Allowed

Suman Kumar Karsh v. State of Chhattisgarh

Chhattisgarh HC5 Oct 2023WPS/2761/2022

Case brief

AI extract

What is this about?

The High Court allowed a writ petition challenging the rejection of a police employee's mother's medical bills. The court set aside the impugned order, holding that during the severe second wave of Covid-19, authorities could not apply rigid rules and must reconsider the claim under Rule 13 of the 2009 Rules.

What did the court decide?

Impugned order set aside; respondents directed to reconsider the medical reimbursement claim under Rule 13 of the Rules of 2009 promptly.

Suman Kumar Karsh Vs State of… — Pension and Retirement Benefits | Chhattisgarh HC (2023)

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AFR

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HIGH COURT OF CHHATTISGARH, BILASPUR

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Order reserved on 13.6.2023 Order delivered on 05/10/2023

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WPS No.2761 of 2022

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Suman Kumar Karsh S/o Shri Devendra Kumar Karsh Aged About 39 Years Working As A Assistant Sub Inspector, Police Station City Kotwali, Rajnandgaon, District Rajnandgaon Chhattisgarh.

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---- Petitioner

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Versus

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State Of Chhattisgarh Through Its Principal Secretary, Department Of Home (Jail), Mahanadi Bhavan, Mantralaya , Naya Raipur , District Raipur Chhattisgarh 492002.

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The Director General Of Police Police Headquarter, New Raipur , District Raipur Chhattisgarh.

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The Superintendent Of Police Rajnandgaon, District Rajnandgaon Chhattisgarh.

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Directorate Medical Education, Through Its Director , Old Nurses Hostel, Dks Bhawan, Parisar , Raipur Chhattisgarh.

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The Joint Director Medical Education , Old Nurses Hostel, Dks Bhawan Parisar, Raipur Chhattisgarh.

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State Of Chhattisgarh Through The Secretary, Health And Family Welfare Department , Mantralaya , Naya Raipur , District Raipur Chhattisgarh.

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---- Respondents

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For Petitioner : Mr. Sunil Pillai, Advocate For Respondent-Stae : Ms. Ruchi Nagar, Dy. Govt. Advocate

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Hon'ble Shri Parth Prateem Sahu, J C A V Order

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Aggrieved by the order dated 16.3.2022 (Annexure P-10) rejecting claim of petitioner for reimbursement of medical bills of treatment of his mother, petitioner has preferred this petition seeking following relief:-

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““10.1.To call for entire records pertaining to petitioner's case for kind perusal of the Hon'ble High Court.

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10.2. To direct respondents to reimburse to the petitioner medical claim which is more than Rs.6 lacs along with 10% interest.

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10.3. To direct respondent No.2, 3 & 6 to initiate disciplinary proceedings and fix responsibility against all the persons/employees who are held liable for delaying the medical claim of petitioner expended for treatment of his mother for Covid-19 during second wave.

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10.4. To direct respondents to recompense the petitioner with an amount of Rs.2,50,000/(Two lacs fifty thousand) for the mental agony and sufferance due to delay caused in reimbursement of medical claim.

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10.5. To direct respondents to pay to petitioner cost of litigation.

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10.6. To grant any other relief deemed fit and proper in facts and circumstances of the case.”

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Learned counsel for the petitioner would submit that due to

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fever, mother of petitioner was taken to the Government District Hospital, Janjgir where she was diagnosed with Covid-19 and referred to the Government Covid Centre, but due to nonavailability of bed, mother of petitioner was not admitted for treatment. Petitioner’s mother got infected with corona virus in the month of May, 2021 when second wave of Covid-19 was on its peak across the country and death rate was on higher side. Even there was acute shortage of beds in the government hospitals and in many private hospitals recognized for treatment of Covid-19. Petitioner fortunately got one bed in Life Care Hospital, Bilaspur where his mother was admitted for treatment of corona virus. Petitioner’s mother was treated as indoor patient from 22.5.2021 to 7.6.2021. Total expenses incurred by petitioner in treatment of his mother was

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Rs.6,58,960/-. Upon submission of medical bills of his mother for reimbursement, when petitioner has not received any response for sufficient time, he preferred writ petition bearing WPS No.74/2022 and the same was disposed of vide order dated 16.2.2022 observing that as per Circular issued by the State Government on 03.12.2019, the Department of Home (Police Department) will be Competent Authority under the Rules of 2009 for considering claim of reimbursement of medical bills of petitioner and directed the respondents No.1 & 2 therein to consider and decide the claim of petitioner within specified time.

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After passing of order by this Court, respondent No.2 considered the claim of petitioner for medical reimbursement and rejected the same vide order impugned on the ground that mother of petitioner was treated in a hospital not enlisted as recognized private hospital. He submits that while considering claim of petitioner for medical reimbursement, the respondent No.2 has not properly applied mind and rejected the claim in mechanical manner.

