The right to medical reimbursement for government employees cannot be denied on technical grounds when urgent treatment is needed but unavailable locally.

JUDGMENT :

HARISANKAR V. MENON, J.

1. The petitioner, working as a teacher in the Government Higher Secondary School, Alamellur, in Palakkad District, has approached this Court pointing out the predicament faced by him with reference to the refusal on the part of the Government in reimbursing the treatment charges expended for the treatment of his daughter, who was diagnosed with a rare disease – Adolescent Idiopathic Scoliosis- Type 6.

2. Heard Smt.Amrutha Sanjeev, the learned counsel for the petitioner, as well as Smt. Sylaja S.L., the learned Government Pleader.

3. As already noticed, the petitioner’s daughter was suffering from a rare disease. The afore disease is stated to be one that progresses rapidly, and if not treated in the appropriate stage, would lead to a situation where the patient would have to lead the balance of her life with the assistance of others. It is in such circumstances that the petitioner submitted Ext.P4 before the Government, pointing out that treatment for the afore disease was not available in Kerala and therefore, upon enquiry, he came to know that there is treatment available in a hospital at Coimbatore and hence, seeking sanction for carrying out the afore treatment through the said hospital with the hope that the Government would reimburse the charges. The application filed as above was forwarded to the Government. In the meantime, treatment was also carried out by the petitioner in the year 2015 since, as noticed earlier, the petitioner or his daughter was not in a position to wait till the Government took a decision in the matter. The petitioner again submitted Ext.P7 dated 30.06.2017, repeating that there is no treatment facility available in the Government hospitals in Kerala, and the treatment is being carried out through a hospital at Coimbatore. Ultimately, by Ext.P9, the Government informed the 3^rd respondent, as under:

“I am to invite your attention to the reference cited and to inform you that Government have tentatively decided to accord expost facio sanction for the Scoliosis correction, infection at fusion site treatment of Kumari Shimna A D/o Sri. Yusuff. A.M Higher Secondary School Teacher (English) GHSS, Aliparamba, Malappuram at Ganga Medical Centre, Coimbature as a special case in relaxation of existing KGSMA Rules. In the above circumstances, I am to forward herewith the application for medical reimbursement along with original bills and connected documents for retransmitting the same with the verification report of the Director of Health Services regarding the admissible amount at Government rate as per clause of the Circular No.107/2014/Fin dated 18.12.2014.”

4. Even thereafter, by Ext.P11, the application filed by the petitioner came to be returned to him, since according to the Government, the treatment was carried out through a non- empanelled private hospital, outside Kerala. A Circular dated 12.06.2020 was also relied upon, as per which, taking into account the financial issues faced by the Government, a decision was taken not to provide reimbursement facilities where treatment was carried out in private hospitals. Through Ext.P14, a subsequent request made by the petitioner also came to be rejected for the very same reasons.

5. I have considered the submissions made across the Bar as well as the connected records.

6. In Daily Rated Casual Labour v. Union of India [ (1988) 1 SCC 122 ], the Apex Court held that “the Government should be a model employer”.

7. In Shiva Kant Jha v. Union of India [AIR 2018 SC 1975], the Apex Court, considering the claim for reimbursement for medical expenses which was denied on account of the treatment bei