The main legal point established is that the department is obligated to reimburse the amount for medical treatment undertaken in a private or unrecognized hospital, to the extent permissible under the Rules governing the same.

JUDGMENT

1. The present writ petition has been filed by the petitioner, who is a retired government employee with the prayer for reimbursement of the medical claims qua the treatment of the petitioner's wife pertaining to replacement of both knees at Ahmedabad.

2. Briefly stated facts of the case are that petitioner along with his wife had gone to Ahmedabad to meet their relatives where she developed acute pain in her legs and was advised to undergo knee-replacement surgery by the doctors of Apollo Hospital, Ahmedabad (Gujarat). The petitioner was admitted for operation on 11.04.2013 and remained admitted till 17.04.2013. A sum of Rs. 4,25,000/- was incurred for both knee-replacement surgery underwent by the petitioner. The petitioner submitted medical bills along with necessary documents for reimbursement to the department. The respondent department vide order dated 05.09.2014, rejected the request for reimbursement on the ground that the same is not covered under Rajasthan Civil Services (Medical Attendance) Rules, 2008.

3. Aggrieved by this, the present writ petition has been preferred. Learned counsel for the petitioner submitted that in an emergent situation, the petitioner underwent both knee- replacement on 12.04.2013 at Apollo Hospital, Ahmedabad, Gujarat. Counsel further submitted that denial of reimbursement of the medical bills deserves to be declared illegal and arbitrary by this Court. Reliance was placed on a judgment of this Court in Raghuveer Sharma v. State of Rajasthan & Ors. reported in (2007 WLC (Raj.) UC 516. In the aforesaid case, the Court has held as under:-

"prime consideration in case of grave emergency, which comes in the mind of family is to save the life of patient and at that point of time whatever hospital comes to their mind and considered just is felt as the best because emergency knows no law and no procedure and when human life is at stake in such situation ultimately responsibility of State cannot be washed out. Technicalities of Rules and Regulations under the Scheme are not required to be followed just in a mechanical manner so as to frustrate very purpose of the Scheme because a person having put in his whole life in the service of the State till attains age of superannuation always require human considerations."

4. Per contra, learned counsel for the respondents submitted that an employee is not permitted to undergo treatment in a private hospital without any emergent situation. Counsel submitted that the claim for reimbursement of expenses incurred in the treatment undertaken at Apollo Hospital, Ahmedabad had rightly been rejected as the procedure prescribed under the Medical Attendance Rules, 2008 was adhered to by the petitioner.

5. Heard learned counsel for the parties and perused the material available on record.

6. A coordinate Bench of this Court in the case of Mool Singh v. the State of Rajasthan & Ors. in S.B. C.W. No.5592/2018 vide order dated 09.09.2022 pleased to hold as under:-

"The medical claim qua the said amount was raised before the respondent Department but the same was rejected on the ground that the petitioner has not shown any emergent situation wherein his wife was required to be treated in the private hospital i.e. SAL Ahmedabad. In Surjit Singh v. State of Punjab and Ors. reported in AIR 1996 SC 1388, decided on 31.01.1996, the Hon'ble Apex Court held as under:-

"10....... In such an urgency one cannot sit at home and think in a cool and calm atmosphere for getting medical treatment at a particular hospital or wait for admission in some Government medical institute. In such a situation, decision has to be taken forthwith by the person or his attendants if precious life has to be saved. We share the views afore- expressed"

7. In Rama Prasad Sharma v. State of Rajasthan & Ors.; S.B.C.W.P. No.7469/2016, decided on 21.01.2022, passed by this Court, it was held as under:-

"............ It is now a settled position of law that even in cases where the treatment of an employee has