Krishna Colony, Naya Khera, Jaipur Raj v. The Chief General Manager, Telecom Department

Judgment

1. The Chief General Manager, Telecom Department, Telecom Circle, Sardar Patel Marg, Jaipur.

2. The Principal General Manager of Telecom, District Jaipur, M.I. Road, Jaipur Raj.

3. The Accountant Establishment, C/o. Office Of Principal General Manager Telecom, District, Jaipur, M.I. Road, Jaipur Raj.. ----Respondents For Petitioner(s)

: Mr.Hanuman Choudhary For Respondent(s) : Mr.Jitendra Sharma JUSTICE ANOOP KUMAR DHAND Order 13/02/2025

1. By way of filing this petition, a prayer has been made by the petitioner for issuing direction to the respondents to reimburse the amount of treatment taken by the petitioner at Heart and General Hospital, Jaipur.

2. Learned counsel for the petitioner submits that the petitioner suffered heart problem and under the emergent situation, he was admitted at Heart and General Hospital, where blockage was found in his arteries and thereafter, coronary angioplasty and PTCA + DE stent process was done and stents were implanted in the arteries of the petitioner to safe his life. Counsel submits that in the aforesaid treatment, the petitioner incurred the expenses of [2025:RJ-JP:6508] (2 of 4) [CW-14572/2017] Rs.1,46,560/- and immediately, after recovery, the petitioner submitted an application for reimbursement of the bills before the respondents, which has been rejected due to absence of the authorization letter as well as the visitation certificate issued by the respondents.

3. Counsel submits that the treatment was taken in an emergent situation, hence, the above formalities could not be completed. Counsel submits that hence, under these circumstances, appropriate orders be passed.

4. Per contra, learned counsel for the respondents opposed the prayer and submitted that the petitioner remained under treatment with effect from 08.04.2016 till 11.04.2016, but no intimation was sent by him to the respondents till 02.06.2016. For the first time, when the bills were submitted by the petitioner for reimbursement, the respondents were intimated about the said fact. Counsel submits that as per the policy of the respondents, prior to taking the treatment, an authorization letter was required to be taken by the petitioner and he was supposed to send intimation, so that an Officer of the respondent would visit the place where the treatment was being taken to verify the factual aspect of the matter. Counsel submits that in absence of compliance of the aforesaid provision, the respondents have not committed any error in declining the medical bills of the petitioner, hence, under these circumstances, interference of this Court is not warranted.

5. Heard and considered the submissions made at Bar and perused the material available on record. [2025:RJ-JP:6508] (3 of 4) [CW-14572/2017]

6. Perusal of the record indicates that the petitioner suffered chest pain on 08.04.2016 and thereafter, he was admitted in Heart and General Hospital, where his coronary angioplasty was done and blockages were found in his arteries and thereafter, the procedure of PTCA+DE was done and stents were implanted in the arteries of the petitioner. In the aforesaid process, the petitioner incurred expenses of Rs.1,46,560/- and after recovery, an application was submitted by the petitioner for reimbursement of the aforesaid amount which has been denied by the respondents on the technical count that prior to the aforesaid treatment, prior permission/ authorization letter was not taken by the petitioner and the respondents were not intimated about the above treatment, hence, in absence of the verification, the reimbursement of the petitioner was declined.

7. It is the settled proposition of law that under any emergent situation to save the life, the petitioner or his family members are not expected to seek prior permission from the concerned Authorities. In order to save the life of the petitioner, he can be admitted anywhere and in the instant case also the petitioner was admitted at Heart and General Hospital at Jaipur, where the above process was conducted.

8. In the case of 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 [2025:RJ-JP:6508] (4 of 4) [CW-14572/2017] 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....."

9. In view of the ratio laid down by the Hon’ble Apex Court in the case of Shiva Kant Jha (supra), this petition stands disposed of with direction to the respondents to reimburse the medical bills of the petitioner, as per the rates applicable in the approved CGHS hospitals within a period of three months, from the date of receipt of a certified copy of this order.

10. It is made clear that in case, compliance of this order is not made within the above stipulated time, then the petitioner would be entitled to get interest @ 6% per annum from the date of passing of this order till its actual payment.

11. All pending application(s), if any, also stands disposed of. Aayush Sharma /36 (ANOOP KUMAR DHAND),J