Rajasthan High Court - Jodhpur
Krishan Lata vs State And Ors on 19 September, 2022
Bench: Kuldeep Mathur
HIGH COURT OF JUDICATURE FOR RAJASTHAN AT
JODHPUR
S.B. Civil Writ Petition No. 4196/2016
Krishan Lata S/o Shri Duni Ram Lata, aged about 49 years, by
caste Lata, resident of 15 H, Bhop Colony, Sri Ganganagar,
District Sri Ganaganagar (Rajasthan)
----Petitioner
Versus
1. State of Rajasthan, through its Secretary, Finance
Department, Govt. Of Rajasthan, Secretariat, Jaipur
(Rajasthan)
2. Secretary, Urban Development and Housing Department
(Govt. Of Rajasthan) Jaipur, Rajasthan.
3. Urban Improvement Trust, Sri Ganganagar, through its
Secretary.
----Respondents
For Petitioner(s) : Mr. G.J. Gupta.
For Respondent(s) : Mr. Dron Kaushik.
HON'BLE MR. JUSTICE KULDEEP MATHUR
Order
19/09/2022
Briefly stated facts of the case are that the petitioner went to
Gurgaon for personal trip and there he suffered severe headache.
The petitioner on becoming unconscious was taken to Medanta
(Medicity) Hospital, Gurgaon. The treating Doctor after MRI Scan
advised the petitioner to undergo surgery under emergent
circumstances. For the surgery underwent, amount of ₹2,47,426/-
was incurred. The petitioner was operated on 07.02.2015 and
remained admitted from 06.02.2015 to 11.02.2015. Thereafter, he
submitted an application dated 22.06.2015 claiming
reimbursement of medical bills. The respondent-authorities in
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pursuance of the application submitted by the petitioner accepted
partial claim to the extent of ₹30,793/-. Aggrieved by partial
acceptance of the claim, the petitioner has preferred the present
writ petition.
Learned counsel for the petitioner submitted that the
petitioner had undertaken brain sugery under emergent
circumstances and his claim for medical reimbursement ought to
have been accepted in toto by the respondent-authorities.
Per Contra, learned counsel for the respondents submitted
that the petitioner had taken treatment outside the State without
being referred from any medical authority. It was further
submitted that the no prior permission was taken from the
respondent-authorities. Counsel urged that the claim had been
accepted in consonance of Rajasthan Civil Services (Medical
Attendance) Rules, 2013 and should not be interfered with.
Heard learned counsel for the parties and perused the
material available on record.
So far as the question regarding reimbursement of the
treatment undertaken in a private and unrecognized hospital is
concerned, the law is no longer res integra.
In Shiva Kant Jha Vs. Union of India (UOI); AIR 2018
SC 1975 decided on 13.04.2018, the Hon'ble Apex Court held as
under: -
"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
(3 of 4) [CW-4196/2016]
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....."
In Surjit Singh v. State of Punjab and Ors. reported in
AIR 1996 SC 1388 decided on 31.01.1996, the Hon'ble Apex
Court held as under:-
"10. ...........In such an urgency one cannot sit at
home and think in a cool and calm atmosphere
for getting medical treatment at a particular
hospital or wait for admission in some
Government medical institute. In such a situation,
decision has to be taken forthwith by the person
or his attendants if precious life has to be saved."
In Rama Prasad Sharma v. State of Rajasthan and
Ors.; SBCWP No.7469/2016 decided on 21.01.2022,coordinate
Bench of this Court held as under:-
".........It is now a settled position of law that
even in cases where the treatment of an
employee has been taken in non-recognized
hospital the medical reimbursement has to
be made at the rate that may be applicable
for similar treatment in the recognized
government hospitals."
The ratio laid down in the above judgments makes it clear
that even in the cases where an employee undergoes treatment in
a non-recognized hospital/private hospital, the medical
(4 of 4) [CW-4196/2016]
reimbursement has to be made to the extent permissible under
relevant Rules/Scheme/Policy. In the present matter, the amount
which has been reimbursed appears to have been made against
the procedure undertaken. So far as the medicines, drugs,
anesthesia and room charges etc., are concerned, amount qua the
same is also required to be reimbursed in terms of the Rules of
2013.
Therefore, in view of the ratio laid down by the Hon'ble Apex
Court and peculiar facts, the present writ petition is partly
allowed. The respondents are directed to reconsider the claim of
the petitioner and reimburse amount qua the medicines, drugs,
anesthesia, room charges and all other heads as payable in terms
of the Rules of 2013, if not already paid. The complete
consideration and reimbursement thereof to be completed within a
period of eight weeks from the date of receipt of this order.
All pending applications also stand disposed of.
(KULDEEP MATHUR),J
12-Prashant/-
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