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Judgment
Shorn of details, petitioner is admittedly a central government employee, working in Radio Kashmir, Srinagar. His son, who was studying in
Bangalore, met with an accident there in the year 1994 and was admitted to a private hospital (Manipal Hospital, Bangalore) for treatment owing
to his serious condition. The petitioner is governed by Central Rules for the purposes of medical facilities. As the Manipal Hospital is a private
hospital, they charged an amount of Rs. 52, 877/ from the petitioner submitted the bill to respondent No. 3 for reimbursement in accordance with
the rules. The respondents , on receipt of the bills, wrote to the registrar Manipal Hospital, Bangalore enquiring from them as to whether the
hospital was recognised for providing medical treatment to the government employees or not. The Manipal Hospital authorities replied the above
communication vide their letter dated 08071994 in affirmative. Respondents avoided to reimburse the medical claim. The petitioner made
representation vide annexure P2. However, respondent No. recommended the case of the petitioner to respondent No. 2 for reimbursement of the
claim. Respondent No. 2 raised certain queries which were duly replied by respondent No. 3 vide annexure PA. Respondent No. 2, not feeling
satisfied, raised certain more queries from respondent No. 3 Respondent NO. 3 again replied the communication vide letter dated 01021995,
reiterating the genuineness of the medical claim of the petitioner upto the tune of aforesaid amount. Respondent No. 2, however, accorded sanction
to the medical reimbursement only to the tune of Rs. 11,187/ instead of Rs. 52,877/ on the ground that the amount has been calculated by
respondent No. 2 after deducting Rs. 25/ from each claim in pursuance of Health Ministry's order.
The petitioner, aggrieved of this sanction, filed this writ petition on the ground that the claim of the petitioner is not only genuine in accordance
with the relevant rules, but a total claim in similar case has been reimbursed to one J.P. Angoranda vide annexure P11. According to the petitioner
discriminatory treatment has been given to him when his claim was arbitrarily cut from Rs. 52,000/ and odd to Rs. 11,000/ and odd. Respondents
have filed the counter. It has been admitted that the petitioner is a central government employees and is governed by Central Rules for the purpose
of medical facilities. It has been contended that the Central Services (Medical Allowance) Rules, 1944 are not applicable. These were applicable
under British Rules. However, it has been admitted that the petitioner is governed by Central Rules and is entitled to such reimbursement under the
provisions of Central Services (Medical Allowance) Rules as applicable. It has been contended that the Manipal Hospital, Banglore was not
recognised. One of the plea raised by the respondents is that the petitioner is entitled to reimbursement under rules if such treatment would have
been undergone in government hospital of Karnataka (Banglore) the expenditure would have been Rs. 7131/ and Rs. 2381/ respectively plus the
ward charges admissible to the petitioner as per the basic pay instead of Rs. 35,271/ and Rs. 17.606 as claimed by the petitioner. In para No. 8 of
the counter, respondents have shown helplessness while saying that the case of the petitioner was recommended to the Head of the Department for
reimbursement and it was recommended that the government servant can admit him and his family members' claim if they were admitted on
accident. The expenditure can be sanctioned by the Head of the Station. In para No. 9 also it has been categorically admitted that respondent No.
3 has at all times processed the case of the petitioner in time and has not, at any stage, kept pending the claim petition. In para No. 10 it has been
admitted that in case of serious accident central government employee can be admitted in the nearest hospital in absence of government hospital
and reimbursement of such medical expenses can be provided in full subject to the condition that the requisite certificate is recorded. The main
obstruction in reimbursing the medical claim according to the respondents is that they passed in pursuance of Health Ministry's order. lt has been
admitted in the objections that J.P. Angorana was admitted in All India Institute of Medical Sciences, New Delhi and the claim was reimbursed in
full.
Heard learned counsel for the parties. Mr. Bhan has raised a preliminary objection that CS (MA) Rules of 1944 under which the petitioner
claims the medical reimbursement was in operation when India was under British Rule and, as such, are not applicable now. According to him, the
petitioner has no claim for reimbursement under rules. The matter was examined. Mr. Bhan has not been able to show clearly which rules in the
alternative are applicable. He has admitted that the petitioner is entitled to reimbursement under CS (MA) Rules, but the year from which these
Rules are applicable have not been spelled out by him. The rules have been examined. The basic CS (MA) Rules have been framed undoubtedly in
1944 and have been made applicable there from. These rules are even now applicable, with certain modifications made from time to time, as has
rightly been contended by learned counsel for the petitioner also has been processed under these very rules by the respondents.It cannot be denied
that our civil and criminal laws and other related rules mostly pertain to British era and are mostly based on those laws which were applicable
before 1947. However, Mr. Bhan has not concentrated on this point. I think he has raised the point only for the sake of argument and is not
serious about it. Otherwise, he would have come forward with the rules which according to him are applicable at present.
Secondly, he has argued that Manipal Hospital, where the petitioner's son was admitted immediately after the accident, is not recognised under
CS (MA) Rules. So that medical claim cannot be reimbursed on the basis of the bills put in by such Hospital. Regarding this point also Mr. Bhan is
compelled not to be serious and has not made any efforts to convince the court regarding this argument, learned counsel for the petitioner has
invited my attention to Chapter V under the Head' arrangement in certain states. At page 118 of these rules, Manipal Hospital, Banglore has been
treated as recognised for the treatment of Central Government servants and members of their family under Rule 2 (d) of CS (MA) Rules, 1944.
