In emergency cases, denial of reimbursement solely based on non-recognition of the hospital is unjust and unfair, emphasizing the right to life and the lack of options for government employees in emergency cases.

Vinod K. Sharma, J.

1. Avtar Singh petitioner by way of present writ petition has sought a writ of mandamus for re-imbursement of the medical expenses incurred for treatment of his wife at Sir Hurkisondas Nurrotumdas hospital and Research Centre, Mumbai for being operated upon and has also sought quashing of order dated 31.5.2005 vide which his claim was rejected by the managing Director, Uttar Haryana Bijli Vitran Nigam (hereafter called the nigam), Panchkula on the ground that the treatment was taken from a private hospital without taking advice of the authorities of the government hospital.

2. The facts leading to the filing of the present petition are that the petitioner is employed as Assistant Line Man in the office of the Sub divisional Officer of the Nigam at Chour Mastipur, Ambala. Wife of the petitioner, Smt. Kamaljit Kaur, while in Mumbai on his visit to her parents house developed problem pertaining to heart and being a case of emergency she was taken to Brihan Mumbai Mahanagar Palika Hospital on 11.10.2004. The illness was diagnosed as acute heart problem and she was advised admission. However,since that hospital did not have adequate arrangement for immediate operation she was admitted in t. N. Medical college and B. Y. L. Nair Hospitals, where she remained admitted up to 27.10.2004. However, as her problem deteriorated further, she was admitted in Sir Hurisondas Nurrotumdas Hospital and Research Centre, mumbai where facilities for operation were available and she was operated upon on 29.10.2004 and in the process expenses to the tune of Rs.1,31,954/-as per details given in Annexure P.4 to the writ petition were incurred on her treatment. The petitioner accordingly submitted his claim for medical reimbursement along with essentiality certificate attested by dr. S. M. Doshi who was doctor in-charge of the wife of the petitioner.

3. The policy of the Government framed for medical reimbursement has been upheld by the HON BLE Supreme Court in case State of Punjab and others Vs. Ram Lubhaya Bagga and others 1998 (2)RSJ 313. The State of Haryana has also framed a policy which is made applicable to the Universities, Municipal Committees, Market committees, state Boards and Corporations and thus the policy for reimbursement of medical expenses was applicable to the employes of the Nigam.

4. The Nigam has adopted the policy of the reimbursement of medical expenses and by way of Memo. No. CH/50/uh/ga/reg-70 dated 11.12.2002 issued instructions relating to medical claim for treatment from non-Government/ Non recognised Hospitals in emergency, relevant portion of which reads as under: "the issue regarding medical claim for treatment from Non cwp No.16913 of 2005 (4)Government/ Non recognised Hospitals in emergency was discussed by the WTDs in their meeting held on 21.11.2002 on the basis of instructions issued by HVPNL and DHBVNL and it has been decided as under:

"the medical claims for the treatment taken in emergency from non-Government/ Non recognised Hospitals shall hence forth be submitted to SE/ Admn. by all the employees/ retirees. The se/admn. shall forward such claims to Chief Medical Officer for examination whether the medical claim falls within the definition of emergency treatment and treatment has been taken from a hospital of repute fulfilling the criteria/ qualification for providing emergency treatment. In those cases where the Chief medical Officer is satisfied that the medical claim falls in the ambit of emergency treatment and also fulfills the qualification of a hospital prescribed for emergency treatment, the medical claim shall be submitted to the competent authority for consideration and approval in relaxation of rules. Sd/ Under Secretary/ga for MD/uhbvn, Panchkula"

5. It was on the basis of these instructions the petitioner had submitted the claim for reimbursement of medical expenses which was rejected by the Nigam merely on the ground that no prior sanction was taken from the authorities of