Punjab-Haryana High Court
Som Dutt Sharma vs State Of Haryana And Others on 27 November, 2009
C.W.P. No. 3107 of 2009 (O&M)
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IN THE HIGH COURT OF PUNJAB AND HARYANA AT
CHANDIGARH
C.W.P. No. 3107 of 2009 (O&M)
Date of decision: 27.11.2009
Som Dutt Sharma
....Petitioner
Versus
State of Haryana and others
....Respondents
CORAM: HON'BLE MR. JUSTICE VINOD K. SHARMA
Present: - Mr. U.K. Agnihotri, Advocate,
for the petitioner.
Mr. Rajiv Kawatra, Sr. DAG, Haryana,
for respondent No. 1.
Mr. D.K. Khanna, Advocate,
for respondents No. 2 and 3.
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VINOD K. SHARMA, J (ORAL)
The petitioner has approached this Court under Articles 226/227 of the Constitution of India to challenge the order vide which the medical reimbursement claim of the petitioner, stands declined by the respondents.
The petitioner is working as Superintendent Accounts in the Haryana School Education Board, Bhiwani, since last 25 years. On 14.7.2001, the petitioner was admitted in Civil Hospital, Bhiwani, having suffered an attack of jaundice and remained admitted there upto 17.7.2001. For lack of improvement in his condition, he was referred to PGIMS, Rohtak, for further treatment where he remained admitted upto 31.7.2001. The petitioner submitted his reimbursement bills for his C.W.P. No. 3107 of 2009 (O&M) -2- treatment, which was duly reimbursed to him.
On 17.9.2001, the petitioner suffered severe pain in his stomach and he was immediately taken to GMC Hospital, Bhiwani, i.e. a private hospital, on account of emergency. His condition became very serious due to bursting of his intestines. Keeping in view the emergency, the petitioner was referred to Sir Ganga Ram Hospital, New Delhi, Immediately on his admission in Sir Ganga Ram Hospital, he was operated upon on 18.9.2001. The petitioner remained admitted there as indoor patient till 1.10.2001. The petitioner spent a sum of Rs.97,278/- (Rupees ninety seven thousand two hundred and seventy eight only) on his treatment. The essential certificate in support of his claim is attached as Annexure P-1 to the writ petition.
The petitioner submitted his medical bills for reimbursement to the Secretary of the Board. However, it was only on 25.1.2002 that the petitioner was asked to submit reference certificate.
In reply thereto, the petitioner submitted explanation, that on 17.9.2001 because of the bursting of the intestines, his condition had become critical and it was in the emergent situation that he was referred to Sir Ganga Ram Hospital, New Delhi, by a private hospital at Bhiwani, where he was taken for immediate treatment.
The application submitted by the petitioner was returned on 12.4.2002 with a direction to get ex post facto sanction for reimbursement of the medical bills from the Director, Health Services, Haryana. Thereafter, there was correspondence between the petitioner and the department and it was finally on 21.8.2006 that the claim of the petitioner was rejected vide Annexure P-12. The Chairman declined the C.W.P. No. 3107 of 2009 (O&M) -3- application made by the petitioner for ex post facto sanction.
The petitioner served a legal notice for reimbursement of the amount but as no action was taken thereto, present writ petition has been filed by the petitioner praying for quashing of the impugned order, and for issuance of writ of mandamus directing the respondents to release the medical reimbursement.
In support of his claim, the petitioner has placed reliance on the Government of Haryana instructions issued from time to time for reimbursement of medical bills of the employees of the Boards, Corporations of the Haryana Government.
Stand of the petitioner that Sir Ganga Ram Hospital, New Delhi, was recognised since 31.10.2002 is disputed by the respondents wherein it is stated that Sir Ganga Ram Hospital, New Delhi, was recognised only w.e.f. 31.10.2004.
It is also the stand of the petitioner, that the medical reimbursement should not have been rejected on technical grounds, but human and compassionate approach should have been taken.
The writ petition is contested by the respondents, firstly on the ground that the writ petition is belated as the petitioner has approached this Court only in the year 2009, whereas his claim was rejected on 3.12.2002 vide Annexure P-4. Stand has also been taken, that the petitioner is not entitled to reimbursement of the medical bills as he had not taken prior approval of the Director Health Services for treatment from an unrecognised institution, nor he has pleaded that it was a case of emergency, therefore, his claim has rightly been rejected.
It is also the stand of the respondents, that the State of Haryana C.W.P. No. 3107 of 2009 (O&M) -4- had approved three other hospitals i.e. All India Institute of Medical Sciences, Batra Hospital and Escort, therefore, the treatment from Sir Ganga Ram Hospital, New Delhi, was not permitted without special sanction from the Director Health Services.
