Tripura High Court
Sri Babul Mandal vs The State Of Tripura on 6 December, 2017
Author: S. Talapatra
Bench: S. Talapatra
THE HIGH COURT OF TRIPURA
AGARTALA
WP(C). No. 517 of 2017
Sri Babul Mandal,
son of late Dhananjoy Mandal,
resident of North Joynagar, P.S. West Agartala, District: West Tripura,
Pin:799002
.........Petitioner
-VERSUS-
1. The State of Tripura,
to be represented by the Secretary, Department of Secondary Education,
Agartala, West Tripura, New Secretariat Complex, Pin: 799006
2. The Director,
Department of Secondary Education, Agartala, West Tripura, Government of
Tripura, Akhaura Road, P.O. Agartala, P.S. West Agartala, Pin: 799001, District:
West Tripura
3. The Secretary,
Department of Health & Family Welfare,
Government of Tripura, New Capital Complex, Pin: 799006
4. The Secretary,
Department of Finance,
Government of Tripura, Pin: 799006, New Capital Complex, New Secretariat
Complex
.......Respondents
BEFORE THE HON'BLE MR. JUSTICE S. TALAPATRA For the petitioner : Mr. P. Maishan, Advocate For the respondents : Mr. J. Majumder, Advocate Date of hearing & delivery of judgment and order : 06.12.2017 Whether fit for reporting : NO Judgment and Order (Oral) Heard Mr. P. Maishan, learned counsel appearing for the petitioner as well as Mr. J. Majumder, learned counsel appearing for the respondents.
WP(C). No. 517 of 2017 Page 1 of 9 [2] Mr. Majumder, learned counsel appearing for the respondents has in terms of the order dated 04.12.2017 produced the memorandum under No. F.5 (3)-FIN (G)/2009 dated 19.09.2009. It appears from the said memorandum dated 19.09.2009 that the scheme of medical reimbursement has been revised and re-structured. It has been declared that the officers/employees who are provided the grade pay (GP) of Rs. 2,600/- shall also be entitled to get the benefit of medical reimbursement w.e.f. 01.10.2009. For purpose of reference, the entire text of the said memorandum is reproduced hereunder:
"F.5(3)-FIN(G)/2009 Government of Tripura Department of Finance Dated, Agartala, the 19th September, 09 MEMORANDUM Subject: Reimbursement of the cost of Medical Treatment- revised norms of admissibility following revision of pay structure as per TSCS (RP) Rules, 2009.
The undersigned is directed to say that according to the Finance Department's O.M. dated 01.12.1988 and O.M. No. F.6(3)-FIN(G)/1999 dated 20th April, 1999, all officers and employees holding posts belonging to Group-A and Group-B, irrespective of status of Gazetted or not, have been allowed the benefit of reimbursement of Medical expenses under the norms prevailing in the State.
(2) Consequent upon introduction of revised pay structure under TSCS (RP) Rules, 2009, it has become necessary to fix revised norms of entitlement for availing the benefit of Medical Reimbursement. Accordingly, following norms are fixed for providing the benefit.
(i) All Officers/employees who are provided Grade-Pay of Rs.
3,100/- and above will continue to get benefit of Medical Reimbursement as per aforesaid circular. The officers/employees who are provided Grade Pay of Rs. 2,600/- , will also be entitled to get the benefit of Medical Reimbursement w.e.f. 1st October, 2009.
(ii) Availing of this benefit will not carry any relevance to determine the status of Group classification as provided under Rule 17 of the TSCS (RP) Rules, 2009.
WP(C). No. 517 of 2017 Page 2 of 9
(iii) Those employees who are drawing Grade Pay below Rs. 2,600/- will be entitled to get Medical Allowance under revised rate i.e. is Rs. 250/- P.M. in pursuance of this Department's Memorandum No. F.5 (3)-FIN(G)/2009 dated 5th May, 2009. In respect of employees drawing Grade Pay of Rs. 2,600/-,Medical Allowance @ Rs. 250/- per month would be admissible for the period from 1st January 2009 to 30th September, 2009, if not already drawn.
