Madhya Pradesh High Court
Rajendra Mahajan vs The State Of Madhya Pradesh on 22 August, 2025
NEUTRAL CITATION NO. 2025:MPHC-GWL:18978
1 WP-2899-2013
IN THE HIGH COURT OF MADHYA PRADESH
AT GWALIOR
BEFORE
HON'BLE SHRI JUSTICE ANAND SINGH BAHRAWAT
ON THE 22nd OF AUGUST, 2025
WRIT PETITION No. 2899 of 2013
RAJENDRA MAHAJAN
Versus
THE STATE OF MADHYA PRADESH AND OTHERS
Appearance:
Shri D.S. Raghuvanshi - Advocate for the petitioner.
Shri K.S. Tomar - Government Advocate for the respondent/State.
ORDER
This petition under Article 226 of the Constitution of India has been filed by the petitioner seeking following reliefs:-
"(i) That, the respondents be directed to reimburse the medical bill of the petitioner of Rs.30,70,576/- and Rs.1,42,865/- (Total Amount of Rs.32,13,441/-) with interest 18% p.a. treating the same to be special category in terms of circular dated 17.12.1999 and remaining amount be directed to be paid ignoring the order Annexure P/1. The respondents therefore may be directed to reconsider the case of petitioner for reimbursement of medical bills submitted by him and to make payment of remaining amount forth with.
(ii) That, the other relief doing justice including cost be awarded."
2. Learned counsel for the petitioner has submitted that the petitioner is holding post of Divisional Project Engineer in PWD, Gwalior. In the month of August 2009, the petitioner was suddenly fell ill and in Sir Ganga Ram Hospital, New Delhi, after full checkup, Dr. A.S. Soni found that the Signature Not Verified Signed by: MONIKA SHARMA Signing time: 8/29/2025 11:58:29 AM NEUTRAL CITATION NO. 2025:MPHC-GWL:18978 2 WP-2899-2013 petitioner was suffering from Fulminant Hepatic Failure and only cure this dieses is the Liver Transplant. Thereafter, wife of the petitioner was donated her Liver and the operation of petitioner was held on 19.08.2009 and in this regard, petitioner has enclosed Annexure P/2, i.e., the certificate issued by Sir Ganga Ram Hospital, New Delhi dated 10.03.2010 in which it is mentioned that the petitioner was admitted from 07.08.2009 to 08.09.2009. It is also submitted that the petitioner was admitted in emergency and he was suffering from Fulminant Hepatic Failure and underwent emergency Liver Transplant on 19.08.2009 which was the only cure for his terminal liver disease. It is also mentioned that the hospital is authorized for liver transplant operation.
3. In the above operation, the petitioner incurred Rs.30,70,576/- and Rs.1,42,865/-, for his wife as she was donated her liver for which a medical bill was issued on payment by Sir Ganga Ram Hospital, New Delhi. After transplant, petitioner had approached before the respondents for reimbursement of medical bills of Rs.30,70,576/- including Rs.1,42,865/-. Thereafter, the Chief Engineer, PWD, Bhopal has forwarded the aforesaid claim of the petitioner to Director, Medical Education, Satpuda Bhawan, Bhopal. Thereafter, the Government sanctioned Rs.4,00,000/- vide order dated 21.12.2010 on the ground that the petitioner has undergone the Liver Transplant at Sir Ganga Ram Hospital, New Delhi. State Government by memo dated 14.06.2005, has limited sanction of amount of expenditure of medical reimbursement for liver transplant to maximum amount of Rs.4,00,000/- or actual expenses whichever is less for obtaining treatment Signature Not Verified Signed by: MONIKA SHARMA Signing time: 8/29/2025 11:58:29 AM NEUTRAL CITATION NO. 2025:MPHC-GWL:18978 3 WP-2899-2013 outside the Central Government or any other State Government hospital. On aforesaid basis, the respondents have issued impugned order dated 13.04.2011 (Annexure P/1) and they have only granted Rs.4,00,000/- and not reimbursed the entire amount.
