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2004 Supreme(Del) 1184

High Court Of Delhi
J.K.SAXENA - Appellant
Versus
GOVERNMENT OF NCT OF DELHI - Respondent
W.P.(C.) 5015 of 2003
Decided On : 12/16/2004

Advocates Appeared:
ARUN ARORA, AVINISH AHLAVAT, T.S.Ahuja

Government servants are entitled to reimbursement for medical treatment received at recognized hospitals under the Central Services (Medical Attendance) Rules.

Headnote:

Medical Reimbursement - Government Servant - Entitlement to Treatment - Interpretation of Central Services (Medical Attendance) Rules

Fact of the Case:

The petitioner, a government servant, sought reimbursement for medical treatment received at recognized hospitals. The respondent denied payment of the balance amount, claiming that the petitioner was not entitled to it as a retired employee.

Finding of the Court:

The court found that the petitioner was entitled to reimbursement of the full amount based on the interpretation of the Central Services (Medical Attendance) Rules and previous case law.

Issues: The main issue was the entitlement of the government servant to medical reimbursement for treatment received at recognized hospitals.

Ratio Decidendi: The court interpreted the Central Services (Medical Attendance) Rules and relied on previous case law to establish the petitioner's entitlement to full reimbursement.

Final Decision: The court allowed the petition and directed the respondent to pay the balance amount of Rs. 36,000 to the petitioner, with the petitioner also being entitled to interest at 9% per annum if the payment was not made within six weeks.

Manmohan Sarin, J.

( 1 )

( 2 ) THE matter had been adjourned on 3. 11. 2004 to enable the respondent to seek instructions, if the reimbursement could be made to the petitioner of the balance amount of Rs. 36,000/ -. Counter affidavit has been filed by the respondent. The plea taken in the counter affidavit to deny the payment is that respondent has reimbursed the package amount payable under the policy of rs. 1,04,900/-, which was due in terms of Office Memorandum dated 9. 9. 1999. It is averred that reimbursement has been made of Rs. 1,04,900/- inclusive of the package of Rs. 99,000/- and the balance amount of Rs. 36,000/-, petitioner was not found entitled to by the Competent Authority, being a retired employee.

( 3 ) THE facts are not in dispute. Petitioner, in November, 1999 had felt chest pain and was given treatment at the Clinical Research Centre V. P. Chest institute. Thereafter, he had cardiac attack on 6. 1. 2000 and was admitted in emergency of St. Stephen Hospital and given treatment. Petitioner had also reported to G. D. Dispensary, Model Town, recognised by the Delhi Government, which advised the petitioner to go to a Government recognised hospital. Be that as it may, petitioner was referred to the National Heart Institute for open heart surgery, which is a recognised empanelled hospital of the respondent. Under the Central Services (Medical Attendance) Rules,the Government servant is entitled for treatment free of charge at the Government or empanelled hospital for special treatment.

( 4 ) REFERENCE may be invited to the decision of this Bench in V. K. Gupta v. Union of India, reported at 97 (2002) Delhi Law Times 337, and a decision of the division Bench in Sqn. Commander Randeep Kumar Rana v. Union of India, III (2004) DLT 473 (DB ). The Division Bench in the above cited case had, while dealing with the amount charged in excess than the package rate held as under: "now we come to the plea which has been taken by the respondent in the counter affidavit. It has been contended in para 11 of counter affidavit that it is the duty of the citizens to see and ensure that such recognised hospitals do not charge excess of the package rates. How a citizen can ensure that a hospital does not charge over and above the package rate. The power to lay down guidelines is with the respondent. A citizen is a mere spectator to what State authority do and decide. If the hospital has charged over and above the package rate, the respondent is under an obligation to pay such charges as the petitioner has incurred over package rates at the first instance and if in law State can recover from the hospital concerned they may do so but they cannot deny their liability to pay the government employee, who is entitled for medical reimbursement. " in view of fne foregoing dictum, as laid down by the Division Bench petitioner is entitled to reimbursement of the full amount. A writ of mandamus shall issue to the respondent to pay the balance amount of Rs. 36,000/- to the petitioner within six weeks from today. In case, payment is not made petitioner would also be entitled to interest @ 9 % per annum on the aforesaid amount in future. Petition is allowed in the above terms petition allowed.

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