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2024 Supreme(Online)(GUJ) 18466
HIGH COURT OF GUJARAT
MR. JUSTICE BIREN VAISHNAV, MR. JUSTICE PRANAV TRIVEDI, JJ
CHAIRMAN / ADMINISTRATOR – Appellant
Versus
MAGANBHAI KALIDAS PATEL – Respondent
R/LETTERS PATENT APPEAL NO. 1303 of 2023
In emergencies, employees have the right to seek immediate medical treatment without being penalized for not using approved hospitals, reinforcing the fundamental right to life under Article 21.
Headnote:(A) Constitution of India - Article 21 - Medical reimbursement - The petitioner, a bus driver, sought reimbursement for medical expenses incurred due to an emergency cardiac procedure, which was initially denied by the Corporation. The learned Single Judge ruled in favor of the petitioner, emphasizing the urgency of medical treatment and the right to life. The court found the Corporation's refusal arbitrary and unreasonable. (Paras 6, 6.1, 6.2)
(B) Medical Reimbursement Policy - The court reiterated that in emergencies, employees should not be penalized for seeking immediate treatment at non-approved hospitals. The right to self-preservation is fundamental and cannot be compromised by bureaucratic procedures. (Paras 5.1, 5.2, 5.3)
Facts of the case:
The petitioner suffered a cardiac emergency on 08.01.2016 and incurred medical expenses of Rs.2,05,755/- for treatment, which the Corporation denied reimbursement for, citing policy limits.
Findings of Court:
The court directed the Corporation to reimburse the petitioner the claimed medical expenses with interest at 6% from the date of refusal.
Issues: The main issues were whether the petitioner was entitled to full reimbursement despite not using an approved hospital and the reasonableness of the Corporation's denial.
Ratio Decidendi: The court held that the urgency of medical treatment supersedes bureaucratic restrictions, affirming the right to life under Article 21.
Result: Appeal dismissed with directions for reimbursement.
ORDER
(PER : HONOURABLE MR. JUSTICE BIREN VAISHNAV)
1. Heard learned advocates for the parties.
2. This appeal, under clause 15 of the Letters Patent, has been filed challenging the judgement and order dated 12.09.2023 passed by the learned Single Judge in Special Civil Application No. 6056 of 2016 by which the learned Single Judge has answered the prayers sought therein in favour of the petitioner granting benefits of reimbursement of medical expenses to the tune of Rs.2,05,755/-.
3. Facts of the petition indicate that the petitioner was serving as a bus driver with the Dabhoi S.T. Depot, Gujarat State Road Transport Corporation. He was to retire on 31.05.2016. It is the case of the petitioner before the learned Single Judge that on 08.01.2016, he suffered chest pain was required to be moved to hospitals at Modasa where he underwent preliminary cardiac care.
He was thereafter moved to the HCG hospital where he underwent coronary angioplasty and was discharged on 13.01.2016.
3.1 Faced with a medical expense of Rs.2,05,755/- he sought reimbursement of the same which was denied.
Aggrieved by the same, he approached this court by filing the writ petition. The learned Single Judge as referred hereinabove held in favour of the petitioner.
4. Mr. H.S. Munshaw, learned advocate appearing for the appellant Corporation would submit that the petitioner is not entitled to reimbursement of expenses to the extent of full amount or at best in light of the Corporation’s resolution dated 20.12.2005 the maximum reimbursement could be to the tune of Rs.1,25,000 to Rs.1,50,000/- if it is a case of angioplasty in two vessels. He submitted that in case of angioplasty in a single vessel, the maximum reimbursement would be to the extent of Rs.1,00,000/-.
4.1 Mr. Munshaw would submit that the chronology of the dates would indicate that the petitioner suffered chest pain on 08.01.2016. He was moved to Dhanvi Hospital at Modasa and thereafter he was moved to Modasa Heart Care and ICCU Center. The original petitioner was thereafter shifted to Star Hospital at Naroda from where he was shifted to HCG hospital, Ahmedabad where he underwent angioplasty. He therefore had sufficient time to choose any of the hospitals indicated in the resolution as good as Apollo Hospital which included angioplasty and avail reimbursement to the maximum as the corporation had fixed in accordance with the resolution.
4.2 In support of his submissions, Mr. Munshaw would rely on a decision of the Apex Court in the case of State of Punjab and others vs. Mohan Lal Jindal [(2001) 9 SCC 217] to submit that at best reimbursement could have been restricted to an amount of Rs. 1 lakh or Rs.1,25,000/- depending upon the number of vessels that were involved in the angioplasty.
4.3 Mr. Munshaw would further submit that the interest be not awarded at all or at the most be not awarded at the rate as directed by the learned Single Judge.
5. Ms. Sneha Joshi, learned advocate appearing for the original petitioner would support the order of the learned Single Judge and submit that no interference is called for.
6. The learned Single Judge in the impugned judgement and order has observed as under:
- “5. Not only that the stance of the Corporation is depricable in treating the case of the petitioner with insensitivity and unbecoming of a statutory body which is a limb of the welfare State, the action on part of the respondents in denying the reimbursement stand is in defiance of the settled law laid down by the Supreme Court and this Court in various decisions.
5.1 In Surjit Singh vs. State of Punjab and Others ( AIR 1996 SC 1388 ), it was in terms observed and held that the government cannot insist an employee to get himself treated at a recognised government institution and also cannot require him to claim the rates prevailing there only. The Supreme Court endorsed the views expressed by th
