Medical Officer, Mahespur Colliery, M/s. Bharat Coking Coal Ltd., P.O. Tundoo, P.S. Sonardih, Dist. Dhanbad.

                                                      ..........      Respondents.
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                 CORAM: THE HON'BLE MR. JUSTICE DR. S.N.PATHAK
                                (Through: Video Conferencing)
               For the Petitioner :     Mr. Ajay Kumar Trivedi, Advocate
               For the BCCL       :     Mr. Anoop Kumar Mehta, Advocate
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05/ 08.09.2021 Heard the parties.

2. The petitioner has approached this Court with a prayer for direction upon the respondents to pay Rs.1,59,231 on account of medical expenses incurred towards his treatment in Christian Medical College Hospital, Vellore, as per rules of respondent-company.

3. The facts of the case lies in a narrow compass. The petitioner was initially appointed on 29.12.1978 to the post of Dresser (Med) in Jogidih Colliery of M/s. Bharat Coking Coal Ltd. (for short "M/s. BCCL") and he worked to the full satisfaction of his superior without complaint from any corner. Thereafter, on attaining the age of superannuation, the petitioner retired from the services of M/s. BCCL on 31.01.2018. It is the case of the

petitioner that while working under respondent-BCCL, he met with an accident in the month of November, 2015 resulting into head injury and thereafter, he lost his consciousness and further developed difficulties in passing stool, urinary retention, giddiness and headache. He was initially treated in Central Hospital, Dhanbad and when his condition did not improve, he was referred to Mission Hospital, Durgapur from where after treatment he was discharged with an advice to come after 15 days for recheck-up but his condition got deteriorated and he was unconscious during the said time, therefore, he was not able to obtain approval for treatment by the Superior Authority of the respondent-Company. Hence, without approval from his Controlling Authority, the family members of the petitioner admitted him to Christian Medical College Hospital, Vellore where he was treated for a month and after recovering from his ailments, he joined his duty.

4. It is the further case of the petitioner that after joining his duties, he filed a mercy petition on 30.07.2016 along with medical bills for reimbursement before respondent Nos. 2 and 5. Thereafter, he also submitted one reminder letter dated 25.08.2016 before respondent No. 2 but till date he has not received any response on his representations. Hence, the petitioner has been constrained to knock the door of this Court.

5. Learned counsel for the petitioner submits that petitioner was serious and unconscious and under such medical emergency his family members proceeded for CMC, Vellore without seeking prior approval from competent Authority for proper treatment which otherwise could have proved fatal. After recovery from his ailments, petitioner joined his services and thereafter, he submitted the medical bills for the expenses incurred for his treatment at CMC Vellore, for reimbursement before the respondent-BCCL. Learned counsel for the petitioner submits that the respondents have illegally and arbitrarily kept pending his claim on the ground that the petitioner had not taken prior approval for his treatment at CMC Vellore. In this regard learned counsel submits that petitioner was not able to obtain prior approval at that point of time because he was suffering from serious head injury and was unconsciousness and hence, there is no fault on the part

of the petitioner. Learned counsel submits that the respondents have committed gross violation of the mandate of the National Coal Wage Agreement and the respondents have no power to refuse the genuine claim of the petitioner. Learned counsel accordingly submits that a direction may be given to the respondent-BCCL for reimbursement of his medical expenses incurred by him for his treatment at CMC Vellore.

6. On the other hand, Mr. Anoop Kumar Mehta, learned counsel appearing for the respondent-BCCL submits that the petitioner has no legal right to claim reimbursement of medical expenses as alleged to have been incurred by him for his treatment in CMC Vellore, as the said treatment was not in accordance with the applicable Medical Attendance Rules more particularly the Rules relating to Medical Facilities in respect of piece rated, daily rated and monthly rated employees. Learned counsel further argues that the petitioner has not made any representation giving details of unpaid amounts and once representation is submitted, the respondents shall get the same examined. Learned counsel further argues that the petitioner has also not stated whether no dues certificated has been submitted by him or not. As regards claim towards medical reimbursement is concerned, the same is not admissible inasmuch as the Incharge of Chief Medical Services of M/s. BCCL has already regretted the claim of the petitioner on the following grounds:

(I) It is a non-referral case inasmuch as the petitioner was not referred by the respondents for his treatment at CMC Vellore.

