Government employees are entitled to medical reimbursement for treatment in non-recognized hospitals at applicable rates for similar treatments in recognized hospitals.

Order :

ANOOP KUMAR DHAND, J.

1. By way of filing this writ petition, a prayer has been made for issuing directions to the respondents to make full reimbursement of the treatment expenses i.e. Rs.4,86,603/- towards the expenses incurred in the treatment of petitioner’s wife.

2. Learned counsel for the petitioner submits that the wife of petitioner was suffering from Kidney problem for which she required Renal Transplantation. Learned counsel submits that looking to the critical condition of his wife, a treatment was taken at Institute of Kidney & Research Centre Civil Hospital Campus, Ahmedabad where the petitioner incurred expenses of Rs.4,86,603/-. Learned counsel submits that after recovery of his wife, the petitioner submitted an application for disbursement of medi-claim before the State Authorities for the aforesaid amount but the same has been declined by the respondents on a technical count that the wife of the petitioner was not referred for her treatment in a private hospital. This treatment was available at SMS Hospital, Jaipur hence the petitioner is entitled to get Rs.50,000/-. Learned counsel submits that even the aforesaid amount has also not been disbursed to the petitioner. Hence, under these circumstances, the petitioner has approached this Court by way of filing this writ petition.

3. Per contra, learned counsel for the respondents opposed the arguments raised by learned counsel for the petitioner and submitted that the petitioner is not entitled to get the entire medi- claim in terms of Rule 10(3) of the Rajasthan Civil Services (Medical Attendance) Rules, 2008. Learned counsel submits that if any treatment is taken in an emergent situation, the Government may reimburse the medical expenses incurred in the treatment that would have been incurred at SMS Hospital. Learned counsel submits that, under these circumstances, the petitioner is not entitled to get entire medi-claim.

4. In support of his submissions, learned counsel for the respondents has placed reliance on the judgment passed by the co-ordinate Bench of this Court in the case of Moti Lal Gupta Versus State of Rajasthan & Others (S.B. Civil Writ Petition No.11939/2009)

5. Heard and considered the submissions made at Bar and perused the material available on the record.

6. This fact is not in dispute that the wife of petitioner was suffering from Kidney problem for which she required Renal Transplantation. This fact is also not in dispute that the aforesaid surgical treatment was taken by the petitioner at a private hospital which was not recognized by the Government.

7. Now the question which remains for consideration of this Court is whether the petitioner is entitled to get the entire payment or he is entitled to get the payment of bills as per rates applicable in approved hospitals.

8. The issue involved in this petition has already been set at rest by the Hon’ble Apex Court in the case of Shiva Kant Jha Vs. Union of India (UOI), reported in 2018 (16) SCC 187 as under:-

"It is a settled legal position that the Government employee during his life time or after his retirement is entitled to get the benefit of the medical facilities and no fetters can be placed on his rights. It is acceptable to commonsense, that ultimate decision as to how a patient should be treated vests only with the Doctor, who is well versed and expert both on academic qualification and experience gained. Very little scope is left to the patient or his relative to decide as to the manner in which the ailment should be treated. Speciality Hospitals are established for treatment of specified ailments and services of Doctors specialized in a discipline are availed by patients only to ensure proper, required and safe treatment. Can it be said that taking treatment in Speciality Hospital by itself would deprive a person to claim reimbursement solely on the ground that the said Hospital is not included in the Government Order. The right to medical claim cannot be denied merely because the nam