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| Medical expenses claim can’t be denied to genuine contenders: High Court | | |
Early Times Report
Jammu, Apr 27: The Jammu & Kashmir and Ladakh High Court has held that the claim for reimbursement cannot be denied on the ground that it is not one of the approved hospitals.
The rejection of the claim of the petitioner by the respondents vide communication dated 01.06.2015, seeking reimbursement of the medical expenses incurred by the petitioner on the treatment of her husband, has prompted the petitioner to approach this Court through the medium of this writ petition for not only quashing of the communication dated 01.06.2015 (Supra), but also for directing the respondents to reimburse the medical expenses for an amount of Rs. 14,99,511/- along with interest at the rate of 12 percent per annum from the date, the bills were submitted by the petitioner with the respondents.
The facts necessary for the disposal of this writ petition are that while the petitioner, who was a contractual employee with the respondent No. 1, was on a private visit to Nagpur along with her husband in the year 2009, her husband fell seriously ill and was admitted in Kalaptaru Hospital in Nagpur on 15.10.2009. The husband of the petitioner was operated and he was found to be suffering from 'Carcinoma Rectum'. The husband of the petitioner underwent emergent treatment i.e. chemotherapy as well as radiotherapy at Yashodha Cancer Hospital, Nagpur. Though the petitioner claims to have spent more than Rs. 25 Lakhs upon the treatment of her husband who expired on 08.09.2011, but the petitioner further claims to have retained the bills only for an amount of Rs. 12,31,711/- regarding which she made a claim with her employer for reimbursement, but was paid an amount of Rs. 1.5 Lacs only in March, 2011. The petitioner after submitting the above mentioned bills submitted more bills for an amount of Rs. 2,67,000/- as the treatment of her husband was continuing even after 2010. The verification regarding the nature of the treatment of the husband of the petitioner was sought by the respondents.
The claim of the petitioner was rejected which is the subject matter of the present writ petition.
Justice Rajnesh Oswal after hearing Sr. Adv Rahul Pant with Advocate Ms. Aarushi Shukla for the petitioner whereas AAG Amit Gupta for the UT, observed that rule 8(2) of the Rules (Supra) vests the power with the Government to relax the rules in case the operation of the Rules cause undue hardship in a particular case. The power of relaxation of the Rules has been vested with the Government not for the purpose of adorning the 'Rule Book' only but for its exercise in genuine cases, where the strict adherence to the Rules would operate harshly against the beneficiary.
In the instant case, the petitioner who was admittedly a contractual employee at the relevant point of time and her husband was dependent upon her and further because of emergent medical situation, when she was out for private tour along with her husband, she spent huge expenditure on the treatment of her husband, itself demonstrate the pathetic case of the petitioner.
The respondents were well within their power to relax these rules under Rule (Supra) to reimburse the medical claim of the petitioner for treatment obtained outside the State from hospitals which were not in the list of the approved hospitals. In such type of situation, humane view was required to be taken while considering the claim of the petitioner. It appears that the respondents have passed the order impugned, rejecting the claim of the petitioner for reimbursement of medical expenses incurred by her on the treatment of her husband being oblivious to the rules. 16.
The court observed that the claim for reimbursement cannot be denied on the ground that it is not one of the approved hospitals.
With these observations, High Court quashed the communication/order impugned bearing No. PD/ERA/31/2014-15 dated 01.06.2015 and directed the official respondents to consider the claim of the petitioner for reimbursement of medical expenditure in accordance with the spirit of the rules and pass fresh orders in light of the judicial precedents mentioned hereinabove within a period of two months from the date copy of this order is served upon the respondents. (JNF) |
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