IN THE HIGH COURT OF JUDICATURE, ANDHRA PRADESH AT HYDERABAD (Special Original Jurisdiction) PRESENT: THE HON’BLE MR. JUSTICE C.V.NAGARJUNA REDDY WEDNESDAY, THE THIRD DAY OF DECEMBER, TWO THOUSAND EIGHT ONLY WRIT PETITION No.19275 of 1999 Between: Sri R.Ganga Raju. … Petitioner And The Secretary, Education Department, Government of Andhra Pradesh, Saifabad, Hyderabad and three others. … Respondents Counsel for the petitioner: Sri Satish Deshpande Counsel for the respondents: GP for Medical & Health for R.2. AGP for Higher Education for R.1,R.3 & R.4. This Court made the following: ORDER:- This Writ Petition is filed for a Writ of Mandamus to declare the action of respondent No.3 in issuing proceedings dated 21-8-1998, 30-10-1998 and 18-7-1999 as arbitrary, illegal and violative of principles of natural justice. The petitioner also sought for a consequential direction to the respondents to reimburse the sum of Rs.1,42,755/- together with interest thereon at 18% per annum from 18-10-1997. Heard Sri Satish Deshpande, learned counsel for the petitioner, and the learned Government Pleader for Medical and Health. The petitioner is a retired Junior Lecturer in Economics in a Government Junior College. He underwent bypass surgery on 10-11-1997 in Care Hospital, Nampally, Hyderabad. His application for reimbursement of the medical expenditure incurred by him having been rejected by the respondents, he filed the present Writ Petition. The ground on which the said rejection was made is that Care Hospital, Nampally, Hyderabad, was not included in the list of private hospitals for the purpose of medical reimbursement at the time when the petitioner underwent bypass surgery. At the hearing, learned counsel for the petitioner strenuously contended that in view of the emergency situation, the petitioner got himself admitted in the said private hospital, and refusal to reimburse the medical expenses is wholly arbitrary. In the counter-affidavit filed by respondent No.2 i.e., the Principal Secretary to Government, Health, Medical & Family Welfare, it is, inter alia, stated that in G.O.Ms.No.38 dated 23-1-1996 the Government of Andhra Pradesh recognized eight private hospitals in the State and eight private hospitals outside the State for treatment of the State Government employees/retired employees and their dependants; and all those hospitals were treated as referral hospitals for all types of cases, including, myocardial infarction, acute coronary disease, acute renal failure, severe cases of head and spinal injury and cases of coma. It is further averred that by G.O.Ms.No.150 dated 20-5-1998 the Government recognized six more private hospitals as referral hospitals and included them in the list of referral hospitals for treatment of Government employees/retired employees and their dependants on reimbursement basis; and that the Care Hospital, Hyderabad, is one among the said hospitals. The answering respondent further referred to G.O.Ms.No.175 dated 29-5-1997, wherein the Government permitted the Government employees/retired employees and their dependants to receive immediate treatment in emergency cases without even referral advice from the designated hospitals. It is pleaded that the petitioner approached the Care Hospital, Nampally, Hyderabad, on his own choice on 7-11-1997 and underwent bypass surgery; that the petitioner could have approached any of the Government Teaching Hospitals, like Gandhi Hospital, Osmania General Hospital or Nizam’s Institute of Medical Sciences (NIMS), Hyderabad, for obtaining treatment and operation; and that respondent No.1 examined and rejected the request of the petitioner by memo dated 9-6-1998. Admittedly, at the time of surgery, Care Hospital, Hyderabad, in which the petitioner underwent bypass surgery, was not one of the eight private hospitals included in the list wherein a Government employee/retired employee and their dependants could receive treatment on the referral advice given by the designated institutions. Ex facie, the petitioner is, therefore, not entitled to receive medical reimbursement. Even if a person has received treatment in a private hospital approved by the Government, the same should be preceded by a referral letter from NIMS, Hyderabad or S.V. Institute of Medical Sciences, Tirupati. However, this requirement was relaxed in G.O.Ms.No.175 dated 29-5-1997 subject to the condition that such treatment was received by the Government employee/retired employee and their dependants in an emergency situation. The petitioner’s claim for reimbursement is not sustainable on two grounds, viz., admittedly Care Hospital, Hyderabad, which is a private hospital, was not a recognized private hospital for the purpose of treatment when the petitioner underwent bypass surgery; and even assuming that, for any reason, his request could have been considered, the petitioner could not satisfy the requirements of G.O.Ms.No.175 dated 29-5-1997. Though the petitioner in his affidavit pleaded that due to emergency condition he underwent bypass surgery in Care Hospital, the documents filed by himself belie this plea. The petitioner’s representation dated 3-12-1997 addressed to the Director of Higher Education, Nampally, Hyderabad, shows that he paid Rs.12,000/- to Care Hospital, Hyderabad, under receipt No.11497 dated 18- 10-1997. He filed a copy of the said receipt dated 18- 10-1997, which shows that the said amount was paid towards inpatient advance amount. This material clearly shows that the petitioner was under investigation and treatment at least from 18-10-1997, if not earlier. Admittedly, he underwent bypass surgery on 10-11- 1997. These facts clearly demonstrate that the petitioner had ample time to obtain referral letter before he underwent bypass surgery and that it was not a case of emergency situation leaving him no time to seek referral advise from NIMS. For the above-mentioned reasons, the Writ Petition is dismissed. ------------------------------------ C.V.NAGARJUNA REDDY,J Date:03-12-2008 MNR