Advocates:
['LK PUROHIT', 'NARENDRA S RAJPUROHIT AGC', '', 'SANDEEP SHAH', 'ANIL KUMAR GAUR']

HIGH COURT OF JUDICATURE FOR RAJASTHAN AT

JODHPUR

S.B. Civil Writ Petition No. 11726/2016

Smt. Pramila Tak W/o Late Shri Jugal Kishor Caste-Tak, aged

about 60 years, Resident of Sardarpura 1^st

B Road, Near

Kumharo Ka Mandir, Jodhpur (Rajasthan).

----Petitioner

Versus

1.

State of Rajasthan through the Principal Secretary,

Department of Finance, State Secretariat, Jaipur.

2.

Director, Pension and Pension Welfare Department, State of

Rajasthan, Jaipur.

3.

Treasury Officer (Rural), Jodhpur.

----Respondents

For Petitioner(s)

:

Mr. Ramesh Purohit

For Respondent(s)

:

Mr. Sandeep Shah, Sr. Advocate-cum-

AAG assisted by

Ms. Pratyushi Mehta

HON'BLE MR. JUSTICE KULDEEP MATHUR

Order

23/09/2022

Briefly stated facts of the case are that the petitioner's

husband was admitted in Krishna Super Speciality Hospital,

Jodhpur due to severe chest pain. The treating doctors looking at

the severity of case, referred him to Apollo Hospital, Ahmedabad,

where he passed away on 08.09.2015 while taking treatment.

The petitioner applied for reimbursement of medical bills

before the respondent-authorities amounting to ₹9,80,992/-. The

bills were returned with an assertion that the petitioner’s husband

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[CW-11726/2016]

availed treatment in a non-empanelled hospital and has also not

annexed the certificate of the treating doctor, showcasing

emergent

situation

for

availing

treatment

in

a

non-empanelled/private hospital.

Learned counsel for the petitioner submitted that petitioner’s

husband had been taken to a private hospital due to emergent

circumstances therefore, reimbursement cannot be rejected solely

on the ground that the hospital was not an empanelled one or the

certificate of treating doctors justifying emergency for availing

treatment was not annexed. Reliance was placed on a judgment of

this Court in the case of Raghuveer Sharma v. State of

Rajasthan & Ors. reported in (2007 WLC (Raj.) UC 516, in

which it was held as under:-

“prime consideration in case of grave emergency, which

comes in the mind of family is to save the life of patient

and at that point of time whatever hospital comes to their

mind and considered just is felt as the best because

emergency knows no law and no procedure and when

human life is at stake in such situation ultimately

responsibility of State cannot be washed out.

Technicalities of Rules and Regulations under the Scheme

are not required to be followed just in a mechanical

manner so as to frustrate very purpose of the Scheme

because a person having put in his whole life in the

service of the State till attains age of superannuation

always require human considerations.”

Per contra, learned counsel for the respondents submitted

that the treatment in a non-empanelled/private hospital can be

taken in case of grave urgency viz. life threatening disease like

kidney or heart ailments and accidents. It was further submitted

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[CW-11726/2016]

that according to the rules/policy in vogue, emergency certificate

of treating doctor establishing emergent situation is necessary for

making any claim for reimbursement in a private hospital.

A co-ordinate Bench of this Court in the case of Mool Singh

Vs. the State of Rajasthan & Ors. in S.B.CWP No.5592/2018

vide order dated 09.09.2022 was pleased to held as under:-

“The medical claim qua the said amount was

raised before the respondent Department but the

same was rejected on the ground that the

petitioner has not shown any emergent situation

wherein his wife was required to be treated in the

private hospital i.e. SAL Ahmedabad.

In Surjit Singh Vs. State of Punjab and Ors.

reported in AIR 1996 SC 1388, decided on 31.01.1996,

the Hon’ble Apex Court held as under:-

“10. ........... ............ In such an urgency one

cannot sit at home and think in a cool and calm

atmosphere for getting medical treat