Rajasthan High Court - Jodhpur
Prabhu Ram Khileri vs State Of Rajasthan on 19 September, 2022
Bench: Kuldeep Mathur
HIGH COURT OF JUDICATURE FOR RAJASTHAN AT
JODHPUR
S.B. Civil Writ Petition No. 6199/2020
Prabhu Ram Khileri S/o Sukh Ram Khileri, Aged About 40 Years,
R/o Village Post Sonadi, Tehsil Sedwa, District Barmer.
----Petitioner
Versus
1. State Of Rajasthan, Through The Director, State
Insurance And Provident Fund Department, 2-2A, Bima
Bhawan, Sawai Jai Singh Highway, Bani Park, Jaipur.
2. Additional Director, General Insurance And Mediclaim
Wing, State Insurance And Provident Fund Department,
Block D, Second Floor, Vit Bhawan, Janpath, Jaipur.
3. Deputy Director, Office And The Joint Director State
Insurance And Provident Fund Department, Collectorate
Campus, Barmer.
----Respondents
For Petitioner(s) : Mr. Mahendra Bishnoi
For Respondent(s) : Mr. Pratyushi Mehta, for
Mr. Sandeep Shah, Sr. Advocate-cum-
AAG.
HON'BLE MR. JUSTICE KULDEEP MATHUR
Order
19/09/2022
Briefly stated facts of the case are the petitioner's mother
slipped over a surface and suffered injury in her knees and was
immediately taken to Vasundhra Hospital, Jodhpur for check-up.
On the advice of treating doctors, petitioner's mother underwent
both knee joint replacement surgery on 13.05.2019 and was
discharged on 17.05.2019. The petitioner thereafter submitted an
application dated 22.05.2019 claiming reimbursement of medical
bills to the tune of ₹2,75,570/-. The respondent-authorities
refused the claim for medical reimbursement on the count that the
(2 of 3) [CW-6199/2020]
treatment was taken at Vasundhra Hospital does not fall within the
list of state-recognized hospitals. Aggrieved by the denial off
medical reimbursement, the petitioner has preferred the present
writ petition.
In Surjit Singh Vs. 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. We
share the views afore-expressed"
In Rama Prasad Sharma Vs. State of Rajasthan & Ors.;
S.B.C.W.P. No.7469/2016, decided on 21.01.2022, passed by
this Court, it was 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."
In view of the ratio laid down in the above mentioned
judgments, it is a settled law that even if some medical treatment
is undertaken in a private/unrecognized hospital, the department
is under an obligation to reimburse the amount to the extent
permissible under the rules in vogue. In the present case, the
treatment was taken by the petitioner's wife on 28.11.2015, so it
is governed by Rajasthan Civil Services (Medical Attendance)
Rules, 2013 (hereinafter referred to as 'the Rules of 2013'). The
(3 of 3) [CW-6199/2020]
hyper technical ground cannot supersede the object of Rules of
2013 i.e. to provide shield against increasing medical costs due to
hospitalization in severe illness. The claim cannot be merely
rejected on these hyper technical grounds when the treatment is
not disputed by the respondent-department.
Therefore, the present writ petition is allowed. The
respondent authorities are directed to consider the medical claim
of the petitioner and reimburse the amount payable in terms of
the Rules of 2013. The complete consideration and the
reimbursement thereof would be made within a period of two
months from the date of the receipt of this order. In case, the
claim of the petitioner is not settled within the aforesaid period,
the same shall carry an interest @ 6% per annum.
No order as to costs.
(KULDEEP MATHUR),J
20-Prashant/-
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