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2009 Supreme(Mad) 4415
High Court of Judicature at Madras
THE HONOURABLE MR. JUSTICE V. DHANAPALAN
D. Sundaram
Versus
Government of Tamil Nadu, rep. by Secretary to the Government, Pay Finance (Pension) Department, Chennai & Others
W.P. No.6317 of 2009
Decided on: 26-10-2009
For the Petitioner:R. Saseetharan, Advocate.
For the Respondent:S. Siva Shanmugam, Government Advocate.
Ratios:
a. Reimbursement of medical claims of the retired Government servant is an obligation of the Government and also a constitutional mandate
b. State is having Constitutional obligation to provide and bear medical expenses of its employees.
Headnote:(A)Service-Government service-Pensioners-Medical reimbursement-Approved hospital-Fundamental right-Right to health-Petitioner is a pensioner and a member of State health fund-For his injury, he underwent treatment in a hospital-Respondent refused to reimburse the expenses by saying that the hospital was not an enlisted one and the disease was not covered by the scheme-Petitioner challenged the order-Held, Right to health is a part of fundamental right to life and the Government servant is entitled to maintain his health by getting reimbursement of his medical expenses. Rejection of reimbursement claim on the ground that the hospital from which the petitioner got treatment was not enlisted one is not a valid ground-Writ petition allowed.
(B)Service-Government service-Pensioners-Medical reimbursement-Fundamental right-Right to health-Reimbursement of medical claims of the retired Government servant is an obligation of the Government and also a constitutional mandate
In respect of payment of reimbursement of such medical claims, it is not bounty, but it is an obligation of the Government, especially, when the petitioner being the pensioner, subscribing to the Health Fund and it is also a constitutional mandate. Para 4
(C)Service-Government service-Pensioners-Medical reimbursement-Approved hospital-Right to health-State is having Constitutional obligation to provide and bear medical expenses of its employees.
The Government has constitutional obligation to provide health facilities. If the Government servant has suffered an ailment which requires treatment, it is the duty of the State to provide and bear the expenditure.
Para 4
This writ petition is filed challenging the orders of the 2nd respondent dated 6. 2008 and 8. 2008, respectively, and for a consequential direction to the respondents to reimburse an amount of Rs. 48,048/- incurred towards the treatment undergone by the petitioner at Vasudeva Vilasam Nursing Home, Trivandrum, State of Kerala for ailment in spinal cord.
2. The petitioner worked as Primary School Headmaster at Navalakkampatti, Kovilpatti Panchayat Union, Thoothukudi District and retired from service and is receiving pension from the Government of Tamil Nadu. He suffered pain at spinal cord and he underwent treatment at Vasudeva Vilasam Nursing Home, Trivandrum, State of Kerala between 210. 2007 and 211. 2007 for a period of 31 days. The doctor diagnosed his ailment as spinal cord degeneration, bulging and stenosis and gave treatment. He incurred an expenditure of Rs. 48,048/-. Since the petitioner is the subscriber to the Tamil Nadu Pensioners’ Health Fund, he claims medical reimbursement of the above expenditure. In that regard, he made a representation to the 2nd respondent on 112. 2007. The 2nd respondent rejected the said claim on the basis that (1) the Hospital in which treatment/surgery undergone is not found in the accredited list of the references cited and (2) the surgery/treatment undergone is not found in the list of specialised surgery/treatment of the references cited.
3. The issue involved in this writ petition viz., the treatment undergone by a pensioner from a hospital which is not accredited or the nature of treatment not enlisted, has been decided by this Court on many occasions by holding that such a refusal is an arbitrary exercise of powers apart from holding that the nature of treatment to a patient to be decided by the doctor and that cannot be curtailed by any condition that only a certain type of treatment should be taken. In a decision in the case of Ramalinjam v. Director of Collegiate Education, (2006) 3 MLJ 641 : 2006 (4) CTC 832, it was held that the medical claim cannot be denied merely because the name of the hospital is not included in the Government Order. The real test must be a factum of treatment before the medical claim is honoured. The same was followed subsequently in a decision in the case of C. Nagamuthu v. State of Tamil Nadu and Others. (2006) 2 MLJ 747 : (2006) 3 L.W. 529.
4. In respect of payment of reimbursement of such medical claims, it is not bounty, but it is an obligation of the Government, especially when the petitioner being the pensioner, subscribing to the Health Fund and it is also a constitutional mandate. With reference to right to life under Article 21 of the Constitution of India, it was held by the Supreme Court in consumer Education and Research Centre and Others v. Union of India and Others AIR 1995 SC 922: (1995) 3 SCC 42 : 1995-II-LLJ-768, that right to health to a worker is an integral facet of meaning full right to life. The Government has constitutional obligation to provide health facilities. If the Government servant has suffered an ailment which requires treatment, it is the duty of the State to provide and bear the expenditure.
5. In view of the settled legal position, the impugned orders of the 2nd respondent issued on 6. 2008 and 8. 2008 are set aside and the writ petition stands allowed with a direction to the respondents to reimburse the amount of medical expenses incurred by the petitioner, expeditiously, in any event, within a period of four weeks from the date of receipt of a copy of this order. No cost.
Petition allowed.
