Allowed

Rajendra B. Kasare v. Union of India, Ministry of Law and Justice, Dept of Legal Affairs and Ors.

Bombay HC25 Mar 2014WP/11434/2012

Case brief

AI extract

What is this about?

In a writ petition, the Bombay High Court directed the respondents to consider and clear pending and future medicine reimbursement bills for a permanently disabled petitioner within four weeks, rejecting the 10-day prescription rule for chronic conditions.

What did the court decide?

Directed respondents to consider pending medicine reimbursement claims within four weeks and clear future bills within four weeks of submission.

Rajendra B. Kasare Vs Union of India… — Pension and Retirement Benefits | Bombay HC (2014)

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IN THE HIGH COURT OF JUDICATURE AT BOMBAY

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CIVIL APPELLATE JURISDICTION

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WRIT PETITION NO.11434 OF 2012

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Rajendra B. Kasare ...Petitioner v/s. Union of India & Anr. ...Respondents

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Mr.Vishal Kanade with Ms.Rachana Chavan and Mrs.Uma Palsuledesai i/b Tejal Chavan for the petitioner. Ms.S.V.Bharucha for respondents.

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CORAM: MOHIT S. SHAH, C.J. & M.S.SANKLECHA, J. DATE : 25 March 2014

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ORAL ORDER: (Per Chief Justice)

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Learned counsel for respondents prayed for adjournment on the ground that learned Addl.Solicitor General has been instructed to appear in this matter. Having regard to the facts and circumstances of the case and the nature of defence adopted by respondents, we do not consider it necessary that learned Addl.Solicitor General shall be troubled for a small matter like this.

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Rule. Returnable forthwith.

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This is an unfortunate case where the petitioner, working under Assistant Garrison Engineer, Naval Work, Uran, District: Raigad as a Refrigerator Mechanic, suffered a paralytic stroke in the year 2006. The aforesaid stroke rendered him permanently disabled by 50% and to add to his woes the respondents are failing to reimburse his medical bills for small amounts between Rs.2000/and Rs.5000/-. Thus, leading him to knock the doors of this Court for relief.

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The petitioner was employed in the office of respondent No.6 on 13 December 1982. On 11 July 2006, when the petitioner was leaving for duty, he suffered from a paralytic stroke. In view of his serious condition the local Authorized Medical Attendant (AMA) viz. Dr.B.V. Devanikar for the Central Government Employees referred the petitioner to a Neurosurgeon at the Bombay Hospital in Ambulance. Accordingly from 11 July 2006 to 10 August 2006 the petitioner was under the medical care of Dr.Suneel Shah, MCH (Neurosurgeon) attached to the Bombay Hospital which is an authorized hospital. The petitioner has been under care and medical treatment of the said Dr.Suneel Shah from 11 July 2006 onwards. The Petitioner submitted bills for reimbursement for costs of medicines, which were prescribed by Dr.Suneel Shah and which the petitioner has been taking for the relevant period. Though some of the bills have been cleared by respondents and the petitioner has been paid, including reimbursement for angioplasty dated 12 July 2012, in the amount of Rs.1,54,590, respondents have not cleared all the bills for reimbursement of the costs of medicines.

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It is contended in the affidavit-in-reply that an Authorized Medical Attendant (AMA) is authorized to give OPD treatment for not more than 10 days as per per Appendix of Central Services (Medical Attendance) Rules 1944, and accordingly AMA is supposed to refer the patient to recognized Government Hospital for further medical treatment and thereafter the petitioner is required to take treatment/medicines for his illness from the Government recognized hospital and submit the bills duly signed by the Government hospital only. The aforesaid procedure, it is alleged, is not being followed by the petitioner. It is further stated that the petitioner has submitted the certificate dated 31 March 2010 issued by Dr.Suneel Shah, Neurosurgeon, Bombay Hospital advising the petitioner to continue medical treatment for one year from 31 March 2010 and therefore respondents are justified in calling for certificate from Bombay Hospital for the period beyond 31 March 2011.

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Learned counsel for the petitioner relies upon the certificate dated 10 December 2012 of the Bombay Hospital prescribing various medicines annexed to his affidavit in rejoinder. The petitioner has also relied upon the certificate dated 4 June 2010 of the Associate Professor in Neurology of Sir J.J.Group of Hospitals inter alia pointing out that if the prescribed medicines for controlling High Blood Pressure, diabetes and lipids are not taken regularly, it can lead to brain infarct, Ischenic heart disease and brain stroke.

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As against the above, the counsel for the respondents submits that in view of Appendix IX & XI of the Central Service (Medical Attendance) Rules 1994 no fault can be found with the action of the respondents.

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We have considered the rival submissions. In view of the stand taken by respondents, it is necessary to refer to following Rules which are contained in the Central Servide (Medical Attendance) Rules, viz. Appendix-IX & XI thereof. The relliance is placed upon para 1 of Appendix-IX “MedicinesInstructions Regarding Prescription and Purchase”, which reads as under:-

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“1. The Authorized Medical Attendant should prescribe such quantities of medicines as are necessary and sufficient for treatment of the disease within a period of ten days from the commencement of treatment. Ordinarily medicines should be prescribed in the first instance, for a short period so as to watch the effect and avoid excess purchase of medicines. The medicines thus prescribed must be purchased by the Government servant on or before the date of completion of treatment as shown in the Essentiality Certificate, viz., the 10^th day from the commencement of treatment. If, on the last day of the treatment, viz., the 10^th day, the patient needs further medication, he/she should be forthwith referred to the out-patient department of a Government/Recognized hospital/ dispensary by the Authorized Medical Attendant for further treatment.

