Smt. Santosh Phogat vs The State of Haryana and Another

Harjit Singh Bedi, J.—The petitioner, a Nursing Sister, is presently employed in the Pandit Bhagwat Dayal Sharma, Post Graduate Institute of Medical Science, Rohtak (hereinafter called "the PGI"). She was admitted to the PGI on 19th June, 1997 suffering from service headache. The attending Surgeon advised her to undergo a Magnetic Resonance Imaging (in short the MRI) Test at the All India Institute of Medical Sciences, New Delhi (hereinafter called the AIIMS") as the same was not available in the PGI and a sanction letter Annexure P-2 dated 19th June, 1997 was also issued for this purpose. The letter aforesaid also allowed the petitioner the services of an attendant to take her from Rohtak to New Delhi. The petitioner was accordingly discharged from the PGI on 24th June, 1997, and on the basis of the sanction letter, attended the AIIMS on 2nd July, 1997 and undertook the test in question as an outdoor patient. She also incurred an expense of Rs. 8000/- for this purpose for which two receipts Annexures P-3 and P-4 dated 2nd July, 1997 were issued to her. She thereafter made an application for the reimbursement of this amount and her case was duly recommended by the PGI to the State Government but was declined by the latter vide Annexure P-6 dated 16th July, 1998, (endorsed to the petitioner on 11th August, 1998) on the ground that the MRI Test had been taken by her as an outdoor patient and in view of the instructions issued by the State Government any treatment/test taken in that capacity was not reimbursable. The petitioner, has accordingly come to this Court pleading that as per the instructions Annexure P-7 dated 30th November, 1993, the petitioner was entitled to reimbursement of all her medical expenses.

In the reply filed by the respondent, it has been pleaded that as the petitioner was in receipt of a fixed medical allowance, she was not entitled to claim reimbursement of the expenses incurred by her as an outdoor patient on the MRI Test in the AIIMS. Reliance for this plea has been placed on the instructions dated 2nd December, 1988 (though they have not been appended with the reply). In paragraph 3 of the reply it has, however, been admitted that the petitioner would have been reimbursed for the MRI test taken in the AIIMS if she had taken the test as an indoor patient.

Mr. S.K. Bansal, the learned counsel appearing for the petitioner, has argued that the petitioner had undergone the MRI Test on the recommendation of the PGI as the said test was not available in that Institution and in this view of the matter the petitioner was entitled to the reimbursement of the medical expenses. He has also urged that the MRI Test was an essential investigatory procedure which was to be carried out before the petitioner could be treated for her Neurological problem and as such, the said test constituted an integral part of the petitioner''s treatment and could not be isolated therefrom.

Mr. Jain the learned State Counsel has, however, relied upon the averments made in the written statement and has pleaded that as the State Government instructions on the point in question were very clear and in this situation, no reimbursement could be made for treatment or tests taken as an outdoor patient.

After hearing the learned counsel for the parties, I am of the opinion that this petition deserves to succeed.

The facts are not in dispute. The petitioner, an employee of the PGI was referred for the MRI Test to the AIIMS by the attending doctors. She was also permitted to undergo this test within one month from 19th June, 1997 and was discharged from the PGI for that purpose. Admittedly, she underwent that test on 2nd July, 1997. It is true that the Government Instructions, referred to in the reply (copy of which have been produced in Court today by Mr. Jain) do show that an employee receiving a fixed medical allowance, would not be allowed reimbursement of medical expenses incurred as an outdoor patient. The Instructions, however, have to be construed in a manner which would enhance their purpose rather than create an anomalous situation. It cannot be disputed that the MRI Test was an essential investigatory procedure for a proper analysis of the petitioner''s malady which would lead to her proper treatment. It was therefore, an integral and inseparable part of the treatment that the petitioner had received in the PGI as an indoor patient. Moreover, it is to be borne in mind that the petitioner had been recommended to the AIIMS, New Delhi, by the PGI itself because the MRI test was not available in the latter Institution. It also stands admitted by the latter Institution. It also stands admitted by the respondents that had the petitioner been admitted to the AIIMS on the 2nd July, 1997 and had undertaken the test as an indoor patient, she would have been allowed reimbursement of her claim. To my mind, this stand is somewhat anomalous and illogical. The purpose behind the instructions apparently is to decrease the burden on the State exchequer. This intention would be completely nullified as an employee would make all efforts to get admission to a hospital for even minor problems which would burden the State even more. Moreover, the issue even otherwise stands concluded by a Single Bench decision of this Court in Satpal Kaur v. State of Punjab, (CWP No. 16622 of 1997) decided on 19.5.1999 wherein it has been held that if the outdoor treatment is an integral part and connected with the indoor treatment, the expenses incurred on the former are reimbursable.

This petition is accordingly allowed, the order Annexure P-6 is quashed and a direction is issued to the respondents to make the payment to the petitioner on the assumption that the test that she has undergone in the AIIMS New Delhi, was reimbursable as indoor treatment. No costs.

Dasti Order.