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1999 Supreme(Mad) 1126
High Court of Judicature at Madras
THE HONOURABLE MR. JUSTICE E. PADMANABHAN
Dr. B. Ramamurthy
Versus
The Government of Tamil Nadu, rep. by its Secretary & Another
Writ Petition No.7071 of 1999, W.M.P.No: 10167 of 1999
Decided On :Decided on : 02-11-1999
For the Petitioner:Kandavadivel Doraisami, Advocate.
For the Respondents: M. Kandasamy, Spl.G.P.
The denial of reimbursement of actual medical expenses incurred by a Government servant for treatment not available in Government Hospitals, while reimbursing the entire cost of treatment for another Government servant who underwent the same treatment at the same hospital, is arbitrary, discriminatory, and violative of Articles 14 and 21 of the Constitution of India.
Headnote:
MEDICAL REIMBURSEMENT - DISCRIMINATION - ARTICLE 14 AND 21 - TAMIL NADU GOVERNMENT EMPLOYEES HEALTH FUND SCHEME - ACTUAL EXPENDITURE - PRIOR APPROVAL - URGENCY - CHIEF MINISTERS RELIEF FUND - MAGNANIMITY - INTEREST ON BELATED PAYMENT
Fact of the Case:
The petitioner, a member of the Tamil Nadu Medical Service, sought reimbursement of Rs. 6,18,969.41 incurred for his wife's medical treatment at Apollo Cancer Hospital, Chennai. The respondents sanctioned only Rs. 1 lakh under the Tamil Nadu Government Employees Health Fund Scheme, citing the maximum limit of Rs. 1 lakh or 75% of the actual expenditure, whichever is higher. The petitioner argued that the treatment was not available in any Government Hospital and that the respondents had reimbursed the entire cost of treatment for Dr. J. Rajappa, the then Director of Medical Education, who had undergone the same treatment at the same hospital.
Finding of the Court:
The court found that the treatment undergone by the petitioner's wife and Dr. Rajappa was identical and that the distinction sought to be made by the respondents was not justified. It also noted that the petitioner had applied for reconsideration and increase in the financial assistance, but the respondents had rejected the application without considering the identical treatment and sanction given to Dr. Rajappa.
Issues: 1. Whether the petitioner is entitled to reimbursement of the entire amount incurred for his wife's medical treatment? 2. Whether the respondents' denial of reimbursement of the actual expenditure is arbitrary and discriminatory?
Ratio Decidendi: 1. The court held that the petitioner was entitled to reimbursement of the entire amount incurred for his wife's medical treatment, as the treatment was not available in any Government Hospital and the respondents had reimbursed the entire cost of treatment for Dr. Rajappa, who had undergone the same treatment at the same hospital. 2. The court held that the respondents' denial of reimbursement of the actual expenditure was arbitrary and discriminatory, as it violated Articles 14 and 21 of the Constitution of India.
Final Decision: The court allowed the writ petition, quashed the impugned order, and directed the respondents to consider the petitioner's claim for reimbursement of the entire amount incurred for his wife's medical treatment under any one of the schemes, including the scheme of reimbursement under the Chief Ministers Relief Fund.
The writ petitioner, a member of the Tamil Nadu Medical Service prays for the issue of writ of certiorarified mandamus calling for the records of the second respondent in his proceedings No. 24447/A2/297 dated 16.12.1998 quash the same and consequently direct the respondents toj forthwith reimburse Rs. 5,18,969.41, the balance of J the amount incurred by the petitioner for Medicall Treatment of his wife at Apollo Cancer Hospital, Chennai.
2. This Court ordered notice of motion on 22.4.1999. The respondents have been served and they have filed their counter affidavit. With the consent of counsel for either side the writ petition itself is taken up for final disposal. The petitioner states that his wife Mrs. Manjula Ramamurthy was diagnosed to have Carcinoma of Right Breast in August 1996 and she underwent Mastectomy on 26.8.1996. The Biopsy of the Specimen showed infiltrating Ductal Carcinoma with 12 Positive Lymphondes in Right Axilla.
3. In view of the large number of positive Lymphondes and occurrence of the disease at younger age, she was categorised as high risk case for relapse with poor prognosis. On these grounds, the petitioners wife was advised high dose of Chemotherapy with Autologous Stem Cell Transplantation for better cure by a team of Oncologists in Apollo Cancer Hospital. The said treatment is not being undertaken in any Government Hospital in Tamil Nadu, and therefore, she underwent the said treatment in Apollo Cancer Hospital. After four cycles of conventional Chemotherapy Rejimen, she underwent high dose Chemotherapy with Autologuous Bone Marrow Transplantation.
4. The petitioner further states that the said treatment was started to his wife on 20.12.1998 in Apollo Cancer Hospital and she was discharged on 30.1.1997. The cost of the High Dose Chemotherapy with Autologous stem cell Translation amounts to Rs. 6,18,969.41 after deducting the concessions shown to him as Doctor.
5. The petitioner claimed reimbursement of Rs. 6,18,969.41 from the respondents. However, the 2nd respondent by his proceedings RS. No. 24447/A2/2/97 dated 27.10.1997 accorded sanction for payment of Rs. 1 lakh only. It is alleged that on the same day, the then Director of Medical Education by name Dr. J. Rajappa has written letter to the 1 st respondent to sanction fund for his bone marrow Transplantation from the Government Employees Health Fund and Chief Ministers Relief Fund and the entire amount spent by the said Dr. Rajappa for his Bone Marrow Transplantation had been sanctioned and reimbursed, mentioning the above fact, the petitioner made further representation and sought for reimbursement of the entire amount spent by him for his wifes medical treatment. But the same has been negatived by the first respondent and the same has been communicated to the petitioner on 24.12.1998.
6. The petitioner heavily relies upon the report of the Oncologist and Haematologist of the Apollo Hospital which would establish that the treatment given to his wife and to the then Director of Medical Education, namely Dr. Rajappa is one and the same. Hence, the ordering of reimbursement of Rs. One lakh only to the petitioner is arbitrary, offends Article 14 as well as 21 of the Constitution.
7. The petitioner claims that he had incurred an expenditure of Rs. 6,18,969.41 for his wifes medical treatment. But the same has been negatived without appreciating the difficulties and monetary expenses incurred by the petitioner. The action of the respondents is discriminatory and the impugned proceedings has been passed without application of mind. The petitioner having no other remedy has approached this Court.
8. A Counter affidavit has been filed on behalf of the respondents by the Deputy Secretary to the Government. As seen from the counter affidavit, the claim of the petitioner that specialised chemotherapy treatment is not available in any Government hospital is not correct as Chemotherapy treatment is available in the Government Hospital, Chennai.