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While the relevant instructions in Appendix-XI being relied upon read as under:-

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Instructions for Doctors

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1.(6) Medicines should not be prescribed for all the 10 days at a stretch. The daily dosage should be indicated in the prescriptions.

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1.(7) Prescription of phials towards the end of the 10 days' period should be avoided, if possible.

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2.(4) If hospitalization is not considered necessary but the treatment is expected to be prolonged requiring many consultations and serveral injections spread over a period of more than 10 days, the patient should be referred to the out-patient department of a Government/recognized hospital at the earliest.

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On bare perusal of the above instructions, it is obvious that the reference is to medicines, which the Government employee may have been prescribed for temporary illness and the treatment is expected to continue for a few days or a few weeks. In case of patient suffering from illness and/or disease of a longer duration, the same seems to have been provided for in 2(4) of Appendix XI and the same appears to have been satisfied by the petitioner.

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Undisputed facts in the present case are that the petitioner suffered a paralytic stroke in the year 2006 after having put in 24 years of service with the respondents. The Medical Board of Sir J.J.Group of Hospitals issued the certificate dated 25 February 2009 to the effect that the petitioner is having left hemiparesis and that his percentage of permanent disability is 50%. The petitioner has, therefore, been taking treatment of Dr.Suneel Shah MCH (Neurosurgeon) attached to the Bombay Hospital since 11 July 2006. The controversy which is the subject matter of the present petition does not pertain to reimbursement of bills for consultation fees, but only bills for costs of medicines, which the petitioner has to purchase for the treatment. It is obvious from the nature of the petitioner's illness that the petitioner has to take treatment lifelong and the treatment cannot be stopped after 10 days. In fact the petitioner has been suffering from this illness for the last eight years and the petitioner will have to continue to take treatment life long. The respondents cannot, therefore, withhold sanctioning the petitioner's claims for reimbursement of the costs of medicines purchased by the petitioner as per the prescription of Dr.Suneel Shah (Neurosurgeon) attached to the Bombay Hospital on the basis that the petitioner requires lifelong treatment. As indicated in the certificate dated 4 June 2010, Associate Professor of Neurology, Sir J.J.Group of Hospitals, if medicines are not taken regularly it can lead to serious consequences in the nature of brain infarct, Ischenic heart disease, brain stroke and the resultant complications.

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We may also refer to the observations made by the Supreme Court in Consumer Education and Research Centre and ors. v/s. Union of India and ors., AIR 1995 SC 922. In the above case on consideration of Article 21 read with Articles 39(e), 41, 43 and 48A of the Constitution the Apex Court held that the workman has a right to health. The Court held that continued medical treatment, while in service and after retirement is a moral, legal and constitutional concomitant duty of the employer and the State. The Apex Court has accordingly held that 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 of the Constitution. We hope and trust that respondents will keep this constitutional mandate in mind while considering the claims of the employees for reimbursement of the medical expenses, particularly when employees are merely claiming reimbursement for costs of medicines purchased by them as per prescription of the doctor.

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Accordingly, writ petition is allowed. Respondents are directed to consider the petitioner's claims for reimbursement of the expenses for purchase of medicines, including the bills which are still pending with the respondents and which may be submitted hereafter on the basis of the observations contained hereinabove. The petitioner's claim as per the pending bills for reimbursement of costs of medicines shall be considered within four weeks from today and in future also whenever the petitioner submits his bill for reimbursement of medicines expenses, such bills shall be cleared within four weeks from the date of their submission.

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Learned counsel for the petitioner states that apart from the issue of reimbursement of costs of medicines, the petitioner also has other grievance regarding non-consideration of his claim for promotion. Since the petition does not contain any prayer to that effect, we did not permit the learned counsel to raise such contention. However, it will be open to the petitioner to make a representation to the concerned authority in respect of his claim for promotion. As and when such representation is made, the same shall be considered as expeditiously as possible and preferably within two months from the date of receipt of the representation.

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We would have considered the question of saddling the respondents with costs of this litigation, but having regard to the fact that respondents have already paid the petitioner substantial amount such as for angioplasty expenses, we leave the matter as it is. However, we make it clear that in case the petitioner is required to come to this Court in future, this Court will consider issuing appropriate direction for payment of costs by the respondents.

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CHIEF JUSTICE

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(M.S.SANKLECHA, J.)

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Rajendra B. Kasare v. Union of India, Ministry of Law and Justice, Dept of Legal Affairs and Ors.

Case brief

What is this about?

What did the court decide?

Rajendra B. Kasare v. Union of India, Ministry of Law and Justice, Dept of Legal Affairs and Ors.

Case brief

What is this about?

What did the court decide?

What the court decided

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