-1- Civil Writ Petition No.13211 of 2006. IN THE HIGH COURT FOR THE STATES OF PUNJAB & HARYANA AT CHANDIGARH ... Date of Decision: February 08, 2008. Ranbir Singh Kundu through his legal representatives Smt.Santosh Devi and others .. Petitioners VERSUS Haryana State Agricultural Marketing Board, Panchkula, and another ... Respondents CORAM : HON'BLE MR.JUSTICE HEMANT GUPTA. HON'BLE MR.JUSTICE MOHINDER PAL. 1. Whether Reporters of Local papers may be allowed to see the judgment ? 2. To be referred to the Reporters or not ? 3. Whether the judgment should be reported in the Digest ? Present: Mr. Ravi Verma, Advocate, for the petitioner. Mr.Durgesh Aggarwal, Advocate, for the respondents. -.- MOHINDER PAL, J. Claim in the present writ petition is for quashing the order dated February 10, 2005 (Annexure P-4) vide which claim of petitioner Ranbir Singh Kundu (since deceased and -2- Civil Writ Petition No.13211 of 2006. represented by Mrs. Santosh Devi -widow, Mrs. Seema Narwal -daughter, Mr. Rohit Kundu -son and Miss Nidhi Kundu -daughter), for medical reimbursement on account of treatment of his son, namely, Rohit Kundu from Delhi Heart & Lung Institute, New Delhi, has been rejected and for issuing a direction to the respondents to make payment of Rs.98,812/- incurred by the petitioner in connection with the treatment of Rohit Kundu. The petitioner was an employee of the Haryana State Agricultural Marketing Board - respondent No.1 (hereinafter referred to as the respondent-Board) and was working as a Mandi Supervisor. Son of the petitioner, namely, Rohit Kundu, dependent upon the petitioner, suddenly fell ill on November 16, 2004 as he suffered onset of severe chest pain. He was got admitted in a nearby hospital i.e Dr. Prem Hospital, Panipat. The Doctors at Prem Hospital diagnosed that Rohit Kundu had sustained Tension Pneumothorax on left side as well as Cardio Respiratory Embracement and accordingly Inter-costal Tube Drainage (ICD) was done and he was put on mechanical ventilation support due to sudden respiratory arrest. As the patient could not recover and his condition was deteriorating, a team of Doctors (Specialists) was summoned from Delhi Heart & Lung Institute, New Delhi, who examined the patient and advised to shift him immediately to the said hospital. -3- Civil Writ Petition No.13211 of 2006. Petitioner also got the same advice from the attending Doctors of Dr. Prem Hospital, Panipat. Accordingly, the patient was shifted to Delhi Heart & Lung Institute, New Delhi. Son of the petitioner remained admitted in the Delhi Heart & Lung Institute, New Delhi, from November 17, 2004 to December 01, 2004 and a sum of Rs.98,812/- was incurred on his medical treatment. The petitioner submitted claim of medical reimbursement of the aforesaid expenses to respondent-Board through proper channel. However, the respondent-Board rejected the claim of the petitioner for medical reimbursement on the ground that the treatment had not been taken in a hospital recognized by the State of Haryana. On notice, the respondents contested the claim of the petitioner for medical reimbursement on the ground that the State of Haryana has framed a policy as contained in letter No.2.10/90/H.B.III dated November 30, 1993 (Annexure P-1) for reimbursement of medical bills of indoor special treatment of its employees/ officers/ pensioners/ family pensioners and their dependents in the approved hospitals. As in the present case the petitioner had taken treatment in Dr. Prem Hospital, Panipat, and Delhi Heart & Lung Institute, New Delhi, which were not on the approved list of the State of Haryana for treatment of its employees and their dependents, therefore, the petitioner was not entitled to medical reimbursement in this case. -4- Civil Writ Petition No.13211 of 2006. We have Mr. Ravi Verma, Advocate, appearing for the petitioner and Mr.Durgesh Aggarwal, Advocate, appearing for the respondents, and have gone through the records of the case. While arguing before us, learned counsel for the petitioner has argued that the objection regarding treatment in a private hospital could not be sustained in the eyes of law in view of the state of emergency arisen because of sudden and severe chest pain from which the patient was suffering at the relevant time. The petitioner had no time at all to shift the patient to other recognized hospital or to get the patient referred through Medical Superintendent / Civil Surgeon, Government Hospital, Panipat, as required under the relevant rules. On the other hand, learned counsel for the respondents, has stressed the point that as the treatment had been taken from a hospital which was not recognized by the respondent-Board, the claim for medical reimbursement was rightly rejected. We are unable to restrain ourselves from observing that the respondents' plea is not only unsustainable but is tidally bereft of any plausible reason. The stand of the respondents does not merit consideration in view of the admitted facts that the condition of the patient had deteriorated to such an extent that he had been referred as a case of emergency and -5- Civil Writ Petition No.13211 of 2006. had been certified so by the attending Doctors of Delhi Heart & Lung Institute, New Delhi. The policy for reimbursement of medical expenses incurred on the treatment taken from some of the hospitals recognized by the respondents, as contained in the letter dated November 30, 1993 (Annexure P-1) is as under:- “ Subject: Grant of recognition of Navedic Prosthetic Centre, Daulatsinghwala, Zirakpur (Punjab), Batra Hospital, New Delhi and Escort Hospital, New Delhi, for the purpose of medical treatment of Haryana Government Officers/ employees/ pensioners/ family pensioners. Xx xx xx and to state that Navedic Prosthetic Centre, Daulatsinghwala, Zirakpur (Punjab), Batra Hospital, New Delhi and Escort Hospital, New Delhi have been given recognition for (a) special treatment/ surgery of officers/ employees/ pensioners/ family pensioners and their dependents of Haryana State on the condition that employees/ officers/ pensioners who will get treatment from these institutions, they shall be entitled to get reimbursement equal to the rate of All India Institute of Medical Sciences (A.I.M.S), New Delhi/ P.G.I, Chandigarh. 