IN THE HIGH COURT OF HIMACHAL PRADESH SHIMLA CWP(T) No.16331 of 2008 (OA No.175 of 2007) Date of decision: July 19, 2010. Surinder Kumar Chona …. Petitioner. Versus State of H.P. and others. …. Respondents Coram: The Hon’ble Mr. Justice Surinder Singh, J. Whether approved for reporting ?1 For the Petitioner: Mr. Ranjan Sharma, Advocate. For the respondents. Mr. A.K.Bansal, Addl. Advocate General. Surinder Singh, J (oral). The petitioner retired as Superintendent from the Department of Food and Civil Supplies, Government of Himachal Pradesh. He had cardiac problem and was recommended for bypass surgery to which he underwent on 22nd March, 2006, in ‘Tagore hospital’ at Jallandhar, for which the petitioner has sought and accorded permission vide letter No.HFW-H(V)A(2)2/2005 dated 10th February, 2006 (Annexure A-1), from the Director, Health Services of respondent No.1, a copy whereof was endorsed to the 1 Whether the reporters of Local Papers may be allowed to see the judgment ? Yes. - 2 - Chief Medical Officer, Chamba and to the petitioner, as well. 2. Vide Annexure R-III, the aforesaid hospital was recognized by the State Government, for the purpose of medical reimbursement to the H.P. Government employees/ Pensioners, for undergoing ‘open heart surgery’ and the rates for the said purpose to be charged for the said hospital was limited to Rs.99,000/-. Clause-2 of the said letter clearly mentions that this package deal for ‘open heart surgery’ will include stay upto 15 days and one day stay for Angiography and will also include room rent from the date of admission to the date of discharge, service charges, nursing/ medical care surgeons and Anaesthesiane’s fee, operation theatre charges and diet etc. 3. Clause-6 of the letter aforesaid says: “no reimbursement will be allowed if the above hospitals charges, the rates over and above the ceiling/ package deal entered into with them and in that event extra charges will be born by the individual”. 4. Since this hospital was located out of the State, thus, permission from the Director of Health Services, - 3 - Himachal Pradesh, for undergoing treatment outside the State was necessary, which was accorded in the instant case as referred above. 5. Rule 6 of Central Services (Medical Attendance) Rules, provides for free charges to the treatment, in such Government hospital at or near the place where the Government servant falls ill as provided therein. Any amount paid by such person on account of such treatment on production of the certificate in writing authorized by the medical attendant in this behalf, is essentially required to be reimbursed to the concerned government servant, subject to rule 2(h) Clause (iii) of the said Rules. But in the instant case, there is no such exclusion. 6. In fact, the bill of the petitioner was found to be correct and passed for Rs.1,37,992/-, but restricted to Rs.99,000/- for reimbursement. Despite repeated requests/ representations, respondents did not reimburse the balance amount of Rs.38,000/- charged for implanting “Intra Aortic Balloon Pump” by the Surgeon which was essential to save the life of the petitioner. The respondents referred to Annexure R-III letter No.HFE-B(A)2-6/96 dated 21.9.2000 declining request that the agreement was - 4 - arrived at between the Government and said hospital for the reimbursement only upto Rs.99,000/-. Hence this petition was filed before the erstwhile Tribunal and after abolition of the said Tribunal, the cases were transferred to this Court alongwith the present one, which was registered as CWP (T). 7. Vide order dated 29th March, 2010 of this Court, the first respondent i.e. State was ordered to file supplementary affidavit by this Court, incorporating the intervening development, explaining also as to whether in the facts and circumstances of the case Annexure R-III would apply and also referring to instruction No.16 of the CCS (Medical Attendance) Rules, precisely whereby reimbursement for such like Pump is admissible. Respondent No.1 sought the clarification from the head of department of Cardiology and also the Principal of Indira Gandhi Medical College and Hospital, Shimla. In this context, it was conveyed by them that normally ‘Intra Aortic Balloon Pump’ is not a part of “CABG package” but it is used only in patients with poor left ventricular function undergoing CABG. 9. The State objected to the release of Rs.38,000/- only on the ground that this package deal did not - 5 - include the aforesaid hospital. But it is pertinent to note that during performing the heart surgery, “Intra Aortic Balloon Pump” was required to be implanted because of the poor functioning of the left ventricular function, which was necessary to save the life of the petitioner. 10. Therefore, against the aforesaid background, in my opinion, the respondents could not have denied the legitimate claim of the petitioner, which is covered under the Medical Reimbursement Rules as also protected under Article 21 of the Constitution of the India. 11. Therefore, for the reasons aforesaid the petition is allowed. Respondents are hereby directed to reimburse the amount of Rs.38,000/- within a period of eight weeks, to the petitioner with interest @ 6% per annum w.e.f. Ist April, 2006, since when the claim of the petitioner was wrongly rejected, till the date of its actual reimbursement. The petition stands disposed of. July 19, 2010. (Surinder Singh), (Pds) Judge.