Allowed

Musunuri Satyanarayana v. the State of Ap

Andhra Pradesh HC2 Jul 2024WP/1278/2023

Case brief

AI extract

What is this about?

Justice Subba Reddy Satti allowed a writ petition by a retired Tahsildar, setting aside an endorsement rejecting his wife's medical reimbursement claim for COVID treatment. The Court held that relying on an outdated G.O. to deny a claim for a pandemic-related illness violated the right to health under Article 21, ordering reconsideration.

What did the court decide?

The endorsement rejecting the medical reimbursement claim was set aside; Collected instructed to reconsider the claim based on submitted evidence within six weeks.

Musunuri Satyanarayana Vs the State… — Pension and Retirement Benefits | Andhra Pradesh HC (2024)

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IN THE HIGH COURT OF ANDHRA PRADESH :: AMARAVATI

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(Special Original Jurisdiction)

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WEDNESDAY, THE THIRD DAY OF JULY TWO THOUSAND AND TWENTY FOUR

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PRESENT

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THE HONOURABLE SRI JUSTICE SUBBA REDDY SATTI WRIT PETITION NO: 1278 OF 2023

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Between:

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Musunuri Satyanarayana, S/o. Basaviah, Aged 83 years, senior citizen. Retired Tahsildar, Door no 2-3, Chundurpalli village Bapatia Mandal and District, AP, Pin 522315, Cell No. 9701253222.

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...PETITIONER

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AND

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The State of Andhra Pradesh, Represented by its Special Chief

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Secretary, Health Medical and Family Welfare Department,^Amaravathi.

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The Chief Executive Officer, DR YSR Arogyasree Health Care Trust,

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Amarbvkiii at Mangalagiri.

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The Collector, Kakinada District Kakinada AP

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...RESPONDENTS

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Petition under Article 226 of the Constitution of India praying that in the circumstances stated in the affidavit filed therewith, the High Court may be pleased to pass an appropriate writ order or direction particularly in the nature of writ of Mandamus directing that the unilateral^{actionoftheCEO} Dr YSR Arogyasree health care trust in rejecting the medical reimbursement claim of the pensioner/petitioner, senior citizen aged 83 years old, who spent Rs. 88,145/- towards treatment of his wife rajamohini for the disease of COVID is contrary to right to health and the settled principles of law and the rights of petitioner protected by Article 21 and 32 of Constitution of India and to the instant order passed by the State Government.

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Counsel for the Petitioner: SRI TAT SINGAIAH GOUD representing SRI VENKATESH KOSARAJU

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Counsel for the Respondent No.1: GP FOR SERVICES- IV Counsel for the Respondent No.2: SMT. K.S.G. PADMAVATHI,^SCFOR DR YSR Arogyasree Health Care Trust

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Counsel for the Respondent No.3: GP FOR SERVICES-I The Court made the following: ORDER

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IN THE HIGH COURT OF ANDHRA PRADESH: AMARAVATI

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HONOURABLE SRI JUSTICE SUBBA REDDY SATTI

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WRIT PETITION Nb.1278 of 2023

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Musunuri Satyanarayana, S/o Basavaiah, aged 83 years, Senior Citizen, Retired Tahsildar, Door No.2-3, Chundurpalli village, Bapatia Mgndal and District, A.P.

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... Petitioner.

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Versus

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The State of Andhra Pradesh, represented by its Special Chief Secretary, Health Medical and Family Welfare Department, Amaravati and two others.

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... Respondents.

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Counsel for the petitioner Counsel for respondent No.1 Counsel for respondent No.2

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Sri Venkatesh Kosaraju Counsel for respondent No.1 Smt.K.S.G.Padmavathi

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ORDER

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The Writ Petition is filed seeking the following relief:

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“... to pass an appropriate writ order or direction particularly in the nature of writ of Mandamus directing that the^unilateral action of the CEO Dr YSR Arogyasree Health Care Trustⁱⁿ rejecting the medical reimbursement claim of the pensioner/petitioner, senior citizen aged 83 years^old,who spent Rs.88,145/- towards treatment of his wife Rajamohini for the disease of COVID is contrary to right to health^and the settled principles of law and the rights of petitioner protected by Article 21 and 32 of Constitution of India^andto the instant order passed by the State Government...”

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Page 2 of 7 SRSJ WP No.1278of2023

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Heard Sri Tata Singaiah Goud learned counsel representing Venkatesh Kosaraju, learned counsel for^petitioner, learned Assistant Government Pleader for Services-IV for 1 St respondent and Smt.K.S.G.Padmavathi learned standing counsel for 2"^^ respondent.

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Learned counsel would submit that the petitioner, a^retired suffered from Covid-19 and was admitted Government employee to SHRl hospitals, Guntur for treatment. He would submit that the petitioner’s wife was also diagnosed with Cough, Cold, and Viral Pneumonia and took treatment in the same hospital from 31.07.2021 to 18.08.2021 as an outpatient. In support,^Exs.P3 and essentiality certificates dated and P4, the emergency 31.07.2021 were filed along with the writ petition.^{Thepetitioners} wife incurred an amount of Rs.88,165/- for treatment. He would also submit that the claim for medical reimbursement was rejected because outpatient-based management of COVID-19 is the medical reimbursement scheme. He not approved under would also submit that denial of the claim i.e. medical reimbursement based upon G.O.Ms.No.74 HM&FW Department dated 15.03.2005, per se, is illegal and arbitrary^{thus,prayedto} set aside the order impugned in the writ petition.