75 % -6- Civil Writ Petition No.13211 of 2006. of the expenses exceeding rates of A.I.M.S, New Delhi/ P.G.I shall be reimbursed and the remaining 25 % of the expenses shall be borne by the claimant himself. Xx xx xx xx. “ Admittedly, Batra Hospital, New Delhi and Escorts Hospital, New Delhi, were the nearest available recognized hospitals from which the petitioner or his dependents were authorized to take treatment and claim medical reimbursement. It is also not disputed that none of these hospitals had a specialization for treatment of the disease from which the petitioner's son was suffering at the relevant time. Batra Hospital, New Delhi and Escorts Hospital, New Delhi, are known hospitals for treatment of heart ailments. However, in the present case, son of the petitioner was diagnosed to be a patient of “c (Rt) Pneumothorax C cyanosis Clst (Rt.) side followed by breathlessness & bluish discoloration (sic). ECG-RAD- RBBB Tachycardia- AP (Bed Side) Hyper- (Rt) old air sitting less costal chest shadow devoid of long Rgonotnot + + making is seen in (Rt) mid & long cyanosis + + zone C collapse (Rt) long marginal medially shift of Trachea & mediasterial shadow to (L) is seen. Opinion - Large (Pt) Pressothesis Meddronal Shift (Rt) long collap.” -7- Civil Writ Petition No.13211 of 2006. Condition of the patient at the time of his admission in Dr. Prem Hospital, Panipat, on November 17, 2004, as observed by the Doctors, is reproduced as under:- “ Keeping in view the serious condition of the patient he is advised to be referred to Delhi Heart & Lung Institute, immediately” Similarly, the Certificate (Annexure P-5) issued by Delhi Heart & Lung Institute, New Delhi, depicts the condition of the patient as under:- “ This is to certify that Rohit Kundu was hospitalized on 17.11.2004 in an emergency condition and is being discharged on 1.12.2004. He was diagnosed as having Atrial Septal Defect (ASD) with Right Pneumothorax. He has been treated for Right Pneumothorax and requires Device Closure for Atrial Septal Defect. The estimated cost of the procedure -8- Civil Writ Petition No.13211 of 2006. would be Rs.1,25,000.00/- (rupees One lakh and twenty five thousand only) for device closure. The procedure cannot be undertaken presently and can be done only after four weeks in view of his underlying acute lung condition.” A close perusal of the policy for medical reimbursement dated November 30, 1993 (Annexure P-1) would show that an employee is entitled to get reimbursement on account of treatment from recognized institutes equal to the rates of A.I.M.S, New Delhi/ P.G.I, Chandigarh and 75 % of the expenses exceeding the rates of A.I.M.S, New Delhi/ P.G.I, Chandigarh. However, the remaining 25 % of the expenses over and above the rates of A.I.M.S, New Delhi/ P.G.I, Chandigarh, are to be borne by the employee from his own pocket. It is interesting to note that in the present case, even the reimbursement at the rate of A.I.M.S, New Delhi/ P.G.I, Chandigarh, has been denied to the petitioner, which is wholly arbitrary and cannot be sustained in the eyes of law. There is no reason nor any has been pointed out to restrict the right of the petitioner to get the best medical treatment available from an institute which is specialized for a particular disease. Since the -9- Civil Writ Petition No.13211 of 2006. provision of free medical treatment or reimbursement in lieu thereof is a beneficial act of the welfare State for its employees, the rules/instructions have to be construed liberally in favour of the employees, for granting them the relief. The authorities are not supposed to adopt a wooden attitude and stick to technicalities while dealing with human problems. There can be no mathematical precision while dealing with human beings. We cannot lose sight of the factual situation that the son of the petitioner required a specialized treatment which was not available at Batra Hospital, New Delhi and Escorts Hospital, New Delhi, which are specialized hospitals for treatment of heart ailments. It was not expected of the petitioner to request to the authorities at that point of time for granting him permission to take treatment for his son from a particular hospital as son of the petitioner was in acute emergency and was put on ventilator. We are of the considered view that refusal of claim of the petitioner is unreasonable, unjust and arbitrary. The impugned order is violative of Article 14 of the Constitution of India. We, accordingly, allow this writ petition, set aside the order dated February 10, 2005 (Annexure P-4) and direct the respondents to reimburse to the petitioner the amount equal to the rates of A.I.M.S, New Delhi/ P.G.I,Chandigarh and 75 % of the expenses exceeding the rates of A.I.M.S, New -10- Civil Writ Petition No.13211 of 2006. Delhi/P.G.I, Chandigarh. However, the remaining 25 % of the expenses over and above the rates of above-mentioned Institutes will be borne by the petitioner. The amount should be reimbursed within two months from the date of receipt of a copy of this order failing which the petitioner will be entitled to claim interest at the rate of nine per cent per annum from the date of the amount became due till its realization. ( HEMANT GUPTA ) ( MOHINDER PAL ) JUDGE JUDGE February 08, 2008. ak