CWP No. 6187 of 1999 -1- IN THE HIGH COURT OF PUNJAB AND HARYANA AT CHANDIGARH CWP No. 6187 of 1999 Date of Decision: 27.07.2010 Sat Paul Jindal ...Petitioner Vs. The Managing Director, State Bank of Patiala & Anr. ...Respondents CORAM Hon'ble Mr.Justice Vinod K.Sharma Present: Mr.Arihant Jain & Arun Jindal, Advocates, for the petitioner. Mr.C.B.Goel, Advocate, with Mr.Manoj Sharma, Advocate, for the respondent. --- 1. Whether Reporters of Local Newspapers may be allowed to see the judgment? 2. To be referred to the Reporters or not? 3. Whether the judgment should be reported in Digest? --- Vinod K.Sharma, J . (Oral) The petitioner has invoked the writ jurisdiction of this court under Articles 226 and 227 of the Constitution of India seeking a writ in the CWP No. 6187 of 1999 -2- nature of certiorari for quashing the order dated 16.4.1998 passed by the respondent/bank, rejecting the claim for reimbursement of medical bills. The petitioner joined as Cashier in the State Bank of Patiala at Malerkotla on 20.2.1962. The case of the petitioner is, that he was working honestly and sincerely and to the best of his ability, on account of his performance he was promoted as Assistant Manager in October, 1972 and to the post of Manager in the year 1978. The petitioner suffered from heart disease in the year 1991 i.e. Angina and he took medicines prescribed by the doctors from time to time. The petitioner had to undergo operation of Rotablator Angioplasty, in the Apollo Hospital, Madras in the year 1992. The claim of the petitioner is, that in spite of his poor health, he was performing his duties to the satisfaction of the bank. The petitioner met with a serious accident in December, 1995. After the accident, his health deteriorated and his angina problem aggravated. The petitioner was checked on 22.4.1997 by Dr.Lall at the Metro Hospital and Heart Institute at Noida. In the medical examination blockade of two blood vessels were noticed, and it was opined by the hospital that the petitioner required immediate operation. The petitioner thereafter in view the serious heart problem, was immediately admitted in the hospital and was operated on 29.5.1997. A stent was implanted in one main artery of heart where operation was not successful. The cost of stent was Rs.62,500/- (Rupees sixty two thousand and five hundred only). The petitioner after operation was discharged on CWP No. 6187 of 1999 -3- 30.5.1997, but he suffered another attack on 31.5.1997. which resulted into heavy damage to the heart. Because of the second heart attack the petitioner was put under intensive care in Bhargava Cardiac Nursing Centre, Chandigarh. After being kept under observation up to 3.6.1997 he was referred to Metro Hospital at Noida for immediate treatment of the damaged heart. Petitioner attached copies of case summary along with bills for reimburse. The amount of bill claimed by the petitioner was Rs.1,51,662.30P (Rupees one lac fifty one thousand six hundred sixty two and thirty paise only), as the respondent bank had paid only a sum of Rs.62,500/- (Rupees sixty two thousand and five hundred only) i.e. the cost of operation and denied the balance payment i.e. the cost of stent and subsequent treatment amounting to Rs.1,51,662.30P (Rupees one lac fifty one thousand, six hundred sixty two and paise thirty only) taken by the petitioner from 31.5.1997 till 13.6.1997, when he was finally discharged. Remaining payment i.e. Rs.1,51,662.30P (Rupees one lac fifty one thousand, six hundred sixty two and paise thirty only) due to the petitioner on account of reimbursement was rejected by way of impugned order,which reads as under:- “ Please refer to your representation dated 9.1.98 addressed to the Managing Director, Head Office, Patiala. We have been advised by Central Accounts Deptt. Patiala that you are not entitled for any further reimbursement of medical charges after retirement. You are also not entitled for stent CWP No. 6187 of 1999 -4- charges, as you have already been allowed package charges.” On notice, in the written statement filed by the respondent, stand taken was, that the petitioner has been paid on the basis of package for specialized treatment for disease pertaining to heart kidney, coronary etc.. The case of the respondent was, that as the package was provided to the officers in the Junior Management and Middle Management Grade, therefore, the petitioner was only entitled to Rs.62,500/- (Rupees sixty two thousand and five hundred only) which already stood paid. It is also the case in the written statement that the petitioner after his retirement was not entitled to any reimbursement on account of medical expenses. No package scheme has been placed on record along with the written statement. On consideration, I find that the petitioner is entitled to whole of the claim raised by him for medical reimbursement. The respondent/Bank issued a circular No.PER/23 dated 11.6.1996 with regard to the reimbursement of hospitalization charges which provides that officers in the Junior Management, Senior Management would be entitled to cent per cent of the amount actually incurred or one mentioned, which ever is lower. Relevant portion of the Circular reads as under:- CWP No. 6187 of 1999 -5- Officers in Junior Management and Middle Management Grade Officers in Senior Management and Top Executive Grade 75% of the amount actually incurred or as mentioned below whichever is lower for family members 100% of the amount actually incurred or as mentioned below whichever is lower for himself 75% of the amount actually incurred or as mentioned below whichever is lower for family members 100% of the amount actually incurred or as mentioned below whichever is lower for himself Rs. Rs. Rs. Rs. 3.1 (a) Hospital Registration Fees 50 75 60 90 (b) Surcharge/tax on hospital bills