HIGH COURT OF JUDICATURE FOR RAJASTHAN AT

JODHPUR

S.B. Civil Writ Petition No. 8857/2015

Jagdish Chandra Bissa S/o Sh. Punam Chand, Aged – 63 years,

R/o – Achlaaton Ka Bas, Brahampuri, Navchokiyan, Jodhpur,

Rajasthan.

----Petitioner

Versus

1. Chairman cum Managing Director, Jodhpur Vidhyut Vitran

Nigam Limited, Sector 7 Ne Poer House Road, Industrial

Area, Jodhpur.

2. Executive Engineer, Jodhpur Vidhyut Vitran Nigam Limited,

Sector 7 New Power House Road, Industrial Area, Jodhpur.

3. Assistant Engineer, CSD, C-1st, Jodhpur Vidhyut Vitran

Nigam Limited, Sector 7 New Power House Road, Industrial

Area, Jodhpur.

----Respondent

For Petitioner(s)

:

Mr. R.S. Mankad

For Respondent(s)

:

Mr. Vikram Choudhary

HON'BLE MR. JUSTICE KULDEEP MATHUR

Order

14/09/2022

The present petition has been filed with a prayer for

reimbursement of some part of medical claim which was not

reimbursed to the petitioner on the count that the Department

was under an obligation to reimburse the amount only to the

extent as permissible in terms of the Rajasthan Civil Services

(Medical Attendance) Rules, 2013 (hereinafter referred to as, ‘the

Rules of 2013’).

The case of the petitioner is that because of a cardiac

problem, he was admitted to Mathura Das Mathur Hospital,

Jodhpur and undergone Angiography and Angioplasty and stents

(2 of 4)

[CW-8857/2015]

were implanted and total expenses incurred were Rs.2,73,832/-.

The petitioner thereafter submitted his claim for reimbursement of

the cost of treatment along with all the required document and

bills as required under Rule 6 of the Rules of 2013 but qua the

total claim of Rs.2,73,832/-, an amount of Rs.1,70,800/- was

reimbursed.

Learned counsel for the petitioner submitted that in terms of

the ratio laid down in the case of Sumer Singh vs. State; S.B.

Civil Writ Petition No.7675/2014 and State of Rajasthan & Ors.

vs. Smt. Mohan Kanwar Bhansali; D.B. Special Appeal Writ

No.246/2019, as the treatment was undertaken by the petitioner

in a government hospital and the stents as implanted were

purchased from a private shop run, the complete amount of the

claim was liable to be reimbursed.

Per contra, learned counsel for the respondents submitted

that Appendix IX of the Rules of 2013 specifically prescribe the

maximum limit of reimbursement and the department has already

reimbursed in terms of the said Rules. He further submitted that

as per Rule 6 and 8 (II), reimbursement for implantation of more

than one DE stent amount cannot be made.

Heard learned counsel for the parties and perused the

material available on record.

Appendix-IX of the Rules of 2013 (as amended in the year

2014) provides as under:

S.No.

Item

No. of

Stents

Extent of Reimbursement (Rs.)

1.

DE Stent

1

Rs.70,500/-

2.

Bare Metal Stent

1

Rs.44,000/-

3.

DE Stent (1) & Bare Metal

Stent(1)

2

Rs.1,14,500 (70,500 = 44,000)

(3 of 4)

[CW-8857/2015]

4.

Bare Metal Stent (2)

2

Rs.82,500/-

5.

DE Stent (1) & Bare Metal

Stent (2)

3

Rs.1,53,000/- (70,500 + 42,500)

6.

Bare Metal Stent (3)

3

Rs.1,10,000/-

7.

Balloon Intyra Arotic

1

Rs.28,000/-

Note : 1. If more than one DE Stent is implanted than

reimbursement for additional DE Stent shall be

allowed upto the limit of Bare Metal Stent only.

2. The reimbursement for more than three stents

shall not be allowed.”

From the perusal of aforesaid rule, it is clear that there is no

impediment in making reimbursement of more than one DE stent.

However, the reimbursed amount can be restricted to the price of

Bare Metal Stent.

In the case of Sumer Singh (supra), the Division Bench of

this Court held as under:

“On the basis of the aforesaid discussion this Court of the

opinion that the treatment taken in a Government Hospital

has to be completely reimbursed to the petitioner as the

language of the scheme is very clear that the person

concerned shall be legitimately entitl