Suman Kumar Karsh v. State of
Case Details
1 RAVI SHANKAR MANDAVI Digitally signed by RAVI SHANKAR MANDAVI Date: 2025.02.07 21:03:54 +0530 2025:CGHC:5591 NAFR HIGH COURT OF CHHATTISGARH AT BILASPUR WPS No. 887 of 2025 1 - Aditya Singh Rajput S/o Shri Narendra Singh Rajput Aged About 38 Years Working As A Constable Batch No. 1146, Cyber Cell Police Department, Rajnandgaon, District Rajnandgaon, Chhattisgarh. versus ... Petitioner 1 - State Of Chhattisgarh Through Its Principal Secretary, Department Of Home, Mahanadi Bhavan, Mantralaya, Naya Raipur, District Raipur, 492002 Chhattisgarh- 2 - The Director General Of Police Police Headquarter, New Raipur, 492002 District Chhattisgarh- Raipur, 3 - The Superintendent Of Police Rajnandgaon, District : Rajnandgaon, Chhattisgarh 4 - Directorate, Medical Education, Through Its Director, Old Nurses Chhattisgarh. Hostel, Bhawan, Parisar, Raipur, D.K.S. 5 - The Joint Director Medical Education Old Nurses Hostel, D.K.S. Chhattisgarh. Bhawan Parisar, Raipur, 6 - State Of Chhattisgarh Through The Secretary, Health And Family Welfare Department, Mantralaya, Naya Raipur, District Raipur, Chhattisgarh. ... Respondent(s) 2 (Cause-title taken from Case Information System)
Legal Reasoning
For Petitioner For State/Respondent/s : Mr. S.S. Choubey, Panel Lawyer : Mr. Sunil Pillai, Advocate Hon'ble Shri Justice Amitendra Kishore Prasad Order on Board 30/01/2025 1. Heard Mr. Sunil Pillai, learned counsel for the petitioner. Also heard Mr. S.S. Choubey, Panel Lawyer learned for the State/respondent/s. 2. By this petition the petitioner has prayed for following relief(s) : “10.1 To call for entire records from respondents for kind perusal of the Hon’ble High Court. 10.2 To direct respondents to reimburse to the petitioner medical claim which is more than Rs. 3.5 lacs alongwith 10% interest. 10.3 To direct respondents to recompense the petitioner with an amount of Rs. 2,00,000/- (Two lacs) for the mental agony and sufferance due to delay caused in reimbursement of medical claim. 10.4 To direct respondents to pay to petitioner cost of litigation. 10.5 To grant any other relief deemed fit and proper in facts and circumstances of the case.” 3. It has been pointed out by learned counsel for the petitioner that in an identical matter, the co-ordinate bench had allowed in part WPS No.2761 of 2022 (Suman Kumar Karsh vs. State of 3 Chhattisgarh and others) vide order dated 05.10.2023 observing as follows : “13. Under the Rules of 2009, Rule 13 talks of relaxation of any of the rules under the Rules of 2009 with the consent of the Finance Department treating the same as a special case. This provision is embodied in the statute to meet out such situation, as the legislature was cautious that any extraordinary situation may crop any time. Respondent No.2 while deciding claim of petitioner for medical reimbursement ought to have invoked Rule 13 of the Rules of 2009 in the facts and circumstances of case, which was not done. Therefore, considering the entirety of facts, particularly unprecedented and extraordinary pandemic situation prevailing all over the country and non-availability of treatment facilities in the government hospitals or private hospitals for want of beds/oxygen beds etc., which was an extraordinary and exceptional situation, the order impugned (Annexure P-10) passed by respondent No.2 giving strict consideration to the provisions of the Rules of 2009 is not sustainable and it is liable to be set aside. 14. In the result, writ petition is allowed in part. Impugned order (Annexure P-10) is hereby set aside. Respondents No.1 & 2 are directed to reconsider claim of the petitioner for reimbursement of medical expenses incurred by him in the treatment of his mother who was tested Covid-19 positive and treated in non-listed recognized private hospital, keeping in mind the peculiar circumstances which were prevailing at that point of time due to spread of of Covid-19 pandemic all over the world, in the light of Rule 13 of the Rules of 2009 expeditiously.” 4. Since, the facts and issue involved in the present case is identical to that of WPS No.2761 of 2022, this petition may also be decided in terms of para 13 and 14 of the same. 4 5. Learned counsel for the respondents do not have any objection on the said submission of the learned counsel for the petitioner. 