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Page 3 of 7

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SRSJ WP No.1278 Qf2023

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Learned standing cpunsel would submit that outpatient treatment for COVID-19 is not included in G.O.Ms.No.74^HM&FW Department dated 15.03.2005 and after following the procedure the claim of petitioner’s wife was rejected.

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Now, the point of consideration is:

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Whether in the endorsement of 3'^'* respondent, impugned in the writ petition, is sustainable?

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COVID-19 is a highly contagious and infectious disease that has spread globally, affecting millions of people^worldwide. The Government of Andhra Pradesh by an order dated 19.04.2020, instructed all the Superintendents of Government Hospitals and management of private hospitals to provide a separate entrance and maintain a separate OP for patients exhibiting symptoms like Fever, Cough and Cold to avoid spreading of Covid-19. The Government also issued G.O.Rt.30 (HM&FW (1.1) Department dated 29.01.2021 extending the medical reimbursement scheme for treatment of Covid-19^within the State and outside the State subject to a ceiling^amountof Rs.2,00,000/-. It seems the said G.O was issued after^theorder dated 09.10.2020 in W.P.No.18429 of 2020

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Page 4 of 7

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SRSJ WP No. 1278 of 2023

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1^-

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Along with the writ petition, the petitioner filed Exs.PS and P4, emergency certificate, and essentiality certificate issued by the authorized signatory of Samishta Hospital & Research Institute, Guntur. In the counter affidavit, nothing was adverted regarding the genuineness of those certificates.

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It is pertinent to mention here that it is not the case of respondent authorities that the petitioner’s wife was neither affected by Covid-19 nor took treatment. The only ground for rejection of the claim is that outpatient-based management of Covid-19 is not approved under the medical reimbursement scheme.

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Before any medical claim is honored, the authorities are bound to ensure as to whether the claimant has taken treatment and the factum of treatment is supported by medical records duly certified by the Doctors of the hospital. Once, it is established about the treatment, the claim cannot be denied on technical grounds. The right to health is guaranteed under Article 21 of the Constitution of India.

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Page 5 of 7

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SRSJ WP No.1278 of 2023

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In State of HP. Vs. Limed Ram Sharma', the Hon’ble

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Apex Court held thus:

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“The right to life includes the quality of life as^understoodin its richness and fullness by the ambit of the Constitution. Access to road was held to be an access to life itself^inthat State.”

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It was further held that -

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“The right to health, medical aid to protect the health^and vigour of a worker while in service or post-retirement is a fundamental right under Article 21, read with Articles^39(e), 41,43, 48-A and all related articles and fundamental^human rights to make the life of the workman meaningful and purposeful with dignity of person”.

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In Re: The Proper Treatment of Covid-19 Patients and Dignified Handling of Dead Bodies in the Hospitals^{^tc.^the} Hon’ble Apex Court held that right to health is a fundamental^right guaranteed under Article 21 of the Constitution of^India. Right to health included affordable treatment.

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Both the petitioner and his wife were given health^cards bearing Nos.PEN 153863/01 and PEN 153863/02. As pointed^out supra, in the absence of any contra material disputing the genuineness of Exs.P3 and P4, rejection of the claim^ofthe

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^ (1986) 2 see 68 2 Suo Moto Writ Petition (eivil) No.7 of 2020 dated^19.06.2020

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Page 6 of 7 SRSJ WP No. 1278 of 2023

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petitioner’s wife on the ground that treatment for outpatient-based management of Covid is not approved under the medical reimbursement scheme, in the considered opinion of this Court, is unsustainable and it is liable to be set aside. The G.O. relied upon by the respondent authorities was issued long before COVID-19 pandemic. The authorities could not foresee the pandemic. Thus, rejection on that ground is illegal, arbitrary and violative of Art 21 of the Constitution of.India.

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Hence, the endorsement issued by 3'^'' respondent, vide REV-ESTB0MR/22/2022-ADMN SEC-KKD CO dated 14.11.2022, rd rejecting the claim of the petitioner’s wife is set aside. The 3 respondent shall consider the medical reimbursement claim of the petitioner’s wife based on Exs.P3 and P4 and pass appropriate orders within six weeks from the date of this order.

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Accordingly, the Writ Petition is Disposed of. No costs. As a sequel, pending miscellaneous petitions, if any, shall stand closed.

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To,

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SD/- K.J.RAJA BABU //TRUE COPY// ASSISTANT! REGIST,RAR SECTI FFiCER

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The Special Chief Secretary. Health Medical and Family Welfare

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Department. State of Andhra Pradesh Amaravathi.

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The Chief Executive Officer, DR YSR Arogyasree Health Care Trust,

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Amarbvkiii at Mengalagiri.

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The Collector, Kakinada District, Kakinada, AP

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^ 4. One CC to Sri Venkatesh Kosaraju, Advocate [OPUC]

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One CC to Smt. K.S.G. Padmavathi, SC for DR YSR Arogya$ree Health ^ Care Tnjst[OPUC]

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Two CCs to GP for Services- IV, High Court of Andhra Pradesh [OUT]

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Two CC’s to GP for Service-1, High Court of A.P. at Amaravati[OUT]

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Three CD Copies.

ssb

HIGH COURT

DATED:03/07/2024

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so 2 6 JUL 202^ m
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X -A- Current Section .

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ORDER

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WP.No.1278 of 2023

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DISPOSING OF THE W.P. WITHOT COSTS

Musunuri Satyanarayana v. the State of Ap

Case brief

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Musunuri Satyanarayana v. the State of Ap

Case brief

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