4. Learned counsel for the petitioner further submitted that the petitioner is entitled for total amount which was spent by him on medical expenses in accordance with M.P. Civil Services (Medical Attendance) Rules 1958. As per judgment of Hon'ble Supreme Court in the case of State of Punjab and Others Vs. Mohinder Singh Chawla, AIR 1997 SCC 1225 , the petitioner is entitled for reimbursement of entire expenses incurred at the time of transplant.
5 . Per contra, learned counsel for the State has submitted that State Government by Memo dated 14.06.2005, has limited sanction of amount or expenditure on medical reimbursement for Liver Transplant to maximum amount of Rs. 4,00,000/- or actual expenses whichever is least for obtaining treatment outside the State in Central Government or any other State Government Hospital. It is further submitted that as per said Memo, it is also mentioned that expenditure exceeding to such limit shall be borne by employee concerned himself. Accordingly, sanction for maximum limit of Rs.4,00,000/- was granted by Department of Medical Education by order dated 21.10.2010. State Government has prescribed procedure for grant of ex-post facto approval for obtaining medical treatment outside the State in Central/State Government Hospital. As per said Memo, also State Government has mentioned that for reimbursement of medical expenses for Signature Not Verified Signed by: MONIKA SHARMA Signing time: 8/29/2025 11:58:29 AM NEUTRAL CITATION NO. 2025:MPHC-GWL:18978 4 WP-2899-2013 severe disease like Liver Transplant for major operation estimate of expenditure is received for more than Rs.2,00,000/- and such decision in this regard in consultation with Director of Medical Education and Finance Department will be taken later on. Learned Government Advocate has also mentioned that it is no where mentioned that such cases come under special category. On the basis of above, learned Government Advocate supports the impugned order and opposed the prayer made by counsel for the petitioner and prays for dismissal of the present petition.
6. Heard learned counsel for the parties and perused the record.
7. It is not disputed that petitioner was admitted in Sir Gangaram Hospital, New Delhi in emergency who was suffering from Fulminant Hepatic Failure and underwent emergency Liver Transplant on 19.08.2009 while remaining admitted in Hospital from 07.08.2009 to 08.09.2009 as per Certificate dated 10th March, 2010, Annexure P/2 which caused an expenditure of Rs.30.70.576/-. It is also not disputed that her wife Smt. Kusum Mahajan had donated Liver Transplant which caused an expenditure of Rs.1,42,865/-, total Rs.32,13,441/- for emergency operation of liver transplant.
8. The State Government has prescribed procedure for obtaining medical treatment outside the State for which sanction of Director of Medical Education is required in advance. But keeping in view the urgency and nature of disease ex-post facto approval for getting the treatment outside the State was granted by Department of Medical Education by order dated 21.12.2010, Annexure P/2.
Signature Not Verified Signed by: MONIKA SHARMA Signing time: 8/29/2025 11:58:29 AMNEUTRAL CITATION NO. 2025:MPHC-GWL:18978 5 WP-2899-2013
9. From the facts stated above, it is clear that the petitioner was operated at Sir Ganga Ram Hospital and his wife has given her liver and petitioner was admitted under department of Liver Transplantation from 07.08.2009 to 08.09.2009. He was admitted in Emergency. He was suffering from Fulminant Hepatic Failure and underwent emergency Liver Transplant on 19.08.2009 which was the only cure for his terminal liver disease. It was a major surgery with regard to the liver transplant, the relevant certificate to this fact has been issued by Sir Ganga Ram Hospital. Copy of which has been filed at Annexure P/2. As per certificate, Doctor has opined that the petitioner was admitted in emergency and transplant is only solution for the disease Fulminant Hepatic Failure.
10. It is not disputed that petitioner has spent Rs.30,70,576/- for petitioner and Rs.1,42,865/- in favour of his wife and total Rs.32,13,441/- for emergency operation of liver transplant.
