Parsh Ram v. State Of Haryana And Others
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Present:
Mr. Sahil Mehra, Advocate with Mr. Parveen Chauhan, Advocate for the petitioner.
Mr. Rahul Dev Singh, Addl. AG, Haryana.
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Prayer 1.
The jurisdiction of this Court under Articles 226/227 of the Constitution of India has been invoked for issuance of a writ in the nature of to quash the impugned orders dated 20.01.2020 and 17.11.2017 (Annexures P05 & P06 respectively) passed by respondent No.4 whereby his claim ₹ for medical reimbursement of an amount of 1,58,725/0 incurred on dialysis treatment of his son was rejected with a further prayer for issuance of a writ in the nature of
directing the respondents to release an amount of Rs.1,58,725/0 on account of medical bills along0with interest @12% per annum.
Brief Facts 2.
As borne out from the record, the son of the petitioner was suffering from End Stage Renal Disease, requiring regular dialysis, which is a life0saving treatment. The treatment was taken from a private dialysis centre due to non0 availability of facilities at PGIMER, Chandigarh, and the emergent nature of the disease. The petitioner submitted medical bills to the department, but the same were rejected primarily on the ground that the hospital was not on the approved panel and the treatment was not certified as "emergency" by the Civil Surgeon. Aggrieved by the rejection, the present petition has been filed. Contentions On behalf of the petitioner 4.
Learned counsel for the petitioner vehemently contends that the impugned action of the respondents is wholly arbitrary, unjust and violative of the fundamental rights of the petitioner. It is submitted that the son of the petitioner was suffering from End Stage Renal Disease, a life0threatening condition, necessitating continuous and regular dialysis, which is not merely a routine treatment but a life0saving medical necessity. The urgency and gravity of the ailment left the petitioner with no real choice but to arrange immediate treatment from the nearest available medical facility.
5.
Learned counsel argues that the rejection of the claim solely on the hyper0technical ground that the hospital was not empanelled and that the treatment was not certified as "emergency" by the Civil Surgeon is wholly untenable in law. The authorities have adopted a mechanical approach, ignoring the overwhelming medical evidence on record demonstrating the life0saving nature of the treatment.
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Reliance has been placed upon the judgment dated 03.12.2018 passed in CWP No. 13494 of 2016 titled as "Manoj Jain vs. State of Haryana and others" wherein this Court has categorically held that medical reimbursement cannot be denied merely because treatment was taken from a non0empanelled hospital or as an outdoor patient, and that such expenses are liable to be reimbursed at prescribed rates. It is, thus, contended that the impugned orders dated 20.01.2020 and 17.11.2017 (Annexures P05 & P06 respectively) are legally unsustainable, being contrary to settled principles of law as well as violative of Article 21 of the Constitution of India, which guarantees the right to life and access to medical treatment.
On behalf of the Respondents 7.
Per contra, learned State counsel has argued that the present writ petition is devoid of merit and deserves outright dismissal. It is contended that the claim of the petitioner has been rightly rejected strictly in accordance with the Government policy dated 06.05.2005 governing medical reimbursement. 8.
Learned counsel submits that the treatment in question was admittedly taken from a private hospital which was not on the approved panel of the Government, and therefore, the petitioner is not entitled to reimbursement as a matter of right. It is further argued that as per the policy, reimbursement in respect of treatment taken from an unapproved hospital can be granted only in cases of duly certified emergency.
9.
In the present case, the Civil Surgeon, Panchkula, upon examination of the medical record, has categorically opined that the treatment was not of emergent nature, and thus the claim falls outside the permissible framework of the
$ policy. It is, therefore, submitted that the competent authority has taken a conscious and reasoned decision based on applicable rules and instructions, and no illegality or arbitrariness can be attributed to the impugned orders warranting interference by this Court.
Analysis 10.
Having heard learned counsel for the parties at length and after perusing the paper0book, this Court is of the considered view that the present petition deserves to be allowed.
11.
