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2023 Supreme(Chh) 650

IN THE HIGH COURT OF CHHATTISGARH AT BILASPUR
PARTH PRATEEM SAHU, J.
Ashok Choudhary S/o Late Tekram Choudhary – Appellant
Versus
State of Chhattisgarh Through The Principal Secretary, Department of Home, Mantralaya - Respondent
WPS No. 4622 of 2020
Decided on : 04-10-2023

Advocates:
Advocate Appeared:
For the Appellant :Mr. Sunil Pillai, Advocate
For the Respondent:Ms. Ruchi Nagar, Dy. Govt. Advocate

The central legal point established in the judgment is the interpretation of the eligibility criteria for medical reimbursement under the Chhattisgarh Civil Services (Medical Attendance) Rules, 2013, specifically focusing on the definition of 'family' and 'specialized treatment'.

Headnote:

medical reimbursement - eligibility for medical reimbursement - Chhattisgarh Civil Services (Medical Attendance) Rules, 2013 - Rule 3 (d) (v) - Rule 3 (j) - The court discussed the eligibility of a government employee for medical reimbursement for the treatment of his mother, focusing on the interpretation of the definition of 'family' and 'specialized treatment' under the Chhattisgarh Civil Services (Medical Attendance) Rules, 2013. The court held that the petitioner's mother, a pensioner, fell within the definition of 'family' for the purpose of specialized treatment, and therefore, the denial of medical reimbursement was erroneous and not sustainable.

Fact of the Case:

The petitioner, a government employee, sought reimbursement of medical expenses incurred for the treatment of his mother. The claim was rejected based on the income of the petitioner's mother from pension, leading to the filing of the writ petition.

Finding of the Court:

The court found that the denial of medical reimbursement to the petitioner was erroneous as the petitioner's mother fell within the definition of 'family' for the purpose of specialized treatment under the Chhattisgarh Civil Services (Medical Attendance) Rules, 2013.

Issues: The key issues revolved around the eligibility of the petitioner for medical reimbursement under the Rules of 2013, the interpretation of the definition of 'family', and the applicability of 'specialized treatment' to the petitioner's mother.

Ratio Decidendi: The court's decision was based on the interpretation of the Rules of 2013, specifically Rule 3 (d) (v) and Rule 3 (j), to determine the eligibility of the petitioner for medical reimbursement for the treatment of his mother.

Final Decision: The writ petition was allowed, and the impugned order was set aside. Respondent No.5 was directed to consider the petitioner's claim for reimbursement in light of Rule 3 (d) (v) of the Rules of 2013 and reimburse the medical bills in accordance with the law.

ORDER :

1. Petitioner has filed this writ petition aggrieved by the order dated 8.9.2020 rejecting claim of petitioner for reimbursement of medical bills of Rs.3,77,298/- incurred by petitioner in treatment of his mother on the ground that income of mother of petitioner is more than Rs.3,050/- per month.

2. Facts relevant for disposal of this writ petition are that the petitioner is working as ‘Head Constable’ in the Police Department. Mother of petitioner due to her suffering with severe knee pain, underwent surgery in Sarwa Trauma Hospital, Raipur on 23.5.2020. She was discharged from hospital on 1.6.2020. Bill towards treatment was of Rs.3,52,000/-, which was paid by the petitioner. Some medicines were also purchased during treatment of mother of petitioner, which made total medical expenses as Rs.3,77,298/-. On 25.8.2020 petitioner submitted an application supported with affidavit for medical reimbursement of aforementioned aggregated amount. Claim of petitioner for medical reimbursement was rejected on the ground that petitioner is not eligible to get the amount reimbursed incurred by him on the treatment of his mother as she is having monthly income of more than Rs.3,050/- from pension. This made petitioner to file this petition seeking following reliefs:-

“10.1.To call for entire records pertaining to petitioner's case for kind perusal of the Hon'ble High Court.

10.2. To quash the impugned order dated 08.09.2020 (Annexure P/5).

10.3. To direct respondents to reimburse to the petitioner an amount of Rs.377298/- as claimed by him for medical reimbursement along with interest @ 10% p.a.

10.4. To grant any other relief deemed fit and proper in facts and circumstances of the case.”

3. Learned counsel for the petitioner submitted that the mother of petitioner is residing with petitioner and is fully dependent on him. As per service rules, the parents of a government employee are also included in the definition of ‘family’ for the benefits of free medical treatment. Claim of petitioner was rejected in a very casual and arbitrary manner only taking note of the Explanation appended to the definition of ‘family’ given under Rule 3 (d) of the Chhattisgarh Civil Services (Medical Attendance) Rules, 2013 (for short ‘the Rules of 2013’). It is contention of the learned counsel for the petitioner that mother of petitioner gets meagre amount of Rs.6,500/- towards monthly pension, which is being expended in purchase of her routine medicines which she has to take for her old age sufferings leaving no savings to meet out expenditure of surgery as inpatient. He contended that respondent authorities have overlooked that medical expenditure of Rs.3,77,298/- incurred in treatment and surgery of petitioner's mother cannot be met out from the meagre amount of pension which mother of petitioner is getting. Relying upon the decision in the case of State of Madhya Pradesh vs. MP Ojha, reported in AIR 1998 SC 659, he submits that the word ‘dependent’ used in the definition of ‘family’ under the Rules of 2013, includes both financial and physical. Mother of petitioner is physically and financially dependent upon the petitioner and therefore, the petitioner is entitled for reimbursement of medical bills. Denial of medical reimbursement to petitioner for treatment of his mother aged about 68 years, is violative to Articles 14 & 21 of the Constitution of India. Dependency cannot be only financial but element of dependence also ways equally when the factor of dependency is to be judged. Order dated 8.9.2020 rejecting claim of medical reimbursement is liable to be quashed. He also placed reliance on the order dated 12.10.2015 passed by Division Bench of this Court in WPS No.3244/2015.

4. Learned State Counsel opposing submissions of learned counsel for the petitioner, would submit that petitioner being employee of the Police Department is a government servant. Reimbursement of medical expenses for government employees governs by the Rules of 2013. Mother of pet

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