11. M.P. Civil Services (Medical Attendance) Rules, 1958 provide as under:-
"(i) "Treatment" means the use of all medical and or surgical facilities available at the hospital in which the Government servant is treated and includes:
i. the employment of such pathological, bacteriological, radiological or other methods as are considered and certified in writing as necessary by the authorized medical attendant; ii. the supply of such medicines, vaccines, sera or other therapeutic substance as are ordinary available in the hospital; iii. such nursing as is ordinarily provided to in patients by the hospital;
iv. blood transfusion;
v. ultra-violet light and vi. in the case of females,-
(a) treatment during confinement (prenatal and post - natal treatment) including treatment for abortion, and
(b) douching."Signature Not Verified Signed by: MONIKA SHARMA Signing time: 8/29/2025 11:58:29 AM
NEUTRAL CITATION NO. 2025:MPHC-GWL:18978 6 WP-2899-2013 It is clear from the aforesaid Statutory rules that the expenses of operation incurred by the petitioner are covered under the definition of treatment.
12. Hon'ble Supreme Court in case of State of Punjab & Ors. Vs. Mohinder Singh Chawla etc. reported in AIR 1997 SCC 1225 has held as under:-
"It is settled law that right to health is an integral to right to life. Government has constitutional obligation to provide health facilities. If the Government servant has suffered an ailment which requires treatment at a specialized approved hospital and on reference where at the Government servant had undergone wuch treatment therein, it is but the duty of the State to bear the expenditure incurred by the Government servant. Expenditure, thus, incurred requires to be reimbursed by the State to the employee. Having had the constitutional obligation to bear the expenses for the Government servant while in service or after retirement from service, as per the policy of the Government, the Government is required to fulfill the constitutional obligation. Necessarily, the State has to bear the expenses incurred in that behalf."
13. With the aforesaid rules and the aforesaid judgment, Supreme Court has already been considered by the Co-ordinate Bench of this Court in W.P.No.1658/2005 vide order dated 25.04.2007 (Rajmal Jain Vs. The State of M.P. & Ors.) has held as under:-
"Hence, as per the above principles of law laid down by the Hon'ble Supreme Court and rules M.P. Civil Services (Medical Attendance) Rules, 1958. In my opinion, the ceiling prescribed by the respondents with regard to payment of expenses up to the limit of Rs.1,07,000/- is arbitrary and illegal. Consequently, the petition of the petitioner is allowed."
14. The State Government has preferred the W.A.No.225/2008 (The State of M.P. & Ors. Vs. Rajmal jain) being aggrieved the order dated Signature Not Verified Signed by: MONIKA SHARMA Signing time: 8/29/2025 11:58:29 AM NEUTRAL CITATION NO. 2025:MPHC-GWL:18978 7 WP-2899-2013 25.04.2007 passed in W.P.No.1658/2005, the said writ appeal has also been dismissed as under-
"10. In the light of the aforesaid factual position, the present case may be considered. Rule 4 (1) of the Rules provides a treatment free of charge to a Government servant in a hospital. When the State Govt. by legislation provide free of charge treatment to a Govt. servant, the petitioner who suffered a serious heart aliment resulting to a open heart surgery was entitled for the benefit of rule 4 of the Rules. The legislation in its wisdom has not provided any limit in the Rules, the appellants by issuing circular were not entitled to limit the expenses of treatment. Apart from this, from the perusal of the circular dated 17.12.1999 a provision was made in respect of a specified ailment of estimate of more than 2,00,000/- rupees is received, the matter shall be referred by the Director, Medical Education to the Finance department, who shall take a final decision in this regard. Meaning thereby that for the treatment in a hospital recognized by the Govt. in which expenses of Rs.2,00,000/- or more was incurred, the employee was entitled to reimburse of the amount on the recommendation of Director, Medical Education from the Finance Department.