On consideration, I find force in the writ petition. The stand of the respondents, that emergency was not pleaded, is factually incorrect. The petitioner has specifically pleaded in the writ petition that on 17.9.2001, he suffered severe pain in his stomach for which he had to rush to the nearby hospital being a case of emergency. It has further been pleaded that trouble was detected to be case of bursting of intestines, for which he was referred to Sir Ganga Ram Hospital by GMC Hospital, Bhiwani. The very fact that the petitioner was operated upon on 18.9.2001, leaves no manner of doubt, that it was a case of emergency, therefore, respondents are not right in contending that emergency was not pleaded.
The plea of the respondents, that writ petition is belated, is also devoid of any merit. Vide Annexure P-4 the claim of the petitioner was not rejected, but only bills submitted were returned to him for getting it processed through proper channel i.e. through the State of Haryana. There has been long correspondence thereafter asking the petitioner to comply with certain formalities. It was only on 21.8.2006 that the Chairman refused to give ex post facto sanction for reimbursement of the bills, and his claim was finally rejected. The writ petition, therefore, cannot be said to be suffering from delay and laches.
The reliance of the respondents on the judgment of this Court in Ramesh Chander Vs. State of Haryana, 2000(2) SCT 536, is also of C.W.P. No. 3107 of 2009 (O&M) -5- no help because in the case of Ramesh Chander Vs. State of Haryana (supra), the claim of the petitioner was rejected as there was no pleading in the writ petition that it was a case of emergency, whereas in the present case, it has been pleaded and proved by immediate operation, that it was a case of emergency.
The Hon'ble Division Bench of this Court in Kultar Singh Virk Vs. State of Punjab, 1997(3) SCT 360 has been pleased to lay down as under: -
"4. Admittedly, the petitioner had submitted the bill for reimbursement on January 23, 1996. A period of more than a year has elapsed since then. No reason whatsoever has been disclosed for the delay in settling the bill. Still further, as observed by the Apex Court in State of Punjab v. Mohinder Singh Chawla, JT 1997(1) SC 416 : 1997(1) SCT 716 (SC), the right to health is an integral part of the right to life. The Government is under an obligation to provide adequate facilities and to reimburse the expenses incurred by a serving or retired civil servant for treatment. This matter has been considered in detail by a Division Bench of this Court in Ram Lubhaya Bagga v. Punjab State etc. Civil Writ Petition No. 13872 of 1996, which was decided on March 21, 1997. It was held that the instructions issued by the Government by which it was directed that reimbursement of expenses shall be at the rates which are prevalent in the All India Institute of Medical Sciences, were held to be illegal. In view of these decisions, counsel for the respondents was not able to controvert the petitioner's claim.
5. Resultantly, the writ petition is allowed. It is directed that the amount of Rs.1,54,137,11 shall be paid to the petitioner within one month from the date of C.W.P. No. 3107 of 2009 (O&M) -6- receipt of a copy of this order. In case of default, the petitioner shall be entitled to the payment with interest @ 12% per annum from the date of default to the date of payment. However, the petitioner's claim for interest on account of delay is declined in view of the decision of the Supreme Court in Om Parkash Garg v. State of Punjab, JT 1996(10) SC 36. No costs."
The Hon'ble Division Bench of this Court again in Ranbir Singh Kundu Vs. Haryana State Agricultural Marketing Board, Panchkula, and others, 2008(2) SCT 314 has been pleased to lay down that the provision of the medical reimbursement is beneficial act of the welfare State for its employees and such provision has to be construed liberally in favour of the employees.
The Hon'ble Division Bench of this Court in Rajinder Singh Vs. The Kaithal Central Cooperative Bank Ltd and another, CWP No. 19502 of 2006 decided on 6.9.2007 has again held that the treatment from un-approved hospital, in case of emergent situation, the employee is entitled to reimbursement at PGI, Chandigarh rates. The judgment of the Hon'ble Division Bench reads as under: -
"After hearing the learned counsel for the parties, we are of the considered opinion that if a Government employee receives medical reimbursement in an emergent situation from an un-approved hospital, he would be entitled to claim reimbursement of the medical bills submitted by him at the PGI Chandigarh rates. In the present case, the petitioner had undergone Angiography and Angioplasty and a Stent was implanted and hence, he is entitled to claim reimbursement of the medical bills submitted by him at PGI Chandigarh rates.
In view of the above, we quash the order Annexure P-5 C.W.P. No. 3107 of 2009 (O&M) -7- and direct respondent No. 1 to reimburse the medical bills submitted by the petitioner at PGI Chandigarh rates within a period of three months from the date of receipt of certified copy of this order. There is no order as to costs."
In view of the settled proposition of law referred to above, there was no justification with the respondents to reject the claim, merely for want of sanction from the Director Health Services, prior to treatment, even though it was a proved case of emergency.
For the reasons stated above, this writ petition is allowed, the impugned order is set aside and the writ of mandamus is issued to the respondents to make reimbursement as per PGI rates to the petitioner along with interest @ 6% per annum.
No costs.
(Vinod K. Sharma) Judge November 27, 2009 R.S.