Heerapura, Jaipur v. Chairman-cum-Managing Director, Head Office, Parivahan Marg

1/2. Vibhor Mathur S/o Late Shri Prakash Narain Mathur, aged about 33 years, Resident of 2 Ch 6, Kamla Nehru Nagar Ajmer Road, Heerapura, Jaipur 1/3. Vaibhav Mathur S/o Late Shri Prakash Narain Mathur, aged about 28 years, R/o 2 CH 6, Kamla Nehru Nagar, Ajmer Road, Heerapura, Jaipur. Versus ----Petitioner

1. The Rajasthan State Road Transport Corporation through its Chairman-cum-Managing Director, Head Office, Parivahan Marg, Chomu House, Jaipur

2. The Financial Advisor, Rajasthan State Road Transport Corporation, Jaipur

3. The Executive Director (Administration), Rajasthan State Road Transport Corporation, Jaipur. ----Respondents For Petitioner(s) : Mr. Aditya Mathur For Respondent(s) : Mr. Rajpal Dhankhar JUSTICE ANOOP KUMAR DHAND Order 30/01/2025

1. By way of filing of this writ petition, the original petitioner is seeking direction against the respondents to reimburse the amount to the tune of Rs. 1,28,417/- towards the medical expenses incurred on his treatment. (2 of 4) [CW-8725/2008]

2. Counsel for the petitioner submits that the petitioner while remaining on leaves, went to Delhi with his family on 04.7.2007 wherein he suffered severe heart attack and looking to his critical condition, he was admitted in Escorts Heart Institute and Research Centre, New Delhi by his family members in an unconscious condition, where he was scheduled for Angiography and blockage was found in his artery and accordingly, stent was implanted in which the petitioner incurred total expenses of Rs 2,03,417/-. Counsel submits that after recovery an application for reimbursement of the aforesaid amount was submitted by the petitioner, but the respondents refused to reimburse the said amount and a petty amount of Rs. 75,000/- has been reimbursed to the petitioner, on a technical count that the treatment was taken out of the city without prior permission. Counsel further submits that under the similar circumstances, the respondents have reimbursed the full amount, to a co-employee for the expenses incurred by him on his treatment. Hence under these circumstances, interference of this Court is warranted.

3. Per contra, counsel for the respondents opposed the arguments raised by counsel for the petitioner and submitted that after availing leaves, the petitioner has taken treatment outside the State, hence under these circumstances, as per Rules, the respondents have paid a sum of Rs. 75,000/- to the petitioner. Counsel submits that the treatment was taken at Delhi in a private hospital, hence under these circumstances, the petitioner is not entitled to get reimbursement of the full amount incurred by him in the aforesaid treatment. Hence, under these circumstances, interference of this Court is not warranted. (3 of 4) [CW-8725/2008]

4. Heard and considered the submissions made at Bar and perused the material available on record.

5. This fact is not in dispute that while availing leaves, the petitioner underwent the heart treatment, at Delhi. As per the assertion of the petitioner, he suffered heart pain and under emergent situation, he was admitted in the Escorts Heart Institute and Research Centre, New Delhi where looking to his condition and blockage in his artery, the stent was implanted, in which he incurred expenses of Rs. 2,03,417/-. The respondents have denied to reimburse the whole medical claim on a technical count that the treatment was taken in a private hospital and a petty amount was paid to the petitioner as per the rules. This cannot be a ground to deny the entire medi-claim of the petitioner. The Hon'ble Apex Court as well as this Court has held in catena of Judgments that if the treatment is taken in private/unrecognized hospitals, the authorities are supposed to make the payment as per the rates applicable in the approved hospital. 6 In Shiva Kant Jha Vs. Union of India (UOI), reported in AIR 2018 SC 1975 the Hon’ble Apex Court has held as under:- "It is a settled legal position that the Government employee during his life time 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 commonsense, 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 (4 of 4) [CW-8725/2008] 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....."

7. In view of the ratio laid down by the Hon’ble Apex Court in the case of Shiva Kant (supra), this petition stands disposed of with directions to the respondents to make the payment to the legal representatives of the petitioner as per the rates applicable in the approved hospitals, after adjusting the amount already paid to the petitioner within a period of three months from the date of receipt of a certified copy of this order.

8. It is made clear that in case compliance of this order is not made within the stipulated time, then the petitioner would be entitled to get interest @ 6% per annum.

9. All pending application(s), if any, also stands disposed of.

10. No order as to costs. Ashu/96 (ANOOP KUMAR DHAND),J