IN THE HIGH COURT OF GUJARAT AT AHMEDABAD
A.S. SUPEHIA, J.
JUGALI BALDEVJI VAGHELA – Petitioner
Versus
STATE OF GUJARAT – Respondent
Special Civil Application No. 17980 of 2016
Decided On : 08-03-2022
Constitution of India, 1950 – Article 226 – Writ petition, petitioner has prayed for relief – Held, Petitioner is challenging action of respondent no. 2 i.e. Director General of Police in refusing to reimburse medical expenditure of petitioner for reason that petitioner has not undergone treatment in certified or empanelled hospital – Held, Thus, in light of observations made by Supreme Court in case (supra), impugned communication is hereby quashed and set aside – Respondents are directed to reimburse medical expenditure of petitioner as per fees or charge of empanelled hospitals – Reimbursement amount shall be paid within a period of eight weeks from date of receipt of writ of this judgment – Aforesaid amount shall be paid with 6% interest – It is clarified that, if aforesaid amount is not paid within time stipulated by this Court, same shall carry an interest of 12%. – Petition allowed.
JUDGMENT :
A.S. SUPEHIA, J.
1. In the present writ petition, the petitioner has prayed for the following relief:
Or in the alternative.
To issue appropriate writ, order or direction quashing and setting aside the impugned order dated 07.07.2016 (Annexure-A) passed by the Respondent no. 2 herein and to further direct the respondents to reimburse the medical expenditure as he is entitled to as per the government notification wherein the petitioner should be reimbursed his medical expenditure till the extent of fees as charged by normal empanelled hospitals.”
2. The petitioner is challenging the action of the respondent no. 2 i.e. the Director General of Police in refusing to reimburse the medical expenditure of the petitioner for the reason that the petitioner has not undergone the treatment in the certified or empanelled hospital. Thus, it is the case of the respondent authorities that the petitioner is not entitled for medical reimbursement since he has not taken or undergone treatment from the empanelled hospital.
3. The respondent authorities are not disputing that the petitioner has in fact undergone the medical treatment in two hospitals i.e. Sai Shraddha Hospital at Nadiad and the Zydus Hospital at Anand.
4. Learned advocate Ms. Shweta Lodha appearing for the petitioner has submitted that while attending the marriage function on 29.02.2016 at Taluka Memdavad, the petitioner suddenly suffered a severe cardiac attack and he was immediately rushed to the nearest hospital being Sai Shraddha Hospital at Nadiad and accordingly, he received primary treatment, however, looking to the deteriorating health and critical condition of the petitioner, doctor referred the petitioner to another hospital having requisite technology and expertise and hence, the petitioner was shifted to Zydus Hospital at Anand, which was the closest super specialty hospital from Nadiad. She has submitted that the petitioner was kept in Intensive Care Unit (ICU) and thereafter, was discharged after taking the medical treatment.
5. Learned advocate Ms. Lodha has submitted that the petitioner applied for the reimbursement of medical expenditure incurred by him under the provisions of the Gujarat State Services Medical Treatment Rules, 2015 and submitted a detailed application with all hospital medical bills, reports and claimed reimbursement of Rs. 1,91,729/-. She has submitted that by the impugned order, the respondent authorities has refused to give the medical reimbursement only for the reason that the hospital, in which the treatment was taken by the petitioner, was not included or empanelled in the notification dated 24.08.2015. She has submitted that such action of the respondent is contrary to the proposition of law. Further, reliance is placed by her on the judgment of the Supreme Court in the case of Shiva Kant Jha vs. Union of India, (2018) 16 SCC 187. Thus, she has submitted that the impugned communication may be set aside and the respondents may be directed to reimburse the medical expenditure.
6. In response to the aforesaid submissions, learned AGP Mr. Rohan Shah has submitted that the impugned order does not require any interference since the petitioner admittedly did not take treatment in the empanelled hospitals, which are specified in the notification dated 24.08.2015. He has further submitted that there were also two hospitals like DZ Patel Cardiology Hospital at Nadiad and DDMM Heart Institute at Kheda, however, the petitioner did not undergo the treatment in the said empanelled hospitals and hence, the writ petition may not be entertained.
7. I have heard the learned advocates appearing for the respective parties.
8. The respondent a
The right to medical claim cannot be denied solely because the hospital is not included in the government order. The factum of treatment and supporting records certified by doctors/hospitals are cruc....
In emergency medical situations, full reimbursement of medical expenses is mandated regardless of any imposed ceiling limits, emphasizing the right to timely medical treatment.
Login now and unlock free premium legal research
Login to SupremeToday AI and access free legal analysis, AI highlights, and smart tools.
Login
now!
India’s Legal research and Law Firm App, Download now!
Copyright © 2023 Vikas Info Solution Pvt Ltd. All Rights Reserved.