Kusumkant Jain vs State And Ors
2022 Latest Caselaw 11861 Raj

HIGH COURT OF JUDICATURE FOR RAJASTHAN AT JODHPUR S.B. Civil Writ Petition No. 8487/2015

Kusumkant Jain S/o Shri Chandrakant Jain, Aged 60 years, R/o Salatwara, Sagwada, District Dungarpur (Raj.).

----Petitioner Versus

1. The State of Rajasthan through the Director, Department of Secondary Education, Bikaner (Raj.).

2. The District Education Officer, Department of Secondary Education, Dungaerpur (Raj.).

3. The Chief Accountant, Secondary Education, Rajasthan, Bikaner.

----Respondents

For Petitioner(s) : Ms. Mehali Mehta For Respondent(s) : Mr. Sarvan Kumar, AGC

HON'BLE MR. JUSTICE KULDEEP MATHUR

Order

23/09/2022

Briefly stated facts of the case are that the petitioner

suffered chest pain while visiting relatives in Ahmendabad on

12.12.2009. The petitioner was taken to Sterling Hospital and at

the advice of treating doctors was shifted S.A.L. Hospital,

Ahmedabad. A bypass surgery was conducted on 14.12.2009 and

a sum of Rs.1,32,171/- was incurred as expenses for the

treatment underwent by the petitioner. The petitioner submitted

reimbursement claim for the treatment undertaken to the

respondents. Pursuant to the petitioner's application for

reimbursement, the respondents sanctioned only ₹44,000/- qua

(2 of 4) [CW-8487/2015]

the medical bills submitted. Aggrieved by partial acceptance of the

claim, the present writ petition is preferred.

As 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 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

(3 of 4) [CW-8487/2015]

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,co-ordinate

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 mentioned judgments

makes it clear that even in the cases where an employee

undergoes treatment in a non-recognized hospital/private hospital,

the medical 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

only 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 2008.

Therefore, in view of the ratio laid down by the Hon'ble Apex

Court and peculiar facts of the case, 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 2008, if not already paid. The complete

consideration and reimbursement, thereof is to be completed

(4 of 4) [CW-8487/2015]

within a period of eight weeks from the date of receipt of this

order. It is also made clear that in case the exercise is not

completed within aforesaid period, the due amount, if any, shall

carry an interest @ 4% per annum.

All pending applications also stand disposed of.

No order as to costs.

(KULDEEP MATHUR),J 115-KshamaD/-

Powered by TCPDF (www.tcpdf.org)