Proportionate to the extent of the bill passed by the bank. Proportionate to the extent of the bill passed by the bank. 3.2 Charges for bed per day (excluding charges for board) 180 225 240 300 3.3 Diagnostic material charges, X-rays, Pathological tests, ECG, etc. As per Annexure- I hereto 3.4 Medicines, drugs, injections, bandage and dressing materials, etc. except tonics 75% or 100% as the case may be of actual expenses incurred 3.5 Operation charges, etc. As per Annexure- II hereto Sic. and Consultant's fees per visit: Officers in Junior Management and Middle Management Grade Officers in Senior Management and Top Executive Grade 75% of the amount actually incurred or as mentioned below whichever is lower for family members 100% of the amount actually incurred or as mentioned below whichever is lower for himself 75% of the amount actually incurred or as mentioned below whichever is lower for family members 100% of the amount actually incurred or as mentioned below whichever is lower for himself Rs. Rs. Rs. Rs. Visit at the Chamber (1) Majot A Class Cities: CWP No. 6187 of 1999 -6- Sic. and Consultant's fees per visit: (a) First Consultation 112.5 150 135 180 (b) Subsequent Consultation 56.25 75 67 90 (2) Other Places: (a) First Consultation 75 112.5 90 135 (b) Subsequent Consultation 37.5 56.25 45 67.5 Officers in Junior Management and Middle Management Grade Officers in Senior Management and Top Executive Grade 75% of the amount actually incurred or as mentioned below whichever is lower for family members 100% of the amount actually incurred or as mentioned below whichever is lower for himself 75% of the amount actually incurred or as mentioned below whichever is lower for family members 100% of the amount actually incurred or as mentioned below whichever is lower for himself Rs. Rs. Rs. Rs. VISIT AT RESIDENCE (1) Major A Class Cities: (a) In case of emergency leading to Hospitalisation 137.5 250 165 300 (b) Second Consultation 112.5 225 135 270 (c) Subsequent Consultations 75 150 90 180 2. Other Places: (a) In case of emergency leading to Hospitalisation 100 187.5 120 225 (b) Second Consultation 75 150 90 180 (c) Subsequent Consultations 50 100 60 120 Visits made by Specialists at the Hospital SPECIAL VISITS (1) Major A Class Cities: (a) During the day time 62.5 100 75 120 CWP No. 6187 of 1999 -7- Sic. and Consultant's fees per visit: (b) During night time 100 150 120 180 (c) Routine Visits 50 62.5 60 75 (2) Other Places: (a) During the day time 50 62.5 60 75 (b) During night time 62.5 100 75 120 (c) Routine Visits 50 62.5 60 75 4. The officers or members of their families (as the case may be) are expected to secure admission in a Government or Municipal Hospital or any private hospital (i.e. hospitals under the management of a Trust, Charitable Institution or a religious mission). But in avoidable circumstances the officers or their family members or both may avail themselves of the services of one of the approved private nursing homes or private hospitals approved by the Bank. Reimbursement in such cases should, however, be restricted to the amount which would have been reimbursable in case the patient was admitted to one of the hospitals mentioned above. 5. Medical expenses incurred within 30 days of pre and post hospitalization period on medical advice on account of the ailment/disease for which the person was hospitalised will be considered as hospitalization expenses for the reimbursement purpose. 6. Charges for engaging a nurse/attendant will not be CWP No. 6187 of 1999 -8- reimbursed.” Reading of the Circular shows that the petitioner being in the Junior Management of the Bank was entitled to cent per cent of the amount actually incurred by him. It is not disputed by the respondents, that the amount claimed, by the petitioner was actually incurred. The stand taken was that the petitioner, was entitled to reimbursement only under the package. In view of the circular which was in force since 11.6.1996 no reliance could be placed on the package, specially when none has been produced along with the written statement showing acceptance of the said package by the petitioner. As regards the plea of the respondent/bank, that the petitioner is not entitled to reimbursement because of his retirement, also cannot be sustained, as admittedly petitioner was operated upon while he was in service, and had suffered second attack, also in service, therefore, once the disease started while the petitioner was in service, merely because within a short span, petitioner retired can not be a ground to deny reimbursement of his ailment which continued up to 13.6.1997, i.e. up to one month of retirement, as this period will fall within post hospitalization in terms of the circular. The circular being a beneficial act for its employees has to be construed liberally in favour of the employee as held by Hon'ble Division Bench of this court in the case of Renbir Singh Kundu Vs. Haryana State Agricultural Marketing Board, Panchkula and Ors. 2008 (2) SCT CWP No. 6187 of 1999 -9- 314. For the reasons stated, this writ petition is allowed. Impugned order is set aside, and writ of mandamus is issued to the respondent to reimburse the balance amount incurred by the petitioner on the treatment of his disease i.e. Rs.1,51,660.30P (Rupees one lac fifty one thousand six hundred sixty and paise thirty only). This amount is due after deducting a sum of Rs.62,500/- (Rupees sixty two thousand and five hundred only) paid to the petitioner towards operation charges. The petitioner shall also be entitled to interest at the rate of 8% per annum on the amount from the date of submission of the bills till realization. The amount is directed to be paid within two months of the receipt of certified copy of this judgment. No costs. (Vinod K.Sharma) 27.07.2010 Judge rp