Apart from this, when the bills of the petitioner were under process a communication No. 15 (2)1 9495/MAD/AC dated 24061994 was sent to
the Registrar Manipal Hospital as to whether the Hospital is recognised for providing medical treatment to the government employees or not. The
authorities of the Hospital replied the above letter stating that the Hospital is a recognised one. Moreover, it is apparent from the communication
No. 22019 (i) 95SL dated 09031995 that the medical reimbursement claim has been examined by the respondents and has party been sanctioned
under the above communication. Even in the objections respondent also has admitted that the case of the petitioner was examined. Respondent
No. 3 who is the Station Director, has recommended the case of the petitioner twice to respondent No. 3 and in his recommendations he has
declared the claim of the petitioner genuine. From this communication also, it appears that the respondents have admitted that the Manipal Hospital
is recognised and the petitioner was within his right to get his son admitted in such hospital due to emergency caused by the accident and there was
no government hospital the near vicinity. Here the controversy comes to an end whether the Manipal Hospital was a recognised Hospital or not.
As I have observed supra, Mr Bhan has not dealt with this point seriously, perhaps being a closed matter. As the reimbursement claim has partly
been sanctioned by the respondents, so .the above controversies has been narrowed down to two points.
(i) First, the petitioner had to enclose the certificate that his bills of private hospital were not more than the government hospital charges for such
treatment; and
(ii) Second, the respondents were right in deducting Rs. 25/ from each claim in pursuance of Health Ministry's order. Learned counsel for the
petitioner has rightly contended that there is no rule in CS (MA) Rules to show that in case of emergency Central Government employees or his
family member if admitted in a private hospital should enclose a certificate with the reimbursement claim that the bill charged by the private hospital
is not higher than the charges of government hospital for such treatment. Learned counsel for the respondent, Mr. Bhan failed to show to the court
any such rule. Even if there would have been any such rule, court does not feel armless to declare a rule ultra vires if it feels that the rule has no
rationale.
The constitution of India envisages the establishment of the welfare State. It is the primary duty of the Government to ensure the welfare of the
people by providing adequate medical facilities, which is even discharged by the government by running hospitals and health centres. Article 21 of
the Constitution imposes and obligation on the State to safeguard the right to life of every person, and preservation of human is thus of paramount
importance. Moreover, even a diseased person, who is infested with incurable disease, is not ready to get away with his life. Who else can look
after his life better than himself. In view of this, statutory rules have been made to guarantee medical facilities to its employees by the employer. It is
admittedly provided in the aforementioned rule that in emergency cases involving the accidents, serious nature of diseases, etc. the person/ persons
on spot may use their discretion for taking the patient for treatment in a private hospital in case no recognised government hospital is available
nearer to the place. Of course, it has been left to the controlling authority to decide each case on its merits. Whether it was a case of real
emergency, necessitating admission of a central government employee of this dependent in a private hospital. In the instant case there is nothing on
record to show that no such emergency in the private hospital, or that there was any government hospital available nearer to the scene of accident
where the petitioner's son could have been admitted for treatment. That apart learned counsel for the respondents has failed to show any such rule
as casts any embargo on the aforesaid rule to the as casts any embargo on the aforesaid rule to the effect that certificate be enclosed showing that
the government hospital for such treatment. Even if such rules would have been there, l have no hesitation in holding that such rule would be a
negation of the facilities provided to the patients in case of accidential emergencies, for, it is not within the competence of such patients to control
the charges of the private hospitals. Authorities cannot provide a facility to its employees on the one hand and on the other hand take the same
back on flimsy pretexts. Once a facility has been given to the employee to get the patient admitted in the private hospital in case of emergency,
whether the charges are higher or lower than the Government hospitals is of less importance. The basic thing is that if there is emergency and the
patient is to be admitted in the nearest hospital, facility has been provided to the employees to get the patients admitted in the private hospitals. If
there is any embargo on this facility, then that is clearly denial of the facility. In view of this, I am of the opinion that there could be no such rule and,
in any case, no such rule has been cited.
Learned counsel for the respondents has secondly contended that Rs. 25/ have been cut on every claim according to some notification issued by
the Central Government. No such notification has been produced, nor any such rule has been shown by the learned counsel for the respondents.
This is a vague argument. That apart, learned counsel has not explained how the amount has been decreased from Rs. 52,000/ and odd to Rs. 11,
187/. This argument is falified by two communications written by respondent is falsified by two communications written by respondent No.3 to
respondent No. 2. Respondent No. 3 has in clear and unequivocal terms and the same in to isgenuine and the amount should be reimbursed.
Respondent No. 2 though has raised certain queries, those queries have been replied by respondent No. 3 by reiterating that the claim of the
petitioner is genuine. How it lies in the mouth of respondent No. 3 to file the counteraffidavit and try to deny the claim in vague terms is not
understandable. Notwithstanding the contest by respondent No. 3, he has in his reply affidavit again willingly no opposed the genuiness of the
claim.
For the foregoing, this petition is allowed. Order No. D12019/195WL/90 dated 09031995 issued by respondent No. 2 is quashed and by
issuance of Mandamus respondents are directed to make the reimbursement of the medical claims of the petitioner to the tune of Rs. 52,877/. As
respondent No. 2 is responsible for the dillydallying tactics in making the reimbursement to the petitioner, it would be just and appropriate to
award interest to the petitioner on the amount. Accordingly, it is directed the reimbursement of Rs. 52,877/ shall be made to the petitioner with
12% interest from 09031993 till the amount is actually paid to the petitioner.
There shall, however, be on order as to costs.