Rajasthan High Court - Jaipur
Gokul Chand Saini vs State (Finance Department) &Anr; on 17 October, 2016
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IN THE HIGH COURT OF JUDICATURE FOR RAJASTHAN AT JAIPUR
BENCH, JAIPUR
ORDER
S.B. Civil Writ Petition No. 8966/2016
Gokul Chand Saini vs. State of Rajasthan & Anr.
Date of Order ::: 17th October, 2016
HON'BLE MR. JUSTICE KANWALJIT SINGH AHLUWALIA
Dr. P.C. Jain, for the petitioner.
Mr. Rishi Pal Agarwal, for the respondents.
The present writ petition has been filed under Article 226 of the Constitution of India, praying that the respondents be directed to make further payment of Rs.1,87,249/- to the petitioner out of the total bill of Rs.3,07,658/- raised by him for replacement of both knees.
A grievance has been made that the respondents wrongly had made payment of Rs. 1,20,409/- only, whereas the petitioner was entitled to the reimbursement of the total amount of the bill raised.
Admittedly, the petitioner had retired from the post of Personal Assistant to the Dy. Director (Education), Jaipur Division, Jaipur, in the year 1994. The petitioner was admitted in Fortis Hospital on 22.12.2014 and was operated on 24.12.2014 for knee replacement.
Dr. P.C. Jain, the learned counsel for the petitioner has submitted that as per rule 10, petitioner can be admitted to referral hospital for specialized treatment. The learned counsel for the petitioner has submitted that as per Appendix IX and X of the rules, the petitioner is entitled to receive Rs.1,10,000 for replacement of each knee. It is not denied that on 15.12.2014, respondents have issued letter Annexure-1. The letter Annexure-1 is reproduced below in verbatim:- 2
"Sub: Amendments in Rajasthan Civil Services (Medical Attendance) Rules, 2013, Appendix-IX and X. In exercise of the powers conferred under Rule 4 of the RCS (MA) Rules, following amendments, as per the decisions of the Health Benefit Empowered Committee (HBEC), are made in Appendixes to these Rules:-
1. In Appendix - IX, a new Para (d) is inserted as follows:
(d) Extent of reimbursement for IGRT will be Rs. 1,20,000 or actual whichever is less.
2. In Appendix-X, Entry no.1 in Table given in Para (a) is substituted as follows:
S.N. Item Extent of
Reimbursement (Rs)
1 KNEE JOINT INCLUDING IMIPLANTS 1,10,000
By order of the Governor,
(Siddharth Mahajan)
Special Secretary, Finance (Budget)"
Mr. Rishi Pal Agarwal, the learned counsel for the respondents has contended that the letter dated 15.12.2014 cannot be applied with retrospective effect. It is not denied that the amount of reimbursement for knee replacement was increased to Rs.1,10,000/- per knee w.e.f. 15.12.2014.
In the reply filed following stand has been taken by the respondents:-
"The difference in reimbursement amount of the petitioner and that of Shri Om Prakash Gupta is due to difference in treatment period and also in effective rates thereof. Notably prior to 15.12.2014 on reimbursement of knee in the government hospital reimbursement was made @ Rs. 55000/- per knee (Order dated 16.9.2013) but vide order dated 15.12.2014 it was increased to Rs.110000/- per knee. The Order dated 15.12.2014 was made applicable on the treatment undertaken in the Government Hospital."
On the pointed query raised by this Court, the learned counsel for the respondent has very fairly conceded that surgery of knee replacement was conducted on 24.12.2014. Thus, there is no question of 3 retrospective application of the letter issued by the respondents. As stated earlier, the letter Annexure-1 was issued on 15.12.2014 and petitioner was operated on 24.12.2014, hence, the petitioner was entitled to receive reimbursement of knee replacement as per Annexure-1.
In view of the letter Annexure-1, issued by the respondents, the petitioner is held entitled to reimbursement of knee replacement at the rate of Rs.1,10,000/- per knee.
Consequently, the present writ petition is accepted. The respondents are directed to pay Rs.1,10,000/- for replacement of each knee to the petitioner after verifying the bill raised. In the light of letter Annexure-1, the respondents shall pay remaining due amount to the petitioner, within a period of one month from the receipt of certified copy of this order.
(KANWALJIT SINGH AHLUWALIA)J. Mak/-
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