2003 Supreme(Raj) 719
Rajasthan High Court Jaipur Bench
Honble ASHOK PARIHAR, J.
V.P. Saxena - Appellant
Versus
State of Rajasthan & Ors. - Respondents
S.B. Civil Writ Petition No. 2645 of 2000
Decided On : August 18, 2003
S.P. Sharma, for Petitioner M. Rafiq, AAG for Respondents
Headnote:Rajasthan State Medical Pensioners Concession Scheme, Para 4(A)(1) – Reimbursement of medical Expenses – Pensioner – Recommended for heart surgery at AIIMS, New Delhi – The Doctors in AIIMS were on strike – In emergent circumstances had to undergo surgery at Escort Hospital – Refused to reimburse the expenses as per rules – Held – Compelling circumstances – Pensioner is entitled to reimbursement of 80% of the hospital expenditure or Rs. 1.20 lacs which is less as per para 4(A)(1) – Denial is arbitrary, unreasonable and unjust – Directed to reimburse upto Rs. 1.20 lacs within 30 days. (Paras 5 to 7)
There could not have been any justification for laying down two different criterias for government servants who are still in service and those who have retired and getting pension. However, the State Government, in the given circumstances, could have given exemption under the emergent circumstances under which a person has to go for such operation. (Para 5)
(2). It has been submitted on behalf of the petitioner that as per order dated 12.5.1998 certain amendments were made in the Rajasthan State Medical Pensioners Concessions Scheme thereby the existing words and figures ``@ 80% of hospital expenditure or Rs. 50,000/- whichever is less, appearing in Sub-para (1) of Para 4 (A) were substituted by the words and figures ``@ 80% of hospital expenditure or Rs. 1.20 lacs whichever is less. It was only as per the above amendment made in the Medical Concession Scheme, the petitioner has claimed Rs. 1.20 lacs as reimbursement of his medical expenses incurred on the heart operation conducted at the Escorts Hospital, New Delhi.
(3). In reply to the writ petition it has been submitted that as per clarification made vide Circular dated 3.3.1999, if a government servant or retired government servant at his own wanted to get himself treated at a private Medical Institute, he shall be entitled to reimbursement of the expenses equivalent to what is spent on such treatment in All India Institute of Medical Sciences and the difference shall have to be borne by the patient. It has further been submitted that as per the estimate submitted by the petitioner, the expenses for subject treatment in the AIIMS was only Rs. 70,000/- and on that basis, the petitioner was entitled to 80% of the said amount i.e. Rs. 56,000/-, which has already been paid to the petitioner.
(4). There is no dispute that the Escorts Heart Hospital, New Delhi is on the approved list of the State Govt. for those employees who are already in service. However, strangely the same has not been approved for the pensioners. Be that as it may, in the present case admittedly the petitioner was recommended for heart operation to AIIMS. However, due to strike in the AIIMS, there was no option for the petitioner but to get himself operated at Escorts Heart Hospital, New Delhi. It was not the personal choice of the petitioner to go for operation at Escorts Heart Hospital, New Delhi. Under the compelling circumstances, the petitioner had to get operated at Escorts, which is also on the approved list of the State Government.
(5). Even otherwise, the Circular dated 3.3.1999 as relied on by the respondents, was issued after the operation already having been conducted on the petitioner on 23.2.1999. There could not have been any justification for laying down two different criterias for government servants who are still in service and those who have retired and getting pension. However, the State Government, in the given circumstances, could have given exemption under the emergent circumstances under which a person has to go for such operation.
(6). A Division Bench of this court in the case of Shankar Lal vs. State of Rajasthan (1), has also observed that denial of reimbursement of expenses incurred on medical evidence and treatment bonafide and genuinely by the public servant for availing treatment for himself or any member of his family at recognised hospital/institution in the circumstance like the present case on such technical grounds shall be clearly arbitrary, unreasonable and unjust.
(7). After having carefully consider