Gopal Chandra Mahato, aged about 66 years, son of Late Bishu Mahato, resident of v. 1. M/s Bharat Coking Coal Limited, through Chief Managing Director cum General Manager, Koyla
Case Details
IN THE HIGH COURT OF JHARKHAND AT RANCHI W.P. (S) No. 4096 of 2023 Gopal Chandra Mahato, aged about 66 years, son of Late Bishu Mahato, resident of Village Maheshpur, P.O. Maheshpur, P.S. Madhuban, District Dhanbad, Jharkhand Petitioner … … Versus 1. M/s Bharat Coking Coal Limited, through Chief Managing Director cum General Manager, Koyla Nagar, P.O. Saraidhela, P.S. Saraidhela, District - Dhanbad. 2. Incharge Chief Medical Services, M/s Bharat Coking Coal Limited, Koyla Bhawan, Koyla Bhawan, P.O. Saraidhela, P.S. Saraidhela, District Dhanbad. 3. The General Manager, Govindpur Area-III of M/s Bharat Coking Coal Limited, Dhanbad, P.O. Govindpur, P.S. Govindpur, District Dhanbad. 4. Project Officer, Maheshpur Colliery, M/s Bharat Coking Coal Limited, P.O. Tundoo, P.S. Sonardih, District Dhanbad. 5. Personnel Manager, Maheshpur Colliery, M/s Bharat Coking Coal Limited, P.O. Tundoo, P.S. Sonardih, District Dhanbad. 6. Finance Management, Maheshpur Colliery, M/s Bharat Coking Coal Limited, P.O. Tundoo, P.S. Sonardih, District Dhanbad. 7. Medical Officer, Maheshpur Colliery, M/s Bharat Coking Coal Limited, … … Respondents P.O. Tundoo, P.S. Sonardih, District Dhanbad. CORAM: HON’BLE MRS. JUSTICE ANUBHA RAWAT CHOUDHARY --- For the Petitioner For the Respondents
Legal Reasoning
--- : Mr. Ajay Kr. Trivedi, Advocate Mr. Sujit Kumar Lala, Advocate Mr. Rakesh Kumar Trivedi, Advocate Mr. Deepa Singh Bhardwaj, Advocate : Dr. Ashok Kumar Singh, Advocate Mr. Rajveer Singh, Advocate Mr. Kumar Siddhart, Advocate --- 04/18th April 2024 1. 2. Learned counsel for the parties are present. This writ petition has been filed for the following reliefs: - “for issuance of an appropriate writ(s)/order(s)/direction(s) in the nature of certiorari for quashing of the order dated 11.05.2023 (Annexure-8) passed by Respondent no. 3 i.e. The General Manager, Govindpur Area III, M/s B.C.C.L. whereby the grievance of the petitioner has again regretted despite of order dated 08.09.2021 by Hon'ble Mr. Justice Dr. S.N. Pathak in W.P(S) No. 5247/2018 in the interest of justice. And Further be pleased to direct the Respondents to pay of Rs.1,59,231 on account of Medical expenses incurred towards the treatment of the petitioner in C.M.C.H. Vellore (Christian Medical College Hospital, Vellore) as per Rule laid down in clause 10.5.1 of the N.C.W.A-2 along with @ 18% interest and appropriate cost for willful delay and unnecessary harassment to the petitioner in the facts and circumstances of this case. And / Or For issuance of an appropriate writ, order, direction as your Lordships may deem fit and proper, in the facts and circumstances of this case and in the interest of justice.” 3. The learned counsel for the petitioner submits that the petitioner suffered a serious head injury arising out of road accident sometimes in the month of November, 2015; he was initially treated at Central Hospital, Dhanbad and after sometime, he was referred to Mission Hospital, Durgapur for better treatment. 4. He submits that the petitioner was discharged from Mission Hospital, Durgapur with an advice to come after 15 days to check up, but his condition deteriorated at home and he used to become unconscious at times and consequently, the petitioner was not able to obtain approval for further treatment by the authority of the Company and without seeking approval, the family members of the petitioner admitted him to Christian Medical College Hospital, Vellore where he remained hospitalized for a period of one month and after fitness he joined his duty. 5. The learned counsel submits that the petitioner has been fighting for reimbursement of his medical bill for the period he was treated at Vellore. In that connection, the petitioner had filed a writ petition earlier being W.P. (S) No. 5247 of 2018 seeking a direction upon the respondents to pay an amount of Rs. 1,59,231/- on account of medical expenses incurred towards treatment at Vellore. The learned counsel submits that after considering the facts and circumstances of the case and the judgments passed by the Hon’ble Supreme Court reported in (2016) 3 SCC 619 (Shailesh Dhairyawan vs. Mohan Balkrishna Lulla and (2018) 16 SCC 187 (Shiva Kant Jha vs. Union of 2 India), the matter was remanded to the concerned authority for passing an order in accordance with law. The learned counsel submits that pursuant to the order passed by this Court, the impugned order of rejection has been passed on the ground that the petitioner did not seek permission for his treatment at CMCH, Vellore. 6. The learned counsel for the petitioner has submitted that seriousness of injury of the petitioner is not in dispute, inasmuch as, the hospital at Dhanbad was not in a position to treat the petitioner on account of which he was referred to Mission Hospital, Durgapur. He submits that the condition of the petitioner deteriorated after some treatment in Mission Hospital, Durgapur and accordingly his family members took him to CMCH, Vellore and ultimately it was his treatment in CMCH, Vellore which could save his life. The learned counsel submits that in a situation of this nature, there were sufficient reasons for not taking due permission before moving to CMCH, Vellore and therefore in view of the judgment passed by the Hon’ble Supreme Court reported in (2018) 16 SCC 187 (supra), the impugned order refusing to reimburse the medical bills of the petitioner’s treatment at Vellore is fit to be set-aside. 