Sd/- 19.09.2009 (A.Roy) Joint Secretary to the Government of Tripura." [3] There is no dispute that the petitioner is getting the pay scale of Rs. 5,700-24,000/- (PB-II) with G.P. of Rs. 4,600/- in the post of Graduate Teacher and in terms of the said memorandum dated 19.09.2009, the petitioner is entitled to get the reimbursement of the medical expenses for him and his family members as provided by the Central Services (Medical Attendance) Rules, 1965 which has been adopted in the State of Tripura for purpose of regulating the medical reimbursement of those who are born in the reimbursement establishment.
[4] The respondents have not disputed that the wife of the petitioner availed the treatment for Acute MS Multiple Sclerosis popularly known as Multiple Sclerosis. The petitioner has asserted that such facility is not available in the State and the petitioner's wife in a deteriorating state was taken to outside the State and was admitted in the Calcutta Medical Research Institute (CMRI in short). [5] The petitioner after defraying the medical expenses, raised 3 (three) medical reimbursement bills for Rs. 60,900/-, Rs.1,59,264/- and Rs. 66,342/- along with travelling allowance bills for Rs. 85,430/-. WP(C). No. 517 of 2017 Page 3 of 9 Those bills were not entertained by the Director of School Education and refund by the memorandum dated 13.06.2016 (Annexure-C to the writ petition).
[6] Thereafter, the petitioner was compelled to serve a demand notice on the respondent No. 2 and the Headmistress of Bijoy Kimar Girls Higher Secondary School, Krishnanagar, Agartala, for reimbursement of the said medical expenses as reflected in those MR bills along with the travelling allowance bills. [7] Initially, the petitioner as it appears from the records that the wife of the petitioner namely Shila Saha Mondal was treated in the I.L.S Hospital at Agartala and thereafter she was taken to Calcutta Medical Research Institute, Kolkata which is admittedly not an empanelled hospital of the Government of Tripura. The cost of treatment as well as the travelling expenses have been sought to be reimbursed by the petitioner.
[8] Having received the demand notice dated 10.03.2016 (Annexure-D to the writ petition), the Director of School Education, the respondent No. 2 herein, has replied to the demand by the memorandum dated 31.03.2016 (Annexure-E to the writ petition). The text of the said reply is extracted hereunder:
"Shri Babul Mandal , PGT, Bijoy Kumar Girls' H/S School, Agartala is hereby informed that his claim of medical reimbursement bills for an amount of Rs. 60,948/- and Rs. 1,59,264/- only was examined clarified by the Health & Family Welfare Department, Govt. of Tripura, Agartala as follows:
WP(C). No. 517 of 2017 Page 4 of 9
The 2(two) nos. medical reimbursement claim has been examined and found that Sri Babul Mandal, PGT for treatment of his wife at I. L. S. Hospital, Agartala without referred by the Standing Medical Board, Agartala, and CMRI, Kolkata is not a empanelment hospital by the Govt. of Tripura. So his medical reimbursement claims may not be considered as per G.O. No. 303 dated 31.04.2014.
Accordingly, your both the bills are returned herewith."
[9] It is an admitted position that the petitioner did not admit his wife in the GBP Hospital, Agartala or in any other Government Hospitals. The petitioner had straightway admitted his wife in the ILS Hospitals, Agartala and there was no reference from the Standing Medical Board for treatment outside the Government Hospitals. Thereafter, again without any reference, the petitioner's wife was taken to Kolkata for treatment in the CMRI.
[10] After defraying the expenses, those medical bills and the travelling allowance bills were raised. By filing a rejoinder, the petitioner has stated that in the GBP Hospital, Agartala, there is no facility for treatment of Multiple Sclerosis and as such, the petitioner had no other alternative but to the report to the ILS hospitals, Agartala first and thereafter to the CMRI, Kolkata.
[11] Mr. P. Maishan, learned counsel appearing for the petitioner has submitted that since no treatment facilities are available in the Government Hospitals, the petitioner had to admit his wife in the ILS Hospital at Agartala which had recommended treatment at the CMRI, Kolkata, the petitioner would be entitled to the medical reimbursements including the travelling allowances. WP(C). No. 517 of 2017 Page 5 of 9 [12] On the other side, Mr. J. Majumder, learned counsel appearing for the respondents has submitted that the treatment of the disease namely Multiple Sclerosis is available in the GBP Hospital, Agartala and there was no medical emergency to justify avoidance of the reference by the Standing Medical Board.