11. Learned counsel for the respondent relying on a judgment of the Apex Court in Laxman Dundappa Dhamanekar and Another Vs. Management of Vishwa Bharata Seva Samiti and another, reported in (2001) 8 S.C.C. 378 , submitted that the Executive orders can be issued only when the statute empower for issuance of such administrative instructions to supplement the statutory rules. But they should be to fill the gaps in the Rules and not be inconsistent with them and submitted that when Rule 4 specifically provides treatment in a hospital free of charge then the circular can not restrict the amount of treatment. The circular which was contrary to Rule 4 has to be ignored.
12. The Apex Court in Mahinder Singh Chawla (supra) considering the similar circumstances held as under:-
"It is settled law that right to health is an integral to right to life. Government has constitutional obligation to provide health facilities. If the Government servant has suffered an ailment which requires treatment at a specialized approved hospital and on reference where at the Government servant had undergone such treatment therein, it is but the duty of the State to bear the Signature Not Verified Signed by: MONIKA SHARMA Signing time: 8/29/2025 11:58:29 AM NEUTRAL CITATION NO. 2025:MPHC-GWL:18978 8 WP-2899-2013 expenditure incurred by the Government servant.: Expenditure, thus, incurred requires to be reimbursed by the State to the employee. Having had the constitutional obligation to bear the expenses for the Government servant while in service or after retirement from service, as per the policy of the Government, the Government is required to fulfill the constitutional obligation. Necessarily, the State has to bear the expenses incurred in that behalf."
13. In the present case, it is not in dispute that the respondent was operated in Apollo Hospital, New Delhi, which was a recognized hospital of the Government. The expenses incurred by the respondent were also not in dispute. The only contest by the parties before the learned Single Judge was in respect of entitlement of the petitioner for reimbursement of the amount beyond Rs.1,15000/-, When Rule 4(1) specifically provides treatment in Govt. Hospital free of charge, the restricting reimbursement of the said purpose to the limit of Rs.1,15,000/- was not proper and the State Govt. has been rightly directed by the learned Single Judge to make reimbursement of the entire amount. The correctness of the expenses was not disputed before the learned Single Judge and the learned Single Judge considering the aforesaid factual aspects, directed to reimbursement of the entire amount by the respondent, no fault is found."
15. In case of Suman Rakheja Vs. State of Haryana and Another, (2004) 13 SCC 562, the Supreme Court has also held as under:-
"4. Counsel for the appellant submitted that in similar case (Annexure P-4) i.e. by the order of the High Court of Punjab and Haryana in Sant Prakash v. State of Haryana¹ wherein in an emergency case the patient had to be immediately admitted in hospital, the relief has been granted. In the present case also the appellant's husband had to be rushed to the private hospital because he had developed a paralytic stroke on the left side of the body, as there was blood clotting on the right side of the brain and therefore, was admitted in an emergency condition in the hospital. In the present case the discharge certificate also shows that the case was an emergency one. In Sant Prakash case¹ the Division Bench held that the petitioner therein would be entitled to 100% medical expenses at the AIIMS rates and 75% of the expenditure in excess thereto."Signature Not Verified Signed by: MONIKA SHARMA Signing time: 8/29/2025 11:58:29 AM
NEUTRAL CITATION NO. 2025:MPHC-GWL:18978 9 WP-2899-2013
16. The Co-ordinate Bench in case of Smt. Nisha Devi Vs. The State of M.P. and Others v i d e order dated 10.09.2024 passed in W.P.No.28006/2023 has held that no prior permission was necessary before taking the treatment in case of emergency.
