Delhi High Court
Daljit Singh vs Govt. Of N.C.T. Of Delhi & Ors. on 10 January, 2013
Author: Valmiki J. Mehta
Bench: Valmiki J.Mehta
* IN THE HIGH COURT OF DELHI AT NEW DELHI
+ WP(C) No.16651/2006
% January 10, 2013
DALJIT SINGH ...... Petitioner
Through: None.
versus
GOVT. OF N.C.T. OF DELHI & ORS. ..... Respondents
Through: Ms.Sujata Kashyap, Adv. for R-1.
CORAM:
HON'BLE MR. JUSTICE VALMIKI J.MEHTA
To be referred to the Reporter or not?
VALMIKI J. MEHTA, J (ORAL)
1. The petitioner was an employee of the Government of NCT of Delhi as he retired from the post of a superintendent from the District Courts, Delhi on 31.5.1995. The petitioner holds the valid medical facility card No.17604 issued by the respondent No.1. The petitioner went through CABG heart operation in the Escorts Heart Institute at New Delhi on 30.5.2002 by informing the District and Sessions Judge office in advance on 22.5.2002. For the treatment and operation of the petitioner a total amount of Rs.2,02,343/- was charged by the Escorts Heart Institute, WP(C) No.16651/2006 Page 1 of 5 however, petitioner was only given a reimbursement of Rs.1,01,746/- by the respondent No.1, leading to filing of the present petition seeking the difference of amount not reimbursed.
2. On behalf of the respondent No.1 it is argued that the petitioner is governed by the CCS (Medical Attendance) Rules, 1944 of which Rule 8 states that the decision of the Government as to the Medical Attendance for treatment is final and under the same Rules there is GOI Decision No.15(A) which provides that the hospitals will be given a package deal with respect to the treatment for the ailments like heart, kidney coronary etc. and therefore it is argued that only the package deal amount can be granted to the petitioner and not the actual medical cost.
3. This issue of whether reimbursement should be of actual amount or only the package deal amount has been the subject matter of various decisions of this Court. One such judgment is the judgment of a learned Single Judge of this Court in Milap Singh vs. Union of India, 2004(113) DLT 91 wherein three earlier judgments of this Court as also the judgment of the Supreme Court in the case of State of Punjab & Ors. vs. Mohan Lal Jindal, 2001 (9) SCC 217 were referred. Paras 9 to 14 of the said judgment read as under:-
WP(C) No.16651/2006 Page 2 of 5
"9. The judgment in V.K. Gupta v. Union of India & Anr., 97(2002)DLT337 is also of a patient treated in the said Hospital. Once again this Office Memorandum dated 18.09.1996 was considered and it was noticed that the rates given in the said Memorandum were to be followed for a period of two years. The Court found that the respondents have to be more responsive and cannot act in a mechanical manner to deprive the employees of their legitimate reimbursement, especially on account of their own failure in not revising the rates after expiry of the initial period. The petitioner was held entitled therein for reimbursement of the full amount.
10. In M.G. Mahindru v. Union of India & Anr. (2001) DLT 59, it has been held that full reimbursement of medical expenses to a speciality hospital, which is on an approved list of CGHS, cannot be denied to a retired Government servant.
11. It has to be appreciated that in cases of emergency like that in the present case, ex post facto sanction can always be granted for specialised treatment. In fact, there is no real dispute in this behalf and the only issue is to the extent of the reimbursement made by the CGHS.
12. In State of Punjab & Ors. v. Mohan Lal Jindal (2001)9SCC217 , the stand of the Government in refusing to reimburse the in-patient charges for the treatment in the said Hospital was rejected and the Government was held to be under a constitutional obligation to reimburse the expenses since the right to health is an integral to the right to life.
13. The attention of this Court is also drawn to the judgment in CWP No. 6658/2002 titled as `V.K. Abbi v.
Director General of Health Services & Anr.' decided on 04.04.2003 on the same issue. It may be noticed that this judgment has been affirmed in appeal by the Division Bench in LPA No. 480/2003 decided on 19.09.2003. WP(C) No.16651/2006 Page 3 of 5
14. The undisputed position that emerges is that a patient is entitled to reimbursement of the full amount of medical expenses and not only at the rates specified in the circular of 1996 and in case respondent No. 2 has charged a higher rate, than could have been charged, it is for respondent No. 1 to settle the matter with respondent No. 2. The petitioner cannot be deprived of the reimbursement. The observations in para 26 of Prithvi Nath Chopra's case (supra) are useful in this behalf, which are as under :-
"26. It can also not be disputed that the Indraprastha Apollo Hospital has been made available land at token amount and it was for the respondents to have settled the amounts of reimbursement at the hospital. If the respondents have any grievance about the quantification of the amounts charged, it is for the respondents to take up the matter in issue with the Apollo Hospital. But that cannot deprive the petitioner of full reimbursement of the amount as charged by the recognised Indraprastha Apollo Hospital. In fact, the petitioner has been compelled to pay the charges first and thereafter reimbursement is taking place while the present policy is stated to be one where the respondents are directly billed by the approved hospitals which policy is salutary since the patient may not at a time have the funds available to first pay the amount and then claim the reimbursement."
(underlining added).
4. In view of the above it is no longer res integra that merely because the Government does not revise the package deal amount under the Medical Attendance Rules from time to time a person cannot be denied actual medical costs, and there has to be reimbursement of the actual medical expenses incurred.
WP(C) No.16651/2006 Page 4 of 5
5. In view of the above, the writ petition is allowed. The respondent No.1 is directed to give medical reimbursement to the petitioner for a sum of Rs.1,41,399/- alongwith interest at 8% per annum simple from the date of filing of the petition till the date of payment. The amount be paid within six weeks. Writ petition is allowed and disposed of accordingly.
VALMIKI J. MEHTA, J JANUARY 10, 2013 ak WP(C) No.16651/2006 Page 5 of 5