CW 10284/07 [1] IN THE HIGH COURT OF JUDICATURE FOR RAJASTHAN AT JAIPUR BENCH S.B. Civil Writ Petition No.10284/07 Sayeed Nawab Hussain Versus State & Ors. DATE OF ORDER : 11/09/2008 HON'BLE MR. JUSTICE AJAY RASTOGI Mr. Dharmendra Agrawal, for petitioner Mr. J.K. Agrawal, Addl. Govt. Counsel, for State Petitioner, who is a senior citizen, retired from service while holding the post of Reader [UDC] on 31st December, 1983. While he was staying at New Delhi at his son's house in ST CRPF Quarter No.21, Block No.2, Campus Jharoda Kalan, New Delhi, he all of sudden felt pain in his chest and was immediately hospitalized in Batra hospital, New Delhi and looking to his seriousness and acute problem, he was advised for bypass surgery and after taking treatment from Batra hospital, petitioner submitted his medical bills [Ann.1] in the office of respondents in February, 2004. His medical bills were rejected by the respondents vide order Ann.2 dt.6th July, 2004 on the premise that since the petitioner had undertaken treatment from the hospital which is not a recognized/approved hospital by the Government, as such medical bills are not reimbursable under Rajasthan State Pensioners Medical Concession Scheme. Counsel for petitioner submits that petitioner has retired from service way back in CW 10284/07 [2] December, 1983 and while he was at the residence of his son at New Delhi, he had a severe pain and immediately taken to nearby hospital i.e. Batra hospital and in such emergent situation, it was not possible for him to take prior consent/ approval from SMS Hospital, Jaipur for treatment at New Delhi. Counsel for petitioner placed reliance on the judgment of Division Bench of this court in State of Rajasthan Vs. Mithulal Gupta (Spl.App(Writ)- 858/07 decided on 24/03/08) in which after examining the Scheme it was observed that he is entitled for payment as per Para 4E of the Scheme. Respondents have filed reply to writ petition raising only objection that since petitioner has taken treatment from hospital which is not recognised/approved by Government, as such, his medical bills have rightly been rejected. Division Bench of this court after examining the Scheme and taking note of precedents laid down by this court finally observed in Para 11, as under: “11. The Counsel for the respondent then submitted that in any case the petitioner was entitled to the reimbursement to the extent of Rs. 1,20,000/- as per the then existing rule 4B. Rule 4B provides the scale of assistance to the extent of 80% of hospital expenses or Rs. 1,20,000/- which is less in the case of bye-pass surgery if the treatment is taken in a CW 10284/07 [3] Government hospital within the State of Rajasthan. The petitioner did not choose to avail of the specialised treatment in SMS Medical College and Hospital although angiography was done there but instead without any reference from that hospital went to Escort Hospital, New Delhi on his own. Having not chosen to have the specialisted treatment in a Government hospital within the State of Rajasthan, the scale of assistance provided in the para 4B of the Rules for treatment in such hospitals cannot be applied. The case of petitioner is covered by para 4E of the Scheme and according to that provision, scale of assistance is limited to Rs.44,000/- being 80% of general award charges of All India Institute of medical Sciences, New Delhi.” In view of what has been observed above, instant petitioner is entitled for reimbursement of medical bills furnished by him, in terms of Rule 4-E of the Scheme. Consequently, writ petition stands allowed. Order (Ann.2) dt.6th July, 2004 rejecting claim of petitioner is hereby quashed and set aside. Respondents are directed to make payment of bills raised in terms of Rule 4E of the Scheme which shall carry interest @9% per annum from the date of presentation of bills till its actual payment. The respondents may ensure compliance of this order within two months. No order as to costs. [AJAY RASTOGI], J. FRBOHRA10284CW07 11-9.doc