"6. So far as the relevant para in the case of Smt. Madu Meena (supra) is concerned, the same read as under:-
"In the aforesaid case also treatment was availed at All India Institute of Medical Sciences, New Delhi, in case of emergency, without the permission of employer, and the writ petition was allowed directing the respondents to reimburse the claim of the petitioner along with interest @ 8% per annum. The Hon'ble Supreme Court in the case of Suman Rakheja Vs. State of Haryana & Anr. reported in (2004) 13 SCC 562 has also dealt with a case of medical reimbursement where the employee was rushed in emergency to a hospital which was a private hospital and the prayer of the employee was allowed. Paras No.3 to 5 of the aforesaid judgment read as under:-
"3. The appellant is the wife of a deceased government servant who had undergone treatment in the Apollo Hospital, New Delhi, which was a private hospital and which was not recognised/approved at that time. For the treatment in that hospital the appellant incurred expenses to the tune of Rs 6,01,166 and the appellant, by way of an application prayed for reimbursement of the medical expenses incurred, but the same was declined by the State, on the ground that the hospital wherein the appellant's husband had undergone the treatment was not an approved hospital.
4. Counsel for the appellant submitted that in similar case (Annexure P-4) i.e by the order of the High Court of Punjab and Haryana in Sant Prakash v. State of Haryana CWP No. 588 of 1998 P&H wherein in an emergency case the patient had to be immediately admitted in hospital, the relief has been granted. In the present case also the appellant's husband had to be rushed to the private hospital because he had developed a paralytic stroke on the left side of the body, as there was blood clotting on the right side of the brain and therefore, was admitted in an emergency condition in Signature Not Verified Signed by: MONIKA SHARMA Signing time: 8/29/2025 11:58:29 AM NEUTRAL CITATION NO. 2025:MPHC-GWL:18978 10 WP-2899-2013 the hospital. In the present case the discharge certificate also shows that the case was an emergency one. In Sant Prakash case the Division Bench held that the petitioner therein would be entitled to 100% medical expenses at the AIIMS rates and 75% of the expenditure in excess thereto.
5. In the result, in this appeal also, the appellant herein would be entitled to get the refund of the amount of 100% medical expenses at the AIIMS rates and 75% of the expenditure in excess thereto."
In light of the aforesaid judgments, as the petitioner's husband was rushed in emergency to a Private Medical College, though it is a Private Medical College, recognized by Medical Council of India and the State Government, this Court is of the opinion that the petitioner is certainly entitled for reimbursement of expenses incurred in respect of treatment of her husband.
The writ petition stands allowed and the respondents are directed to reimburse all the bills incurred by the husband of the petitioner. It is need less to mention that if the amount is not paid within 90 days, the amount shall carry out interest @ 12.5% per annum from the date of entitlement, till the amount is actually paid to the widow.
7. In view of the same, the writ petition stands allowed, impugned order dated 06/10/2023 is set aside and the respondents are directed to reimburse all the medical bills incurred by the husband of the petitioner, within a period of 90 days, failing which, amount of reimbursement shall carry interest @6% p.a."
17. Considering the aforementioned aspect and the law established by the Hon'ble Supreme Court, as well as the provisions in the M.P. Civil Services (Medical Attendance) Rules, 1958, it is my opinion that the limit prescribed by the respondents, regarding the payment of expenses up to Rs. 4,00,000/-, is arbitrary and illegal.
18. Consequently, the petition is allowed and the impugned order dated 13.04.2011 (Annexure P/1) is set aside and respondents are directed to reimburse all the medical bills incurred by the petitioner, amounting to Rs.28,13,441/- (32,13,441-4,00,000) within a period of 90 days failing which Signature Not Verified Signed by: MONIKA SHARMA Signing time: 8/29/2025 11:58:29 AM NEUTRAL CITATION NO. 2025:MPHC-GWL:18978 11 WP-2899-2013 the amount of reimbursement shall carry interest at the rate of 6% per annum from the date of transplant i.e. 19.08.2009 till its actual realization.
19. In view of the aforesaid, this petition is disposed of.
(ANAND SINGH BAHRAWAT) JUDGE Monika Signature Not Verified Signed by: MONIKA SHARMA Signing time: 8/29/2025 11:58:29 AM