Point of Law: This does not ipso facto mean that the choice to go to the ‘Appolo Hospital’ was his alone and Court certain that this would have been guided by the references and advice offered by the hospitals in Kerala.

JUDGMENT :

DEVAN RAMACHANDRAN, J.

1. The petitioner suffered a debilitating liver disease and was rushed to the Government Hospital for treatment in the year 2011. The said hospital found his condition grave and referred him to the ‘Amrita Institute of Medical Sciences’ at Ernakulam. After some treatment there, said hospital also found that it did not have enough facilities to deal with the problem faced by the petitioner and he was thus advised to go to another hospital; pursuant to which, he went to the ‘Appolo Hospital’ Delhi, where he was treated and became well, however, incurring an amount of nearly Rs. 20 lakhs as medical expenses.

2. When the petitioner applied for reimbursement under the applicable Rules, it was rejected solely saying that ‘Appolo Hospital’ is not a recognised one in the Medical Reimbursement Scheme and further that no prior permission had been taken for availing treatment there.

3. The petitioner thus impugns Ext.P12 order issued by the 1st respondent-State of Kerala and prays that its competent Authority be directed to reimburse him the entire amounts as claimed in Ext.P4 application, within a time frame to be fixed by this Court.

4. The afore submissions of Sri. Sajeev Kumar K. Gopal-learned counsel for the petitioner, were, however, controverted by Smt. Parvathy K. - learned Government Pleader, pointing out to Ext.P10, wherein, according to her, the petitioner has made an admission that he had approached the ‘Appolo Hospital’ directly, without a reference being made by either the Government Hospital or the ‘Amrita Hospital’. She submitted that, therefore, the question whether such a course could inure to him the medical reimbursement is doubtful and therefore, that Ext.P12 is irreproachable.

5. Even when I hear the learned Government Pleader as afore, the fact remains that the applicable Rules certainly condone a situation where a patient is rushed in an emergency and forced to avail treatment even in a non-recognized or nonregistered hospital.

6. In the case at hand, the incident happened in the year 2011, when surely our systems were far behind from what we see today. Therefore, no decision could have been taken by the 1st respondent without making a proper investigation as to whether the treatment availed of by the petitioner was absolutely necessary or whether he had any alternative in Kerala, except to rely on the expertise of the ‘Appolo Hospital’ in Delhi.

7. In that perspective, Ext.P10 request of the petitioner cannot be used against him because he honestly admits that since there were no hospitals in Kerala equipped to conduct liver transplantation in the year 2011 and that, considering his grave diagnosis, he was forced to approach the ‘Appolo Hospital’. This does not ipso facto mean that the choice to go to the ‘Appolo Hospital’ was his alone and I am certain that this would have been guided by the references and advice offered by the hospitals in Kerala.

8. In the afore circumstances, I cannot offer imprimatur to Ext.P12 and am firm that this matter will require to be reconsidered by the competent Authority of the Government without any further delay. Since the petitioner’s claim has been pending for more than 10 years, I am certain that reconsideration will have to be swift and concluded within a strict time frame.

9. Resultantly, I order this Writ Petition and set aside Ext.P12; with a consequential direction to the competent Authority of the Government to rehear the petitioner and to take a fresh decision on his application for reimbursement; thus culminating in an appropriate order and necessary action thereon, as expeditiously as is possible, but not later than three months from the date of receipt of a copy of this judgment.

10. Needless to say, while completing the afore exercise, the competent Authority will advert to the applicable Rules and Regulations and will also assess whether the urgency of the petitioner for medical treatment in the year 2011 was so grave that the obtention of a