A Government employee should strictly follow the Government guidelines for medical reimbursement bills: High Court of Tripura.

 HIGH COURT OF TRIPURA WP(C) 234 OF 2021 Sri Pradip Datta S O Late Manindra Chandra Datta Vill Chhanban P.O. Rajarbag Udaipur Gomati District Pin 799120. 1) The state of Tripura Represented by the Secretary cum Commissioner Education Department Government of Tripura New Secretariat Complex P.O.Kunjaban P.S. New Capital Complex Agartala West Tripura. 2) The Director of Secondary Education Government of Tripura P.O. Agartala West Tripura Pin 799001. 3) The District Education Officer Udaipur Gomati District Tripura. 4) The State of Tripura Represented by the Commissioner cum Secretary to the Govt. of Tripura Finance Department New Capital Complex P.O. Kunjaban Agartala District West Tripura. HON’BLE MR.JUSTICE ARINDAM LODH For the petitionerMr. A. Acharjee Advocate. For the respondentHeard Mr. A. Acharjee learned counsel appearing for the petitioner. Also heard Mr. A.K.Deb learned panel counsel appearing for the State respondents. This is a case filed by the petitioner being his application for medical reimbursement was rejected by the State respondents. It is the case of the petitioner that his daughter was suffering from illness and she was under treatment of Dr. J. L. Roy Agartala Tripura. The petitioner had paid visit to Hyderabad for better treatment of his daughter. For two occasions the petitioner went to Hyderabad for the treatment of his daughter. During those two occasions the said daughter was escorted by the petitioner as well as his wife. During second visit the wife of the petitioner fell ill and on being examined by the Doctors of Asian Institute of Nephrology and Urologyin her kidney stone was detected. The wife of the petitioner Smt. Lipika Das Datta underwent surgery there and removed the stone. After returning from Hyderabad the petitioner submitted bills for medical reimbursement as he was eligible for such reimbursement of medical bills for the treatment of his wife. The said bills were rejected by the State respondents on the ground that the petitioner went to Hyderabad and treated his wife at AINU without any referral certificate from the recognized standing Medical Board constituted by the Govt. of Tripura. Mr. Acharjee learned counsel for the petitioner has submitted that in an emergent situation the wife of the petitioner was operated by AINU doctors and for such emergent situation the petitioner could not obtain referral certificate from the Medical Board. On the other hand Mr. Deb learned panel counsel of the State respondent submits that the present case is not the case where the State respondents had rejected the claim for medical reimbursement on any technical ground. learned counsel has emphasized that the present case is not a case where the petitioner had treated his wife in an emergent situation. Mr. Deb learned counsel has drawn my attention to the Memo. dated 16.12.2019 sanctioning the leave of the petitioner by the competent authority wherein it transpires that the petitioner applied for leave “due to personal affairs” where I have noticed that there is specific option for applying “leave on medical ground”. I have also noticed the discharge summary of Mrs. Lipika Das Datta dated 24.12.2019 issued by AINU. The discharge summary reveals that the petitioner undertook so many medical tests of his wife and ultimately stone was detected at her kidney. Under the caption “COMPLAINT(s)” it is written that “right loin pain on and off since 8 years associated with occasional LUTS”. Under the head “HISTORY OF PRESENT ILLNESS” it is written that “Mrs. Lipika Das Datta presented with Right loin pain on and off since 8 years associated with occasional LUTS. History of aggravating same symptoms since 3 months. CT abdomen plain was shown which showed right renal calculus with mild pelviectasis and mesenteric lymphadenopathy. Patient admitted for further evaluation and management.” The said discharge summary further reveals that “patient was admitted and evaluated with appropriate investigations. After thorough pre operative evaluation and pre anaesthetic checkup patient was taken up for surgery. Right Retrograde Intrarenal Surgery with Lessor Lithotripsy + DJ stenting was done under general anaesthesia on Mr. Acharjee learned counsel for the petitioner has pressed into service as many as two judgments passed by this Court in WP(C) 1479 2017 titled as Uttam Pal Vrs. State of Tripura and in WP(C) No.895 2018 titled as Subal Das Vrs. State of Tripura. Having perused those judgments according to me those judgments do not have any relevance to consider the facts of the present In my opinion this is not a case where the petitioner had to treat and admit his wife Smt. Lipika Das Datta in an emergent situation. The exigency was not at that level that the petitioner could not obtain referral certificate from the standing Medical Board. According to me since the wife of the petitioner had been suffering from this illness for about 8 years and for the last 3 months before his visiting to Hyderabad there was pain off and on at her abdomen she could have easily contacted with the Doctors of the Government Hospitals at Agartala for her treatment. The Government instructions regarding reimbursement of petitioner as a Government employee should strictly follow Government guidelines for medical reimbursement bills. More so the petitioner could have applied for leave on medical ground but he applied for granting leave on personal affairs w.e.f. 17.12.2019 to 28.12.2019. Having viewed thus I do not find any error in rejecting the application for reimbursement of medical bills of the petitioner by the In the result the writ petition stands dismissed. However there shall be no order as to costs. 

Summary: A person who is a government employee is only liable to claim medical reimbursement bills when such person has followed the government guidelines for medical reimbursement bills. A single Judge bench comprising Hon’ble Justice Mr. Arindam Lodhi, in the matter of Sri Pradip Datta Vs. The State Tripura (WP(C) 234 OF 2021), dealt with an issue where the petitioner had filed this petition as such application for medical reimbursement was rejected by the respondents – State. In the present case, the petitioner’s daughter was suffering from illness and was under treatment of Dr. J. L. Roy, Agartala, Tripura. The petitioner also visited Hyderabad twice for better treatment of his daughter. During the second visit to Hyderabad, the petitioner’s wife fell ill, and on examination by doctors of the Asian Institute of Nephrology and Urology (for short, AINU), and kidney stone was detected. Thereby petitioner’s wife was operated and the petitioner submitted bills for medical reimbursement as he was eligible for such reimbursement of medical bills. The bill was rejected by the state- respondent stating that the petitioner went to Hyderabad and treated his wife at AINU without any referral certificate from the recognized standing Medical Board constituted by the Govt. of Tripura. The counsel for the petitioner submitted that due to an emergent situation, the petitioner could not obtain a referral certificate from the Medical Board.  To this, the counsel for the respondents submitted that the petitioner did not treat his wife in an emergent situation. The counsel also submitted that the discharge summary reveals that the petitioner undertook many medical tests of his wife and ultimately stone was detected at her kidney it was mentioned in the report that the petitioner’s wife had pain in right loin on and off since 8 years associated with occasional LUTS. Further, the counsel for the petitioner had referred to 2 more judgments passed by the court, but the court did not find it relevant to the facts of the present case. The court observed that the treatment was not done in an emergent situation. Further, the court observed that- “since the wife of the petitioner had been suffering from this illness for about 8 years and for the last 3 months before his visiting to Hyderabad there was pain off and on at her abdomen, she could have easily contacted with the Doctors of the Government Hospitals at Agartala for her treatment.” Further, the court observed that the petitioner as a government employee should follow the Government guidelines for medical reimbursement bills. Thereby the court dismissed the writ petition.