[13] According to the medical reimbursement rules unless the hospital recognized by the State, if any treatment is taken out side those hospitals, the Government cannot be saddled with any liability for reimbursement. If the treatment is availed from the hospital recognized by the State Government/CGHS, the expenditure can be reimbursed, otherwise not.
[14] Mr. Majumder, learned counsel appearing for the respondents has further submitted that the medical reimbursement is strictly regulated by the provisions of the said Medical Attendance Rules. In response, Mr. Maishan, learned counsel appearing for the petitioner has submitted that in the rejoinder the petitioner had filed a list of the treatment facilities available in the GBP Hospital and the said list has been downloaded from the website of Agartala Government Medical College and GBP Hospital. Mr. Maishan, learned counsel has shown that there is no department of Neurology and as such, it has to be presumed that there is no treatment facility for Neurological ailments. [15] It appears from the order dated 31.05.2014 (Annexure-R/1 to the reply filed by the respondents) that the ILS Hospitals, Agartala is WP(C). No. 517 of 2017 Page 6 of 9 a recognized medical hospital w.e.f. 31.05.2014 and thus, on reference, treatment if made in the ILS Hospital, Agartala the petitioner born in the category would be entitled to reimbursement, but in the present case there was no reference as such. Even the petitioner did not claim that there was any reference by the Standing Medical Board. [16] Having situated thus, this Court is of the view that this petition can be disposed with the following directions:
(i) The petitioner shall resubmit the medical reimbursement bills and the travelling allowance bills which are returned by the respondent No. 2 in original within a period of 7 days from the date when the petitioner would get a copy of this judgment to the respondent No. 2, the Director of Secondary Education, Government of Tripura, Agartala.
(ii) The respondent No. 2 after receipt of the said MR bills and the travelling allowance bills shall refer the same to the Director of Health Services, Government of Tripura for his observation and recommendation in the matters viz. (a) whether there is any facility of treatment for Multiple Sclerosis in the GBP Hospital, Agartala. (b) whether there was any medical emergency to rush for treatment in the ILS Hospitals, Agartala without any reference from the Standing Medical Board and (c) if it is found by the Director of Health Services that there was medical emergency and no facility of the treatment of Multiple Sclerosis was available in the GBP Hospital on the relevant day when the petitioner's wife was admitted in the ILS Hospital, Agartala, WP(C). No. 517 of 2017 Page 7 of 9 the Director of Health Services shall recommend the amount what the petitioner is entitled, even if she was treated at the CMRI, Kolkata, inasmuch as the petitioner would be entitled to the rate of the recognized hospital.
[17] But it is made clear that if it is found that the facility of treatment of Multiple Sclerosis was available in the GBP Hospital at Agartala and there was no medical emergency, the petitioner will not be entitled any medical reimbursement for treatment of his wife. [18] It is made further clear that the petitioner is otherwise entitled to the medical reimbursement in view of the memorandum that has been cited above. But for non-observance of the procedure, the petitioner may not be entitled to the medical reimbursement inasmuch as the said Medical Attendance Rules regulates the procedure for reimbursement and that can only be waived in the event of the medical emergency. If the Director of Health Services is of the opinion that there was medical emergency, in that case the petitioner would straightway get the reimbursement of the medical reimbursement bills at the rate of the ILS Hospitals, Agartala. Further, he would get the reimbursement of the bills for treatment in the CMRI, Kolkata, at the rate of the recognized hospital.
[19] However, if it is found that the treatment outside the State was absolutely necessary, in that case, the travelling allowance bills as submitted by the petitioner shall also be reimbursed. The entire exercise WP(C). No. 517 of 2017 Page 8 of 9 shall be completed within a period of 3(three) months from the day when the petitioner shall submit the copy of this judgment along with the original Medical Reimbursement bills and the travelling allowance bills, which he had earlier submitted to the respondent No. 2.
In the result, this petition stands disposed of, with the above observation. There shall be no order as to costs.
JUDGE A.Ghosh WP(C). No. 517 of 2017 Page 9 of 9