(II) The case was not in emergency.

7. Learned counsel for the respondents further argues that as per provision of the Medical Attendance Rules, the respondents have referred the petitioner for treatment to Mission Hospital, Durgapur. After treatment at Durgapur, he was discharged by the Hospital with an advice to come after 15 days for check-up. However, the petitioner did not report to the said Hospital to evaluate his condition and on his own without being referred for treatment to specialized Hospital, he went to CMC Vellore. Learned counsel

submits that the respondents are bound by the applicable Medical Attendance Rules in the matters relating to reimbursement and in absence of any referral being made by the respondents that too without verifying the condition/ status of ailment and whether treatment was available in the hospital of the respondent-Company or not, the petitioner was not justified in proceeding on his own particularly when the case was not an emergency and as such, respondent No. 2 has rightly declined the claim of the petitioner regarding reimbursement of medical expenses incurred while treatment at CMC Vellore.

8. Be that as it may, having heard the rival submissions of the parties and upon perusal of the documents brought on record, this Court is of the considered view that the case of the petitioner needs consideration. Admittedly, the petitioner met with an accident in the month of November, 2015 resulting into head injury and thereafter he lost consciousness and further developed difficulties in passing stool, urinary retention, giddiness and headache for which he was treated at Central Hospital, Dhanbad and when his condition did not improve, he was referred to Mission Hospital, Durgapur from where after treatment he was discharged by the Hospital with an advice to come after 15 days for recheck-up. However, when his condition deteriorated and fell unconscious during the same time, the family members of the petitioner without seeking approval of respondent-BCCL admitted the petitioner at Christian Medical College Hospital, Vellore. Hence, the eventuality that had met the petitioner as a result of road accident could not have waited for seeking prior approval of the competent authority before undertaking emergency treatment of the injured. The life of the person was most important consideration at the relevant time.

9. Though the respondents appear to have relied upon the Medical Attendance Rules, which talks about prior approval but the Rules in such circumstances cannot be said to be inflexible in nature as not to take into account of such emergency where immediate attention is required in such cases of accident. It is otherwise the bounden duty of any hospital to take in for treatment any such persons who is facing life threatening injury as the responsibility is to save life. In such circumstances, the action of the

respondents in refusing to reimburse the medical expenses incurred by the petitioner for his treatment at CMC Vellore appears to suffer from non- applicable of mind and as otherwise observed does not stand the test of reason.

10. The Hon'ble Apex Court in case of Shailesh Dhairyawan vs. Mohan Balkrishna Lulla, reported in (2016) 3 SCC 619 has held that:

"The principle of 'purposive interpretation' or 'purposive construction' is based on the understanding that the Court is supposed to attach that meaning to the provisions which serve the 'purpose' behind such a provision. The basic approach is to ascertain what is it designed to accomplish? To put it otherwise, by interpretative process the Court is supposed to realize the goal that the legal text is designed to realize."

Further, the Hon'ble Apex Court in case of Shiva Kant Jha v. Union of India, reported in (2018) 16 SCC 187 has held:

"The Central Government Health Scheme (CHGS) was propounded with the purpose of providing health facility scheme to the central government employees so that they are not left without any medical care after retirement. It was in furtherance of this objective of a welfare state, which must provide for such medical care that the scheme was brought in force."

11. Accordingly, the matter is remanded to the competent authority under the respondent-BCCL to once again consider the case of petitioner for reimbursement of medical expenses incurred towards his treatment at CMC Vellore, in accordance with law, taking into account the aforesaid judgments. The concerned competent authority under the respondent-BCCL shall also grant one opportunity of personal hearing to the petitioner to produce all necessary materials in support of his case. The aforesaid exercise shall be carried out within a period of eight weeks and the decision of the respondent-authorities be communicated to the petitioner.

12. With the aforesaid observations and directions, the writ petition stands allowed.

(Dr. S.N. Pathak, J.) Kunal/-