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2005 Supreme(Raj) 985

Rajasthan High Court
Honble R.P. VYAS, J.
Laxman Taneja - Appellant
Versus
State of Rajasthan & Others - Respondents
S.B. Civil Writ Petition No. 4446 of 2002
Decided On : April 13, 2005

Advocates Appeared:
Kuldeep Mathur, for Petitioner Rameshwar Dave, Deputy Government Advocate, for Respondents

Headnote:Rajasthan State Pensioners Medical Concession Scheme – Denial of medical reimbursement – Scheme amended – Pensioners and their family members were made entitled to financial assistance for specialised treatment taken in Govt. hospitals within the State of Rajasthan only – Petitioners wife under gone treatment of Mitral valve Replacement operation out side the State in private hospital – Held – It amounts to denial of fundamental right of life and self preservation enshrined in Art. 21 – When a person explains reasons for getting the treatment in a private hospital, the reimbursement should not be denied only on some hyper technical grounds and relaxation should be given in such matters – Entitled to 80% medical expenses or Rs. 1.20 Lac whichever is less. (Paras 25 to 29)

       Pathetic conditions of Government hospitals is well known and the same has been admitted by the Government machinery also time and again. Under the circumstances, when a person explains reasons for getting the treatment in a private hospital, the reimbursement should not be denied only on some hyper technical grounds. The Government must give relaxation in such matters. Apart from that, to preserve health and obtain medical aid in furtherance of self preservation is part of right of life under Article 21 of the Constitution of India and, in given circumstances, the petitioner is also entitled for reimbursement of medical expenses, irrespective of the place where the treatment has been received. (Para 26 & 27)

Honble VYAS, J.–The instant writ petition has been filed by Shri Laxman Taneja-petitioner praying therein that by an appropriate writ, order or direction, the amendment dated 21.11.2002 made in the Rajasthan State Pensioners Medical Concession Scheme (hereinafter referred to as `the Medical Concession Scheme), whereby a pensioner and members of his family have been declared entitled for grant of financial assistance in respect of specialized treatments taken in a Government hospital within the State of Rajasthan only, may be declared illegal, so far as it restricts grant of financial assistance in respect of specialized treatments taken in the Government hospital within the State of Rajasthan. It has further been prayed that by an appropriate writ, order of direction, the respondents may be directed to provide financial assistance to a pensioner and the members of his family in respect of specialized treatments taken in a Government hospital within the State of Rajasthan or from any other hospital where such specialized treatment is available. It has also been prayed that by an appropriate writ, order or direction, the order dated 5.6.2002 (Annexure 6), passed by Respondent No. 4-Treasure, officer of the Treasure, Collectorate, Barmer-rejecting claim of the petitioner for medical reimbursement, may be declared illegal. Lastly, it has been prayed that by an appropriate writ, order or direction, the respondents may be directed to provide financial assistance to the petitioner for specialized treatment taken by his wife as per the bill submitted by him for medical reimbursement.

(2). Brief facts giving rise to the instant petition are that the petitioner was retired from service on February 27, 2001. At the time of his retirement, he was holding the post of Assistant Engineer in Indira Gandhi Nahar Pariyojana.

(3). After retirement, the respondents under Rule 244 (1) of the Rajasthan Service Rules (hereinafter referred to as `the R.S.R.), issued Pension Payment Order (PPO) No. 432212 dated 27.9.2001 (Annexure 1) in favour of the petitioner.

(4). The wife of the petitioner-Smt. Raj Kumari Taneja is suffering from heart disease and had undergone Mitral Valve Replacement Operation (for short, `MVR) in the year, 1986, at Bombay.

(5). The State Government, on 21.11.2001, issued Order No. F.1 (5)/Rules/98 (Annexure 2) making certain amendments in the Rajasthan State Pensioners Medical Concession Scheme, whereby pensioners and their family members have been held entitled for grant of financial assistance in respect of the following specialized treatments taken in the Government Hospitals within the State of Rajasthan:-

S. No. Name of Specialized. Scale of Assistant.

1. By-pass Surgery. 80% of the hospitals expenses or Rs. 1.20 Lacs whichever is less.

2. Open-Heard Surgery. 80% of the hospital expenses or Rs. 1.20 Lacs whichever is less.

3. Valve-Replacement. 80% of the hospital expenses or Rs. 1.20 Lacs whichever is less.

4. Implantation of pacemaker. 80% of the cost of pace maker including its accessories of Rs. 28000 whichever is less.

5. Angioplast/Ballonplasty. 80% of the hospital expenses or Rs. 40000/- whichever is less.

(6). A bare perusal of the above Scheme clearly reveals that a Pensioner is entitled for grant of financial assistance in respect of specialized treatment taken in a Government hospital up to 80% of the hospital expenses or Rs. 1.20 Lacs whichever is less.

(7). The wife of the petitioner fell sick on 28.1.2002 due to her heart problem and as an emergency case, she was admitted in Fortist Heart Institute, Mohali (Punjab).

(8). After diagnosis, she was suggested MVR operation. Thus, to save her life the petitioner got her operated in Fortist Heart Institute, Mohali, on 4.2.2002. The patient remained hospitalized from 28.1.2002 to 11.2.2002. Dr. H.S. Bedi of the Fortist Heart Institute, Mohali has also issued a Certificate (Annexure 3) to this effect.

(9). The petitioner spent a sum of Rs. 2,72,804/- on the treatment of his wife a



































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