Punjab-Haryana High Court
Smt. Ombai vs State Of Haryana And Others on 6 November, 2012
Author: Augustine George Masih
Bench: Augustine George Masih
IN THE HIGH COURT OF PUNJAB AND HARYANA
AT CHANDIGARH
Civil Writ Petition No.8469 of 2011 (O&M)
Date of Decision: November 06, 2012
Smt. Ombai ... Petitioner
Versus
State of Haryana and others .... Respondents
CORAM : HON'BLE MR. JUSTICE AUGUSTINE GEORGE MASIH
Present: Mr. Jai Singh Yadav, Advocate for the petitioner.
Mr. Harish Rathee, Sr. DAG, Haryana.
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AUGUSTINE GEORGE MASIH, J. (Oral)
Petitioner, who is the wife of Raj Pal Singh, who retired as Social Studies Master from the Education Department of Haryana has approached this court, claiming reimbursement of an amount of Rs.93,544.79/- for the treatment which the husband of the petitioner had incurred as a follow up medical treatment. He had taken treatment from the department of Raidotherapy & Oncology Linear Accelerator Centre S.M.S. Hospital, Jaipur as an indoor patient. Thereafter, he had taken follow up treatment from S.K. Soni Hospital, at Jaipur from 11.10.2010 to 01.11.2010 as an outdoor patient. The claim of the petitioner, as far as the indoor patient is concerned amounting to Rs.1,88,124/- has been accepted and has been paid to her but the remaining amount of Rs.93,544.79/- has not been paid to her and stands rejected only on the ground that said medical expenses could not be reimbursed as the husband of the petitioner has taken treatment as an outdoor patient.
At this, counsel for the petitioner contends that the claim of the petitioner deserves to be accepted, in the light of the various judgments passed by this court. Reference has been made by the counsel to judgments passed by this Court in Renu Saigal Vs. State of Haryana 1998(4) S.C.T. 565, Kuldeep Kumar Vs. State of Haryana 2002(3) S.C.T. C.W.P. No.8469 of 2011 -2- 71 and a Division Bench judgment passed by this court in C. B. Gupta Vs. State of Haryana and others 2003(1) S.C.T. 316 to contend that this court had quashed the instructions of the Government of Haryana and had held that where the indoor treatment is followed up by outdoor treatment for chronic disease, the medical reimbursement of such bill cannot be said to be barred or not claimable only on the ground that fixed monthly medical allowance has been paid to such an employee. He at this stage, contends that the writ petition deserves to be allowed and the claim as made by the petitioner for reimbursement of the expenses of Rs.93,544.79/- as an outdoor patient by the husband of the petitioner should be released to her.
On the other hand, counsel for the respondents has submitted that the husband of the petitioner was being paid fixed medical allowances as per the Haryana Government instructions dated 27.01.2009 and since the said benefit was granted to the husband of the petitioner, he was not entitled to medical reimbursement of his expenses, which he had incurred as an outdoor patient. The entitlement of the husband of the petitioner for reimbursement of bills as an indoor patient stands accepted and had been released to the petitioner on the death of her husband. Since the claim of the petitioner is not covered by the Rules/instructions, the prayer made in the petition deserves to be rejected and the writ petition dismissed.
I have considered the submissions made by the counsel for the parties and have gone through the records of the case.
The facts are not in dispute, which need not be repeated here. The issue which has to be decided by this court in the present petition is whether the husband of the petitioner, who was suffering from throat cancer for which he had taken treatment from the department of Raidotherapy & Oncology Linear Accelerator Centre C.W.P. No.8469 of 2011 -3- S.M.S. Hospital, Jaipur from 02.02.2009 to 09.06.2010 for which period the medical claim for reimbursement as indoor patient and has been released to the petitioner, would the petitioner be entitled to the reimbursement of the expenses of the follow up treatment for a chronic disease of throat cancer as an outdoor patient? This issue will not detain this court for a long time in the light of the Division Bench judgment of this court in C.B. Gupta's case (supra) wherein para 3 of the writ petition, it has been held as under:
" The aforesaid amount represented the expenses incurred by the petitioner for the treatment of his wife as outdoor patient taken from Sir Ganga Ram Hospital, New Delhi. According to the learned counsel, the payment of six bills has been denied to the petitioner by the impugned orders which are attached to the petition as Annexure P-59, P-60, P-63, P-64, P-71 and P-
72. Learned counsel has submitted that the medical expenses incurred on indoor and outdoor treatment are reimbursable on the basis of the policy which has been in vogue prior to 01.03.1986. However, from 01.03.1986, by letter dated 06.05.1986, the facility of out door treatment was withdrawn and replaced by a fixed medical allowance of Rs.150/- per annum. Subsequently, the facility of fixed medical allowance of Rs.150/- per annum and the facility of free medical outdoor treatment was made optional. At the time of filing of the writ petition, the case of the petitioner was governed by the instructions Annexures P-8, P-9, P-19 and P-11, which provided that for out door treatment of chronic diseases, a sum of Rs.500/- per month would be reimbursable making a total of Rs.6000/- per year. According to the learned counsel, C.W.P. No.8469 of 2011 -4- the validity of these instructions came up for consideration before this Court in the case of Renu Saigal v. State of Haryana, 1998(4) SCT 565 (P&H): 1998(4) R.S.J.557. After considering the entire matter, this Court has held that the aforesaid instructions, insofar as they deny the benefit of full medical reimbursement to an outdoor patient are void and quashed the same. In that case, a further direction was issued to the respondent to make full reimbursement of medical expenses incurred by the petitioner therein, both as indoor and outdoor patient. Learned counsel for the petitioner further submitted that the case of the petitioner is further covered by a decision of this Court in the case of Kuldeep Kumar v. State of Haryana, 2002(3) SCT 71 (P&H) : 2003(3) R.S.J.115. In the aforesaid case, this Court has quashed the instructions dated 11.08.1992. This matter is stated to be further squarely covered by a Division Bench judgment of this Court in the case of K.K. Ravi Kant v. The State of Haryana and others, 1998(3) R.S.J.705 in which it has been held that if the outdoor treatment is absolutely necessary, the patient shall be entitled to full reimbursement. Even in the case of Krishan Kumar (deceased) through LRs v. State of Haryana and others, 1999(4) R.S.J.386, a Single Bench of this Court has clearly held that outdoor treatment which was a follow up and an integral part of the indoor treatment, must also be reimbursed as indoor treatment."
In the light of the above, the action of the respondents rejecting the claim of the petitioner outrightly on the ground that the treatment incurred as an outdoor patient cannot be reimbursed cannot be C.W.P. No.8469 of 2011 -5- sustained.
A direction is, thus, issued to consider the claim of the petitioner for reimbursement of the amount spent by the husband of the petitioner as an outdoor patient and was a follow up and an integral part of indoor treatment for the treatment of throat cancer, which is a chronic disease, within a period of two months from the date of receipt of certified copy of this order.
On considering the claim of the petitioner, in case the said claim is accepted, the consequential benefits be released to her within a further period of one month. The decision so taken be conveyed to the petitioner forthwith.
Petition stands disposed of with above directions.
(AUGUSTINE GEORGE MASIH)
November 06, 2012 JUDGE
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