In emergency medical situations, procedural strictness must not impede the reimbursement of medical expenses to pensioners, ensuring timely healthcare access under welfare schemes.

ORDER :

FARJAND ALI, J.

1. By way of filing this writ petition under Article 226 of the Constitution of India, the petitioner has prayed for issuance of an appropriate writ, order or direction to the respondents to consider and allow his medical reimbursement claim submitted on 15.11.2007 to respondent No. 3, in accordance with the provisions of the RAJASTHAN STATE PENSIONERS MEDICAL CONCESSION SCHEME . The petitioner has further sought a direction to the respondents to pay interest at the rate of 12% per annum on the delayed reimbursement amount, and to extend any other consequential or appropriate relief deemed just and proper in the facts and circumstances of the case.

2. During the pendency of the present writ petition, the petitioner unfortunately expired on 29.12.2011. The death certificate issued by the Municipal Corporation, Bikaner, on 16.01.2012 is placed on record. The right to seek reimbursement of medical expenses, being a part of the petitioner’s accrued and heritable benefits, survives to his legal representatives.

3. Breifly stated facts of the case are that , the petitioner, retired from the post of Office Superintendent on attaining the age of superannuation on 30.04.1997 and has since been receiving pension regularly vide P.P.O. No. 603720 and T.S. No. 11426. Being a retired government employee, the petitioner was issued a lifetime Medical Diary under the RAJASTHAN STATE PENSIONERS MEDICAL CONCESSION SCHEME (hereinafter referred to as “the Scheme”), entitling him to medical benefits admissible to pensioner. It is not in dispute that the petitioner has a long history of cardiac ailments, having remained admitted to P.B.M. Hospital, Bikaner between 07.10.1996 and 18.10.1996 and having undergone angiography at S.M.S. Hospital, Jaipur on 18.03.1997. In the year 2006, while visiting Ahmedabad for medical consultation of his ailing wife, the petitioner experienced chest pain and, upon medical advice, underwent a T.M.T. test which revealed arterial blockage. On experiencing acute pain again in August 2006, he underwent angiography at Ahmedabad on 28.08.2006, which confirmed triple vessel coronary artery disease, necessitating urgent bypass surgery. Accordingly, the petitioner was admitted to S.A.L. Hospital and Medical Institute, Ahmedabad, where Coronary Artery Bypass Graft (CABG) surgery was performed on 25.09.2006 and he was discharged on 04.10.2006. For the said treatment, the petitioner incurred expenses amounting to Rs. 1,14,410/-, including Rs. 9,410/- for angiography and Rs. 1,05,000/- for bypass surgery, supported by relevant bills. Subsequently, on 11.04.2007, the petitioner again suffered chest pain and was admitted to P.B.M. Hospital, Bikaner, where he incurred an additional expenditure of Rs. 945.30 on medicines. After recovery, the petitioner submitted his medical reimbursement claim in three sets, duly certified, to respondent No. 3 on 15.11.2007. It is stated that respondent No. 3 forwarded the claim to respondent No. 2 on 15.01.2008, but no decision has been communicated to the petitioner during his lifetime, and the claimed amount has not been reimbursed till date. The petitioner also made a representation requesting expeditious settlement of his claim, but to no avail. The grievance of the petitioner is that despite submission of the claim in the prescribed manner and the Scheme providing for reimbursement of such medical expenses, the respondents have failed to take any decision thereon. Being aggrieved by the inaction of the respondents in not deciding or reimbursing the medical claim for a considerable period, the petitioner’s legal repr