7. The learned counsel appearing on behalf of the respondents, on the other hand, has submitted that the petitioner was fully treated at Mission Hospital, Durgapur and was advised to come after 15 days but on his own the petitioner had gone to Vellore for treatment and therefore such treatment is against the norms of the company which clearly provides that prior approval for better treatment is required for the purposes of reimbursement of bills of such treatment. The learned counsel submits that the action of the petitioner is against the norms of the Company and therefore the impugned order does not call for any interference. 8. The learned counsel has submitted that nothing has been brought on record to show that the petitioner was brought in an emergency condition in the hospital at Vellore. The admission slip is not on record. 3 9. However, it is not in dispute that it has been brought on record that the petitioner remained hospitalized in CMCH, Vellore for a period of a few days less than a month, that is, from 04.12.2015 to 31.12.2015. 10. After hearing the learned counsel for the parties and considering the facts and circumstances of this case, it is not in dispute that the petitioner had suffered head injury in an accident in the month of November, 2015 and was admitted in Central Hospital, Dhanbad and when he could not be treated, he was referred to the Mission Hospital, Durgapur for better treatment. It is further not in dispute that the petitioner as per the reference went to Mission Hospital, Durgapur where he was treated and released with an advice to come after 15
Decision
days. 11. As per the writ petition, the petitioner upon being released continued to suffer and his condition became worse and he faced unconsciousness during such time and therefore the petitioner could not take approval from the authority of the Company and the family members took the petitioner to CMCH, Vellore for treatment. The records of the case reveal that the petitioner remain hospitalized for the period from 04.12.2015 to 31.12.2015 at CMCH, Vellore. The seriousness of injury of the petitioner, that too head injury, is not in dispute, inasmuch as, the Central Hospital, Dhanbad was unable to treat the petitioner and he was advised to go to Mission Hospital, Durgapur for better treatment. 12. This Court further finds that as per the case of the petitioner his situation deteriorated and his family members ultimately took him for better treatment in CMCH, Vellore. 13. Considering the totality of the facts and circumstances of this case, this Court finds that the petitioner has given sound reasons in the writ petition for not having taken prior approval of the respondent-Company for his better treatment at CMCH, Vellore. It is not the case of the respondents that the petitioner did not go as per their advice to the Mission Hospital, Durgapur for his better treatment. Considering the nature of injury suffered by the petitioner and also the fact that in order to become fit the petitioner remained hospitalized 4 at Vellore for a period of about one month. The amount of expenses incurred by the petitioner for his treatment in CMCH, Vellore is not in dispute. 14. This Court is of the considered view that the reason for not taking prior approval for his treatment at Vellore is well explained and the circumstances speak for themselves that the condition of the petitioner was quite serious. The seriousness of the condition of the petitioner is not disputed by the respondents in the counter-affidavit also. 15. In such circumstances, the judgment passed by the Hon’ble Supreme Court reported in (2018) 16 SCC 187 (supra) fully applies and this court is of the considered view that the claim of the petitioner cannot be denied on technical grounds. Paragraph 17 of the said judgment is quoted as under: - “It is a settled legal position that the government employee during his lifetime or after his retirement is entitled to get the benefit of the medical facilities and no fetters can be placed on his rights. It is acceptable to common sense, that ultimate decision as to how a patient should be treated vests only with the doctor, who is well versed and expert both on academic qualification and experience gained. Very little scope is left to the patient or his relative to decide as to the manner in which the ailment should be treated. Speciality Hospitals are established for treatment of specified ailments and services of Doctors specialized in a discipline are availed by patients only to ensure proper, required and safe treatment. Can it be said that taking treatment in Speciality Hospital by itself would deprive a person to claim reimbursement solely on the ground that the said Hospital is not included in the government order. The right to medical claim cannot be denied merely because the name of the hospital is not included in the Government Order. The real test must be the factum of treatment. Before any medical claim is honoured, the authorities are bound to ensure as to whether the claimant had actually taken treatment and the factum of treatment is supported by records duly certified by Doctors/Hospitals concerned. Once, it is established, the claim cannot be denied on technical grounds. Clearly, in the present case, by taking a very inhuman approach, the officials of the CGHS have denied the grant of medical reimbursement in full to the petitioner forcing him to approach this Court.” 16. In view of the aforesaid findings, impugned order dated 11.05.2023 rejecting the claim of medical reimbursement to the petitioner, only on the ground that for treatment at CMCH, Vellore, the petitioner did not take prior approval, cannot be sustained in the eyes of law and accordingly, it is set-aside. 17. Consequently, the respondent no.3 is directed to reimburse the medical expenses incurred by the petitioner at CMCH, Vellore amounting to a total of 5 Rs. 1,59,231/- after statutory deductions, if any, within a period of 15 days from the date of receipt of a copy of this order. The amount be remitted to the bank account of the petitioner. 18. This writ petition is accordingly disposed of with the aforesaid observations and directions. 19. Pending I.A., if any, is closed. Mukul (Anubha Rawat Choudhary, J.) 6