Rajasthan High Court - Jodhpur
Smt. Pushp Lata vs State Of Rajasthan on 9 September, 2022
Bench: Rekha Borana
HIGH COURT OF JUDICATURE FOR RAJASTHAN AT
JODHPUR
S.B. Civil Writ Petition No. 10535/2020
Smt. Pushp Lata W/o Late Shri Umrao Singh Rathore, Aged
About 50 Years, R/o 53 Hanwant-A, Gali No. 8 BJS Colony,
Jodhpur, Rajasthan.
----Petitioner
Versus
1. State Of Rajasthan, Through Principal Secretary, Medical
And Family Welfare Department, Rajasthan, Jaipur.
2. The Director, Pension And Pensioners Welfare Scheme,
Rajasthan, Jaipur.
3. Treasurer Officer, Treasury Office (Rural), Jodhpur.
----Respondents
For Petitioner(s) : Mr. Chandra Veer Singh
Mr. Manoj Bohra
For Respondent(s) : Mr. Ravi Panwar, AGC
HON'BLE MS. JUSTICE REKHA BORANA
Order
09/09/2022
The present petition has been filed for reimbursement of the
complete medical claim as raised by the petitioner. It has been
submitted by the petitioner that she being the wife of the
deceased government servant is entitled to the medical
reimbursement of the claim raised by her qua the expenses
incurred for her treatment. The case of the petitioner is that she
was admitted at MDM Hospital, Jodhpur on 01.07.2019 and
discharged on 12.07.2019. On 08.07.2019, AICD implantation
was made and after the treatment she raised the medical claim
amounting to Rs.4,25,000/- for reimbursement. Only an amount
(2 of 4) [CW-10535/2020]
of Rs.2,00,000/- was reimbursed qua her claims and therefore,
the present petition has been preferred for reimbursement of the
remaining amount qua the medical bills.
Learned counsel for the petitioner submitted that the
petitioner underwent the treatment at a government hospital and
the implants were also purchased from the authorized government
shop, therefore, the complete claim as raised by her is
reimbursable in terms of the judgment of this Court passed in
Smt. Mohan Kanwar Bhansali Vs. State of Rajasthan; S.B.
Civil Writ Petition No.13482/2013 decided on 24.08.2018.
The said was the matter wherein the equipment or implants were
purchased from the private shop because of the same being not
available with the authorized government medical shop.
Per contra, learned counsel for the respondents submitted
that in terms of the Rajasthan Civil Services (Medical Attendance)
Rules, 2013 (hereinafter referred to as the "Rules of 2013") the
reimbursable amount qua the AICD implantation is 50% of the
cost or Rs.2,00,000/- whichever is less. Learned counsel
submitted that as Rs.2,00,000/- was lesser amount that would
only be the reimbursable amount to the petitioner and the same
has been reimbursed to her in terms of the Rules of 2013.
In State of Rajasthan & Ors. Vs. Smt. Mohan Kanwar
Bhansali; D.B. Special Appeal Writ No.246/2019, decided on
07.03.2019, while considering the issue whether the complete
amount would be reimbursable even in cases where the Rules
prescribing for a limited amount qua implant, the Division Bench
specifically reached to the conclusion that if a patient is treated at
a government hospital, it is the duty of the government hospital to
provide all the equipment. If a consumable item is not available
(3 of 4) [CW-10535/2020]
there, then the beneficiary is left with no option other than to
purchase from the open market. With the said conclusion, the
Division Bench held that the complete amount qua the medical
expenses would be reimbursable.
Here is a case, where the patient undertook the treatment in
a government hospital and even purchased the required implants
from a government shop. Therefore, when qua the equipment
purchased from a private shop also the Division Bench held that
the same would be completely reimbursable, it cannot be held
that the expenses for the equipment purchased from an
authorized government shop would not be reimbursable.
In Smt. Mohan Kanwar Bhansali's case (supra), wherein
an exact similar controversy was in issue, the coordinate Bench of
this Court held as under:
"There is no quarrel in the factual position that
petitioner is widow of a deceased government
servant and is in receipt of pension, and
therefore, she is entitled for medical
reimbursement as per Rules of 1970 and the
Scheme floated by the State Government for
extending such benefits to the pensioners. She
suffered cardiac problem and remained under
treatment. Reimbursement in full of the
expenditure incurred on treatment and purchase
of medicines, Stent as well on Angioplasty at
recognized Government MDM Hospital, cannot
be denied to her by a welfare State, more so
when the Stents and other accessories were not
available with the Govt. authorized pharmacist
shop and Non Availability Certificate was issued
for its purchase from private shops. The attitude
of the authority concerned of a welfare State in
denying full reimbursement of the expenses
incurred cannot be appreciated in the given
circumstances. It is also noteworthy that bill for
medical reimbursement submitted by the
petitioner before the respondents is duly verified
by the Professor & Unit Incharge of Cardiology
Department, MDM Hospital, Jodhpur inasmuch
as same bears his signature and seal. The
verification of the bill by the Professor and Unit
(4 of 4) [CW-10535/2020]
Incharge, pre-supposes that the amount
mentioned in the bill is incurred by the
petitioner for her treatment. Therefore, in my
considered view, the claim of the petitioner for
reimbursement of full medical expenses merits
acceptance."
In view of the ratio as laid down in Mohan Kanwar
Bhasali's case (supra) and in view of the admitted position that
the treatment was undertaken in a government hospital, the
present petition is allowed. The respondents are directed to
reimburse the remaining amount of claim as raised by the
petitioner within a period of three weeks from the date of
presentation of the present order.
All the pending applications also stand disposed of.
(REKHA BORANA),J
87-AnilKC/-
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