The time period indicated in Rule 11 and Rule 16 of the Rules of 2011 is mainly directory and not mandatory in nature, and the rejection of a medical reimbursement claim should be in consonance with the fundamental right to health and medical aid under Article 21 of the Constitution of India.

JUDGMENT :

1. Heard learned counsel for the petitioner and State counsel for opposite parties.

2. Instant petition has been filed seeking a direction to opposite parties for payment of medical reimbursement to petitioner amounting to Rs.3,04,935/- as reimbursement in lieu of expenses incurred by petitioner for medical treatment of his wife, Late Smt. Durgawati Dwivedi.

3. It is submitted that petitioner's wife was employed on the post of Senior Assistant with the Principal, Government Polytechnic, Pratapgarh and was suffering from serious ailment due to which, she required hospitalisation and treatment but passed away on 24.09.2021. It is submitted that after demise of his wife, petitioner submitted medical claim amounting to Rs.3,41,029/- as medical reimbursement on 16.03.2022. The claim for reimbursement and bills annexed thereto were thereafter forwarded by opposite party no.4 on 28.03.2022 to the Chief Medical Officer, Pratapgarh for scrutiny and after scrutiny, the Chief Medical Officer verified the amount of Rs.3,04,935/- vide letter dated 07.04.2022 but even thereafter, medical reimbursement of the said amount has not been made to petitioner, hence present petition has been filed.

4. In the counter affidavit filed by opposite parties, it has been stated that medical reimbursement to petitioner could not be processed since it was not submitted within a period of thirty days from commencement of treatment as required under Rule 11 of Uttar Pradesh Government Servants (Medical Care) Rules, 2011 (hereinafter referred to as the Rules of 2011) and that they were not on the prescribed format given in appendix (C) and also since it is provided that claim for reimbursement is required to be made within three months from the date treatment ends.

5. Learned State Counsel, therefore, submits that since petitioner's claim not being in consonance with the aforesaid Rules of 2011, medical claims of petitioner could not be processed although no rejection order has been passed.

6. Upon consideration of submissions advanced by learned counsel for the parties and perusal of material available on record, it is evident that petitioner's claim for medical reimbursement has been rejected on the twin grounds:-

(a) It was not within the stipulated time period;

(b) It was not in the prescribed format.

7. With regard to the first ground, it would be necessary to advert to the Rules of 2011. While Rule 11 indicates reimbursement pertaining to emergency treatment of patient, Rule 16 pertains to reimbursement of medical claims. Rule 11 stipulates that information with regard to commencement of treatment is required to be provided to the concerned authority as soon as possible, within a period of thirty days from commencement of treatment. Rule 16 operates in a situation where treatment has already concluded and provides that claim for reimbursement should be made as soon as possible, within a period of three months from the date treatment ends. The Rules 11 & 16 of Uttar Pradesh Government Servants (Medical Care) Rules, 2011 are as follows :

8. The aforesaid rules, therefore, operate in different fields altogether with Rule 11 pertaining to reimbursement of claims regarding expenses incurred in emergency treatment and Rule 16 pertaining to situations for reimbursement of treatment which has already concluded.

9. It is admitted between the parties that claim made by petitioner even otherwise was beyond the stipulated time period of three months as prescribed under Rule 16 of the Rules of 2011. In such a situation, it would be necessary to examine as to whether the time period indicated in Rules 11 and 16 of the Rules of 2011 are couched in mandatory terms or are merely directory. A perusal of both the said rules makes it evident that medical claims are required to be made 'as far as possible' within a period for thirty days in terms of Rule 11 and 'as soon as possible within a period of three months' as per Rule 16 of the Rules of 2011.

10. The aforesaid wording