The Single Bench of the Delhi High Court in the case of Mahendra Kumar Verma vs Govt. of NCT of Delhi & Ors. consisting of Justice Chandra Dhari Singh held that once the State recommended a treatment to be taken by a hospital, they cannot deny the full reimbursement on the basis that the charges incurred by the petitioner over and above the package rate which the respondent had agreed with the said hospital could not be reimbursed.
Brief Facts:
This writ petition was filed by the Petitioner under Article 226 of the Constitution seeking reimbursement of the medical expenses incurred by the Petitioner for the treatment of his son as per the relevant rules applicable.
Brief Background:
In 2003, the Petitioner’s son was diagnosed as suffering from Medulloblastoma (Postop). Two consecutive operations were performed on him. The Petitioner was given an estimate of Rs. 80,000/- for medical expenditure. The same was submitted to the Office of the District & Sessions Judge and accordingly, 90% of the estimated amount was sanctioned for the grant as medical advance. When his son was discharged and he submitted a final bill for Rs. 1,03,122/, he was only reimbursed an amount of Rs. 89,226/-.
The son was referred to Rajiv Gandhi Cancer Institute and Research Centre for radiation and chemotherapy He received the treatment for one and a half years and four estimates were given by the doctors. The Petitioner was not reimbursed fully against the medical expenditure of his son’s treatments.
The Petitioner was further issued a letter in 2004 from the Drawing & Disbursing Officer (Respondent No. 3) asking him to deposit Rs. 51,854/- against the medical advance granted to him of Rs. 2,34,000/- for the treatment in Rajiv Gandhi Cancer Institute. The Petitioner requested the Disbursing Officer to provide him with the details of deductions if any. This representation of the Petitioner was rejected and subsequently, the learned District & Session Judge, Delhi passed the order for recovery of the amount of Rs. 51,854/- from the pay of the Petitioner.
Hence, aggrieved by the said deductions as well as by the demand of Rs. 51,824/- sought by the Respondents, the Petitioner filed this petition.
Contentions Made:
Petitioner: It was contended that Respondents acted arbitrarily, first, by making unreasonable deductions from the medical claims submitted by the Petitioner for his son’s treatment from the Government recognised hospitals, and secondly, by not informing the reasons for such deductions despite his several reminders and representation. The right to health is a constitutional right protected under Article 21 of the Constitution and hence, the Government is obligated to reimburse him. Moreover, Petitioner cannot be denied full reimbursement if the hospital charged a rate exceeding the package deal. Government must effect recovery from the hospital rather than issuing a demand in favour of the Petitioner.
Observations of the Court:
The Court was to decide whether in a case where the actual medical expenditure in a government-recognized hospital was more than the approved rates as per applicable rules, the excess amount was liable to be recovered from the beneficiary Government employee.
The Bench noted that the Petitioner was a government employee serving as a reader in the court of Metropolitan Magistrate in Tis Hazari Court, Delhi and hence, he and his dependants were covered under Central Services (Medical Attendance) Rules, 1944 (CS (MA) Rules). It perused these Rules and opined that the medical attendance rules formulated by Central and State Governments are the beneficiary piece of legislation to facilitate good and sound health for all government employees and their families:
“It does not stand to reason as to why any impediments are read in the rules which tend to defeat the cherished Constitutional rights for which this Court has always stood as a custodian.”
The Bench relied on many cases and opined that if the government servant suffered an ailment that required treatment at a specialised approved hospital and on reference the government servant had undergone such treatment therein, it was the duty of the State to bear the expenditure incurred by the government servant. Expenditure, thus, incurred required to be reimbursed by the State to the employee.
Relying on Sqn. Commander Randeep Kumar Rana vs Union of India, the High Court reiterated that once the Respondent themselves have recommended the treatment to be taken by a hospital, they cannot deny the full reimbursement on the basis that the charges incurred by the petitioner over and above the package rate which the respondent had agreed with the said hospital could not be reimbursed. So, the Petitioner in this case could not be faulted or penalised to pay the excess amount that was charged to him from the Rajiv Gandhi Cancer Institute, when Petitioner in the first instance did not even choose the Hospital but was referred there.
The decision of the Court:
The Bench concluded that the Petitioner was entitled to be fully reimbursed for the expenses incurred by him in the treatment of his minor child. The Respondents were directed to fully reimburse the Petitioner to the extent of bills raised by both the Hospitals and to release the amount retained in the FDR.
Case: Mahendra Kumar Verma vs Govt. of NCT of Delhi & Ors.
Citation: W.P.(C) 3272/2006
Coram: Hon’ble Mr. Justice Chandra Dhari Singh
Advocates for Petitioner: Mr. Rajat Aneja and Ms. Palak Vasisth.
Advocates for Respondent: Mrs. Avnish Ahlawat, Standing Counsel (Services) with Mr. N. K. Singh, Mrs. Tania Ahlawat, and Ms. Laavanya Kaushik.
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