Prof. John M. George vs State of Kerala, The Secretary to Government, The Director of Health Services and The Director of Collegiate Education

Antony Dominic, J.—Petitioner is the Principal of an Aided College. His wife had to undergo an emergency cardiac surgery. It is stated that on the advice of the Medical Attendant of the Government Hospital, Adoor, Petitioner''s wife got admitted at the Miot Hospital, Chennai, where she underwent the surgery.

Subsequently, an application was made for reimbursement of the medical expenses and that was rejected by Ext.P10 order of the 1st Respondent. InExt.P10, it is stated that the hospital is not approved by the Government of Kerala for medical reimbursement for Government Servants and their dependents. It is also stated that that the treatment was taken outside Keralawithout prior permission of the Director of Health Services and that this facility is available in Sree Chithira Thirunal Institute of Medical Science, Trivandrum and Amritha Institute of Medical Science and Research Centre, Kochi. It is challenging Ext.P10, this writ petition is filed.

It is the contention of the learned Counsel for the Petitioner that in terms of the provisions contained in the Kerala Government Servant''s Medical Attendance Rules, the claim is admissible. In my view, Rule 7A dis-entitles the Petitioner the benefit claimed. Rule 7A with Note 1 attached thereto reads as under:

7A. Reimbursement of expenditure incurred "for special treatment" outside the State:

The expenditure incurred by a patient entitled to free medical attendance under these rules for any special treatment obtained by him/her outside the State but within India will be reimbursed subject to the condition that the Director of Health Services certifies

(i) that there were no facilities in the State for such special treatment.

(ii) that the nature of the disease warranted the special treatment outside the State but within India by the specialist concerned, and

(iii) the charges claimed are reasonable.

NOTE 1: Such treatment outside the State but within India shall be taken only with the prior sanction of the Director of Health Services on the recommendation of the Authorised Medical Attendant. The Director of Health Services while sanctioning such treatment shall specify the institution in which the treatment is to be undergone.

Further it is also seen from the provisions of the G.O (MS) No. 122/85/HD dated 3rd July, 1985 that certain hospitals have been identified as having facilities for special treatment and that among the hospitals identified for Bye pass coronary surgery, Miot Hospital, Chennai is not one which is included.

A reading of Rule 7A therefore shows that there are three conditions for claiming reimbursement of the expenditure incurred. Further Note 1 provides that treatment outside the state should be availed of only with the prior sanction of the Director of Health Services. Admittedly none of these conditions are satisfied by the Petitioner. If that be so, Ext.P10 is unassailable and the claim of the Petitioner is inadmissible.

Writ petition fails and it is accordingly dismissed.