Back
IN THE HIGH COURT OF JUDICATURE FOR RAJASTHAN BENCH AT JAIPUR
ANOOP KUMAR DHAND, J.
Amar Singh, S/o. Shri Kalyan Singh - Appellant
Versus
State of Rajasthan & Ors. - Respondents
S.B. Civil Writ Petition No. 6457 of 2007
Decided On : 28-02-2023
MEDICAL REIMBURSEMENT - RAJASTHAN MEDICAL ATTENDANCE RULES - PRIOR RECOMMENDATION/REFERENCE FROM MEDICAL BOARD NOT REQUIRED IN EMERGENT SITUATIONS - RIGHT TO LIFE AND HEALTH - GOVERNMENT'S CONSTITUTIONAL OBLIGATION TO PROVIDE HEALTH FACILITIES.
Fact of the Case:
The petitioner, a government employee, suffered a heart attack and underwent open-heart surgery in an out-of-state hospital in an emergent condition. He applied for reimbursement of medical bills but was denied on the ground that he did not obtain prior recommendation/reference from a Medical Board as required by the Rajasthan Medical Attendance Rules.
Finding of the Court:
The court held that the requirement of prior recommendation/reference from a Medical Board is arbitrary and unjustified in emergent situations. It violates the right to life and health guaranteed under Articles 21 and 47 of the Constitution of India. The court also held that the government has a constitutional obligation to provide health facilities to its employees.
Issues: 1. Whether prior recommendation/reference from a Medical Board is essential for reimbursement of medical expenses incurred in an out-of-state hospital. 2. Whether the requirement of prior recommendation/reference is arbitrary and unjustified in emergent situations.
Ratio Decidendi: 1. The court relied on the Supreme Court's decision in State of Punjab and Ors. v. Mohinder Singh Chawla and Ors., where it was held that the government has a constitutional obligation to provide health facilities. 2. The court also relied on the Supreme Court's decision in Shiva Kant Jha Vs. Union of India (UIO), where it was held that the right to medical claim cannot be denied merely because the name of the hospital is not included in the Government Order. 3. The court further relied on its own decision in Hardev Ram Kaler (Dr.) Vs. State of Rajasthan and Anr., where it was held that the condition of prior recommendation/reference from a Medical Board is illegal and unjustified.
Final Decision: The court directed the respondents to reimburse the petitioner's medical expenses incurred in the emergent situation. The court also directed the Chief Secretary of the State of Rajasthan to constitute a Secretary-Level-High Powered Committee in all the Departments of the State for quick disposal of such cases.
JUDGMENT :
1. Hon’ble Apex Court in the case of Ex-Capt. Harish Uppal vs. Union Of India & Anr., reported in 2003 (2) SCC 45 has held that the Court is under an obligation to hear and decide the cases brought before it and it cannot shirk that obligation only because the lawyers have decided to abstain from the judicial work.
2. Dispensing justice is the fundamental raison d’etre of the judicial system. Timely delivery of justice is indispensable to retaining the faith of the common man in the justice dispensation system. Delay in getting rightful claim gradually declines the citizenry faith in the system. It is the faith and faith alone that keeps the system alive. It provides oxygen constantly. Timely delivery of justice keeps the faith ingrained and establishes the sustained stability. Access to justice is regarded as a human right which is deeply rooted in the foundational concept of democracy and such a right is not only the creation of law but also a natural right. And the instant case is a glaring example where the petitioner, who is a Government employee took treatment of open heart surgery in a recognized hospital out of State in the year 1999 in emergent conditions to save his life but he was denied to get the amount of the medical bills expended in his treatment and he has failed to get reimbursement of these medical bills even after expiry of 24 years.
3. Looking to the short controversy involved in this case, this Court thought it proper to peruse the file and decide the matter on merits.
4. Briefly stated facts of the case are that the petitioner (who expired during pendency of this writ petition) was posted as Police Inspector at Police Station Pratapgarh and he suffered heart attack on 07.06.1999, he was taken to SMS Hospital, Jaipur where his heart rate was found as “EF 20%”. Since his treatment was not possible immediately at SMS Hospital, Jaipur he was taken to Delhi and looking to the serious condition of the petitioner, his open heart surgery was conducted in the Escorts Heart Institute and Research Centre, New Delhi on 19.08.1999 in which the petitioner expended a sum of Rs.2,72,965/-. After recovery, the petitioner applied on 06.10.1999 for reimbursement of medical bills before the respondent authorities amounting to Rs.2,72,965/-. The bills were returned on 14.03.2007 with an assertion that treatment was taken out of State without any recommendation made by the Medical Board of SMS Hospital Jaipur. As per the averments mentioned in the reply, the petitioner did not under went the medical treatment, as prescribed by the Rules. As per the provisions of the Rajasthan Medical Attendance Rules, the medical expenses are reimbursable for treatment out of State only in the condition when the patient is referred by the SMS Hospital, Jaipur and a fixed amount is also determined for reimbursement of such medical expenses. Since the petitioner did not adhere to the prescribed procedure for getting the treatment out of State and therefore amount of Rs.2,72,965/- as medical expenses is not reimbursable.
5. Hon’ble Apex Court in the case of Surjit Singh Vs. State of Punjab and Ors. reported in 1996 (2) SCC 336 has held that under an emergent situation one cannot sit at home and think in a cool and calm atmosphere for getting the medical treatment at a particular hospital or wait for admission in some Government Medical Institute or seek reference by the Medical Board of authorized Hospital to get his treatment out of State.
6. It is well settled that the right of health is an integral to right to life. Their Lordships of Hon’ble Apex Court in the case of Surjit Singh (Supra) has held in para 10 as under:-
The requirement of prior recommendation/reference from a Medical Board for reimbursement of medical expenses incurred in an out-of-state hospital is arbitrary and unjustified in emergent situations. ....
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 th....
An indispensable Tool for Legal Professionals, Endorsed by Various High Court and Judicial Officers
Please visit our Training & Support
Center or Contact Us for assistance
Scan Me!
India’s Legal research and Law Firm App, Download now!
For Daily Legal Updates, Join us on :
Back to top