At the outset, it may be noticed that there is no dispute with regard to the fact that the son of the petitioner was indeed suffering from End Stage Renal Disease and was undergoing continuous dialysis for the same. The medical record placed on file leaves no manner of doubt that the treatment was not elective or optional, but was necessitated by the life0threatening condition of the patient. Dialysis, by its very nature, is a life0sustaining procedure and any interruption therein would seriously endanger life.
12.
The sole basis on which the claim of the petitioner has been declined is that the treatment was taken from a non0empanelled hospital and that the same was not certified as an "emergency" by the Civil Surgeon. This Court is unable to accept such a hyper0technical approach adopted by the respondents. 13.
Reliance can be placed upon the judicial pronouncement rendered in the case of "Surjit Singh v. State of Punjab 1996 (2) SCT 234", wherein the Hon'ble Apex Court rejected the denial of reimbursement on technical grounds where treatment was taken in a non0approved hospital during emergency. Similarly in "State of Punjab v. Mohinder Singh Chawla" 1997 (1) SCT 716", it was held
by the Hon'ble Supreme Court that the State is constitutionally obligated to bear medical expenses of its employees, the right to health being integral to life itself, while observing that,
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14.
The culmination of this evolution is found in "Shiva Kant Jha v. Union of India" 2018 (2) SCT 529", wherein the Hon'ble Apex Court held in clear and unambiguous terms that a government employee or pensioner cannot be denied reimbursement merely because treatment was obtained in a non0 empanelled hospital during emergency. The Court emphasised that technicalities cannot defeat life0saving decisions and that reimbursement must be real and meaningful, not illusory. Relevant extract of the same is as under: #$
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15.
A coordinate Bench of this Court in ./ 0 1
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The ratio of the aforesaid judgment squarely applies to the facts of the present case. The insistence of the respondents on certification of "emergency" by the Civil Surgeon, in the peculiar facts of the present case, is wholly misplaced. When the nature of disease itself is chronic, progressive and life0threatening, requiring periodic dialysis, the treatment cannot be compartmentalized into rigid categories of "emergency" or "non0emergency" so as to defeat a legitimate claim. 17.
It also needs to be observed that the right to health and medical care is an integral facet of Article 21 of the Constitution of India. The State, being a welfare State, cannot shirk its responsibility by resorting to technicalities,
particularly when the treatment itself is not disputed and has been found to be necessary.
18.
In "Paschim Banga Khet Mazdoor Samity v. State of West Bengal" 1996 (4) SCC 37, it was held by the Supreme Court that failure to provide timely emergency medical treatment constitutes a violation of Article 21 and that the State cannot avoid its responsibility on the plea of financial constraints. The constitutional position is thus no longer in doubt as the Court elevated emergency medical care to a constitutional obligation, and held that preservation of life is a paramount obligation of the State, while observing that, 3 *
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The Supreme Court while holding that preservation of human life is of paramount importance, in "Parmanand Katara v. Union of India 1995 (3) SCC 248", observed that no procedural law or technicality can stand in the way of human dignity and stated as under, "4 9
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20.
This Court is of the clear opinion that once the factum of treatment and the necessity thereof stands established, denial of reimbursement on the ground that the hospital was not empanelled or that the treatment was not formally certified as "emergency" is arbitrary and unsustainable in law. Conclusion 21.
For the reasons recorded hereinabove, the present writ petition is allowed. The impugned orders dated 17.11.2017 and 20.01.2020 (Annexures P05 & P06 respectively) are hereby set aside, being unsustainable in law and contrary to the settled principles governing medical reimbursement. The respondents are directed to process and release the claim of the petitioner for medical reimbursement in respect of the treatment of his son along0with interest @ 9% per annum on the admissible amount from the date it became due till the date of actual payment, in view of the unjustified and prolonged denial of legitimate dues within a period of 8 weeks from the date of receipt of certified copy of this order. 22.
Ordered accordingly.
23.
Pending applications, if any, stand disposed of. &
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