6. Having considered the rival submissions made by learned counsel for the parties and having gone through the materials on record, it is evident that the facts and issue involved in this petition is identical to WPS No.2761 of 2022, this Court deems it appropriate not to take a view other than what has been taken in WPS No.2761 of 2022. 7. As the higher authorities of the State are required to more responsive and cannot deprive a government servant from his legitimate right of medical reimbursement in a mechanical manner. Approach of respondent in denying medical reimbursement prima facie appears to be inhuman. In the situation prevailing on the date of admission of petitioner’s mother in a private hospital, it cannot be overlooked that hospitalization of petitioner’s mother was in an emergent condition when survival of human life was prime consideration. The law also does not require that prior permission is to be taken in such situation. Right to claim medical reimbursement cannot be denied merely because name of a hospital is not included in the list of recognized private hospitals notified by the State Government / Police Department for treatment. Real test must be factum of treatment. In such a situation the authorities before honouring such claim could have ensured as 5 to whether patient had actually taken treatment or not. Once the treatment is established, claim cannot be denied on technical grounds. 8. In case of Shiva Kant Jha v. Union of India, reported in 2018 LAB IC 2274, the Hon’ble Supreme Court while considering identical issue of an employee who took treatment in non- enlisted private hospital, has held as under :- “15. In the present view of the matter, we are of the considered opinion that the CGHS is responsible for taking care of health care needs and well being of the central Government employees and pensioners. In the facts and circumstances of the case, we are of the opinion that the treatment of the petitioner in non-empanelled hospital was genuine because there was no option left with him at the relevant time. We, therefore, direct the respondent - State to pay the balance amount of Rs.4,99,555/- to the writ petition. We also make it clear that the said decision is confined to this case only.” 9. In this case also, rejection of the claim of petitioner for reimbursement of amount incurred in medical treatment of his mother during unprecedented pandemic situation across the country when the pandemic Covid-19 was on its peak, the death ratio was on higher side and in almost all the hospitals beds were occupied and there was large scarcity of beds/oxygen beds and public at large was finding it difficult to get proper medical treatment facilities, the case of petitioner is also squarely covered from the aforementioned ruling of 6 Hon’ble Supreme Court. 10. As such, Under the Rules of 2009, Rule 13 talks of relaxation of any of the rules under the Rules of 2009 with the consent of the Finance Department treating the same as a special case. This provision is embodied in the statute to meet out such situation, as the legislature was cautious that any extraordinary situation may crop any time. Respondent No.2 while deciding claim of petitioner for medical reimbursement ought to have invoked Rule 13 of the Rules of 2009 in the facts and circumstances of case, which was not done. Therefore, considering the entirety of facts, particularly unprecedented and extraordinary pandemic situation prevailing all over the country and non-availability of treatment facilities in the government hospitals or private hospitals for want of beds/oxygen beds etc., which was an extraordinary and exceptional situation, the order impugned passed by respondent No.2 giving strict consideration to the provisions of the Rules of 2009 is not sustainable and it is liable to be set aside. 11. In the result, writ petition is allowed in part. Impugned order is hereby set aside. Respondents No.1 & 2 are directed to consider claim of the petitioner for reimbursement of medical expenses incurred by him in the treatment of his parents who were tested Covid-19 positive and treated in non-listed recognized private hospital, keeping in mind the peculiar circumstances which were prevailing at that point of time due to spread of of Covid-19 7 pandemic all over the world, in the light of Rule 13 of the Rules of 2009 expeditiously.” 12. Accordingly, the present petition is allowed in part in terms of the order dated 05.10.2023 passed in WPS No.2761 of 2022. Sd/- (Amitendra Kishore Prasad) Judge Ravi Mandavi