2008 Supreme(P&H) 1003
PUNJAB & HARYANA HIGH COURT
Hemant Gupta and Mohinder Pal JJ.
Sunita Rani
Versus
Union Of India
Decided On : MAY 8, 2008
Follow-up treatment should be considered an integral part of indoor treatment, entitling the petitioner to medical reimbursement.
Headnote:
Medical Reimbursement - Follow up treatment of heart surgery - Central Service (Medical Attendance) Rules, 1944 - Ravi Kant v. The State of Haryana and Ors.
Fact of the Case:
The petitioner, widow of a Class III employee, sought reimbursement for post heart-surgery treatment. The Tribunal dismissed her application citing lack of provision under Central Service (Medical Attendance) Rules, 1944, after the employee's death.
Finding of the Court:
The court held that the petitioner is entitled to medical reimbursement for follow-up treatment of heart surgery, considering it as an integral part of indoor treatment.
Issues: The main issue was whether the petitioner is entitled to medical reimbursement for post heart-surgery treatment after her husband's death.
Ratio Decidendi: The court relied on the case of Ravi Kant v. The State of Haryana and Ors., where it was held that follow-up treatment should be considered an integral part of indoor treatment, entitling the petitioner to medical reimbursement.
Final Decision: The writ petition was allowed, the Tribunal's order was quashed, and the petitioner was held entitled to medical reimbursement for follow-up treatment of heart surgery regularly.
Mohinder Pal, J.
1. The prayer made in this petition is for quashing the order dated October 22, 2003 (Annexure P-11) passed by the Central Administrative Tribunal, Chandigarh Bench, Chandigarh (for short the Tribunal), vide which Original Application No. 94-HR of 2003 filed by petitioner Sunita Rani, who is widow of Vijay Kumar, a Class III employee in the office Garrison Engineer (North), M.E.S., Ambala Cantt (respondent No. 3), for medical reimbursement on account of post heart-surgery treatment she underwent in Post Graduate Institute of Medical Education and Research, Chandigarh, (for short P.G.I.) has been dismissed and for issuing a direction to the respondents to make payment of the expenses incurred by her in this connection.
2. The petitioner was operated upon for heart surgery in P.G.I. on October 04, 1996. She was reimbursed the medical expenses for the same. It is pleaded that she was also being reimbursed the post surgery medical expenses till her husband was alive. Husband of the petitioner died on July 06, 2001. The petitioner requires regular medicines amounting to Rs. 1,500/- to Rs. 2,000/- per month. She submitted bills of her follow-up-treatment to the respondent-department, which were not paid to her on the ground that clarification was being sought from the Headquarters. She per force filed Original Application before the Tribunal, which was dismissed.
3. In the written statement filed by respondents Nos. 1 to 3, it has been stated that reimbursement for follow up treatment cannot be made as there is no such provision under Central Service (Medical Attendance) Rules, 1944, after the death of the person, who was employed with the respondents. It has been further pleaded that the petitioner is entitled to Rs. 100/- per month as fixed medical allowance in pursuance of the recommendations of the 5th Pay Commission. Further that a Government Servant, who is residing in a city where Central Government Health Scheme (for short C.G.H.S.) is applicable, would be entitled to complete benefit and medical reimbursement. Since there is no such provision for reimbursement of medical expenses in the case of family pensioner, the petitioner is not entitled to any benefit of medical reimbursement.
4. Learned Counsel for the petitioner has argued that medicines being regularly consumed by the petitioner after her heart surgery are most essential for her survival and reimbursement of the same cannot be declined merely on the ground that she is getting treatment as an outdoor patient. In the case of Ravi Kant v. The State of Haryana and Ors., wherein similar controversy i.e. as to whether, after kidney transplant of an employee/dependent, he/she is entitled to reimbursement of medical expenses incurred for post operative medical treatment, came up for consideration, a Division Bench of this Court observed as under:
It has been submitted that only a person who receives treatment as an indoor patient, is entitled to be reimbursed, may be that he is in receipt of fixed medical allowance as per the medical reimbursement rules as applicable to him. It has been submitted that as the petitioner is alleged to have taken treatment as an outdoor patient, he cannot claim reimbursement. It is true that the petitioner will not be entitled to reimbursement for this treatment if we go by the strict definition of Indoor and outdoor patients. If we go by the strict definition of indoor and outdoor patient, the petitioner will not be an indoor patient. Fixed medical allowance to the tune of Rs. 100/- is meant to compensate the employee/his family only for the treatment of casual diseases. Intention behind the provision of providing fixed medical allowances does not seem to be that employee/his family should not be compensated for such diseases which can prove fatal if consistency in treatment is not observed. It would bear repetition that petitioner is constantly taking medicines, he is on medicines he has to take medicines daily. If