JUDGMENT :

SANDEEP MOUDGIL, J.

Prayer

1. The jurisdiction of this Court has been invoked under Articles 226/227 of the Constitution of India for issuance of Writ in the nature of mandamus directing the respondents to reimburse the medical expenses incurred by the petitioner on the treatment of his wife Smt. Bala Parmar to the tune of Rs. 2,29,915 - 1,25,666 = Rs. 1,04,249/- which it still pending with the respondent department for the last 10 month. Pay the remaining amount Rs. 1,04,249/- along with the interest at the rate of 9% per-annum.

Brief Facts

2. The petitioner, a regular employee working as a Mechanic with the respondent department, seeks reimbursement of medical expenses incurred on the treatment of his wife, who suffered from a serious cardiac ailment. In an emergency situation, she was admitted to Fortis Hospital, Dehradun, where she underwent heart surgery and remained hospitalized from 30.11.2017 to 02.12.2017. The petitioner incurred total medical expenses amounting to Rs.2,29,915/- and duly paid the hospital through multiple receipts. The treatment and hospitalization were supported by medical records, discharge summary, and an emergency certificate issued by the Civil Surgeon, Sirsa. The petitioner submitted the complete medical claim for reimbursement under the applicable Government policies. However, the respondent department reimbursed only Rs.1,25,666/- and withheld the remaining amount of Rs.1,04,249/- without assigning any justification, despite the hospital being recognized and the disease being chronic in nature.

Contentions On behalf of petitioner

3. Learned counsel for the petitioner contends under the Punjab Services Medical Attendance Rules, 1940, as applicable to Haryana, and the Medical Reimbursement Policy of 2017, the petitioner’s wife squarely falls within the definition of “family” and the treatment of chronic cardiac disease is fully reimbursable. The emergency nature of the treatment is duly certified by the competent authority, and Fortis Hospital is a recognized institution. Reliance is placed on the judgments of the Hon’ble Supreme Court in State of Punjab v. Ram Lubhaya, 1998 (2) RSJ 313 and of this Court in Renu Sehgal v. State of Haryana, 1998 (4) RSJ 558, wherein it has been held that denial of full medical reimbursement for chronic diseases amounts to infringement of the right to life. The unexplained delay and partial reimbursement are stated to be unsustainable in law, and the petitioner is claimed to be entitled to the balance amount along with interest on account of delayed payment.

On behalf of the respondent/State

4. Learned State counsel submits that the petitioner’s wife was treated in Fortis Hospital, Dehradun, which is not an empanelled hospital under the Government of Haryana. As per applicable Government instructions, reimbursement for emergency treatment in an unapproved hospital is admissible only at PGIMER, Chandigarh rates, subject to verification of emergency and approval of the competent authority. The petitioner’s claim was accordingly referred to the Civil Surgeon, Sirsa, who issued an emergency certificate.

5. It is contended that the reimbursement amount was worked out strictly in accordance with Government policies dated 06.05.2005 and 20.05.2008, and a sum of Rs.1,25,666/- was duly sanctioned and paid after approval by the competent authority. There is no provision under the rules for full reimbursement of expenses incurred in an unapproved hospital.

6. Learned State counsel further argues that although the wife of the petitioner falls within the definition of “family,” no valid certificate of chronic disease issued by a duly constituted medical board was submitted, as required under the relevant instructions. Hence, the petitioner is not entitled to full reimbursement on that ground.

7. Heard.

Analysis

8. The material on record establishes that the wife of the petitioner was admitted to Fortis Hospital, Dehradun in an emergent condition and underwent cardiac surgery, a f