JUDGMENT :

SANDEEP MOUDGIL, J.

Prayer

1. The jurisdiction of this Court has been invoked under Article 226/227 of the Constitution of India for issuance of a writ, order or direction especially in the nature of certiorari for quashing of the impugned order dated 18.05.2020 (P-4) to the extent that out of total claim of Rs. 4,63,770/-, Rs. 4,20,766/- has been denied to the petitioner for emergency operation of the wife of the petitioner without assigning any reasons for denial of full medical reimbursement.

Brief Facts

2. The petitioner, Sh. Suresh Kumar, incurred medical expenses for the emergency treatment of his wife, Smt. Poonam, at Indraprastha Apollo Hospital, Sarita Vihar, Delhi. She was admitted in a critical condition to the Obstetrics and Gynecology department, and during the surgery, her uterus and gallbladder were removed, and her hernia was also operated upon. The treatment was urgent, and there was no time to approach an empanelled hospital or seek prior approval. The petitioner submitted a claim of Rs. 4,63,770.51 to the Sub Divisional Officer (Civil), Karnal, for reimbursement of the medical expenses. The Sub Divisional Officer forwarded the bills to the Civil Surgeon, Karnal, who objected on 12.01.2015 that Apollo Hospital was not empanelled and that an emergency certificate was required.

3. The petitioner was informed of this requirement on 21.01.2015. Promptly, he applied for the emergency certificate, which was issued by the Civil Surgeon, Karnal, on 19.08.2015. The certificate was attached to the medical bills and resubmitted to the Sub Divisional Officer on 06.11.2015. Despite repeated reminders by the petitioner through letters dated 28.01.2016 and 30.09.2016, the authorities delayed processing the claim. The Sub Divisional Officer informed the petitioner that the bills had been sent to the office of the Director General, Health Services, Haryana, Panchkula.

4. On 10.01.2017, the petitioner was asked to remove certain objections on the bills, which he promptly complied with. However, no further action was taken by the authorities, leaving the petitioner with no administrative remedy. The petitioner earlier filed a Civil Writ Petition (CWP No. 6846 of 2017) in the Punjab and Haryana High Court, which was withdrawn on 22.07.2019 with liberty to file a fresh petition. Meanwhile, out of the total claimed amount of Rs. 4,63,770.51, only Rs. 43,005 was sanctioned by the authorities vide Annexure P-4 dated 18.05.2020. The authorities did not provide any reasons for denying the balance amount, nor did they give the petitioner an opportunity to be heard. Since October 2014, the petitioner has been pursuing reimbursement through multiple approaches, but due to continued inaction and delays by the respondents, he has suffered mental agony and harassment. Consequently, the petitioner has filed the present writ petition seeking reimbursement of the full amount claimed.

Contentions

On behalf of the petitioners

5. Learned counsel for the petitioner submits that the petitioner is entitled to full reimbursement of Rs. 4,63,770.51 incurred on the emergency treatment of his wife, Smt. Poonam, at Indraprastha Apollo Hospital, Delhi, as she required immediate life-saving surgery. The petitioner had no time to approach an empanelled hospital or seek prior approval due to the urgent nature of the treatment. Despite promptly obtaining the required emergency certificate and complying with all objections raised by the authorities, the respondents have unduly delayed and denied the reimbursement, releasing only Rs. 43,005 without providing any reasons. The petitioner has repeatedly followed up with the authorities since 2014 and has even approached the Hon’ble High Court earlier, but the matter remains unresolved, causing undue mental agony and harassment. Learned counsel submits that the continued inaction of the respondents amounts to arbitrariness and violation of the petitioner’s right to seek reimbursement of legitimate medical expenses