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Learned counsel for the respondent State opposing submissions of learned counsel for the petitioner, would submit that in earlier round of writ petition respondent No.4 to 6 have also filed reply mentioning therein that fresh proposal sent by the Superintendent of Police, Rajnandgaon was returned back with an observation that the same is to be proceeded under the Rules of 2009. From bare perusal of the order impugned

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passed by respondent No.2 it is clear that Life Care Hospital, Bilaspur where mother of petitioner was treated for corona virus, was not enlisted as recognized private hospital and therefore, there is no error in the order impugned warranting interference in exercise of writ jurisdiction.

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I have heard learned counsel for the parties and perused the documents placed in record of writ petition.

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Perusal of the documents placed on record would show that Annexure P-1 is the outdoor patient slip dated 24.5.2021 of the Government Barrister Thakur Chhedilal District Hospital, Janjgir, District Janjgir Champa (CG). In this slip it is mentioned that mother of petitioner is tested Covid-19 positive and she is referred to the Covid Centre.

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In the month of April, 2021, Covid-19 surged back in India with all vigour, intensity and velocity, infected people rapidly and taken away lakhs of lives. In the month of May, 2021 when mother of petitioner was tested Covid-19 positive, test positivity rate Covid-19 was alarming and mortality rate was also high. Every citizen was afraid of corona virus, whether he/she or any of his/her family members is infected with it or not. Most of the hospitals were flooded with Covid-19 infected patients, requiring immediate treatment. This Court is also not unmindful of the fact that during May, 2021 even after making approaches to the authorities, leaders, ministers etc. one could not able to get bed in the government hospitals or even in private hospitals recognized by the State Government, more particularly oxygen

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beds, which were essential for treatment of Covid-19 patients. Even there were scenes, patients waiting in front of the hospitals for want of beds for being admitted. Infection of corona virus was on the respiratory system of human body. Saving lives was one of the priorities for each of the person by somehow getting treatment somewhere. Thousands of persons died due to shortage of beds, shortage of oxygen, and due to other reasons being reported daily in Medias.

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True it may be that Life Care Hospital & Emergency Care Unit, Bilaspur was not enlisted in the list of recognized private hospitals by the Police Department for treatment of police personnel or their family members, who are covered under the Rules of 2009, but at the same time this fact can also not be lost sight that alarming death threatening situation was prevailing across the country in the month of 2021 due to spread of unprecedented pandemic Covid-19. That situation and nature of disease spread across the country cannot be treated to be disease of ordinary nature and likewise period also. Therefore, looking to the period, prevalent situation, nonavailability of treatment in hospitals due to non-availability of bed/ oxygen beds, the respondent authorities ought to have given extra/ special consideration while dealing with medical claims of such nature, like the present one.

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Respondent No.2 while dealing with claim of petitioner for medical reimbursement has not taken aforementioned facts into consideration and rejected claim of petitioner treating it to

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be like a normal claim for medical reimbursement which in the given facts of the case cannot be said to be right approach of the authorities. Respondent No.2 is highest police officer in the Police Department, he should have applied his mind looking to prevailing unprecedented pandemic situation in the entire nation and treatment of mother of petitioner i.e. Covid-19, and should have treated the claim of petitioner as an extraordinary case. However, while considering claim of petitioner for medical reimbursement, the approach adopted by respondent No.2, as is appearing from the order impugned, was mechanical approach, which was unwarranted in view of the fact that during the period of May, 2021 second wave of Covid-19, which was more dreaded than the first wave, was in its full swing, all the hospitals were flooded with the patients, during that crucial period, the entire nation was running short of oxygen, beds, medicines, ambulances etc. and the covid-19 infected patients were losing lives for want of medical facilities.

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The higher authorities of the State are required to more responsive and cannot deprive a government servant from his legitimate right of medical reimbursement in a mechanical manner. Approach of respondent in denying medical reimbursement prima facie appears to be inhuman. In the situation prevailing on the date of admission of petitioner’s mother in a private hospital, it cannot be overlooked that hospitalization of petitioner’s mother was in an emergent condition when survival of human life was prime consideration. The law also does not require that prior permission is to be

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taken in such situation. Right to claim medical reimbursement cannot be denied merely because name of a hospital is not included in the list of recognized private hospitals notified by the State Government / Police Department for treatment. Real test must be factum of treatment. In such a situation the authorities before honouring such claim could have ensured as to whether patient had actually taken treatment or not. Once the treatment is established, claim cannot be denied on technical grounds.

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11.In case of Shiva Kant Jha v. Union of India , reported in 2018 LAB IC 2274 , the Hon’ble Supreme Court while considering identical issue of an employee who took treatment in nonenlisted private hospital, has held as under:-

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“15. In the present view of the matter, we are of the considered opinion that the CGHS is responsible for taking care of health care needs and well being of the central Government employees and pensioners. In the facts and circumstances of the case, we are of the opinion that the treatment of the petitioner in non-empanelled hospital was genuine because there was no option left with him at the relevant time. We, therefore, direct the respondent - State to pay the balance amount of Rs.4,99,555/- to the writ petition. We also make it clear that the said decision is confined to this case only.”

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In the case at hand also, rejection of the claim of petitioner for reimbursement of amount incurred in medical treatment of his mother during unprecedented pandemic situation across the country when the pandemic Covid-19 was on its peak, the

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death ratio was on higher side and in almost all the hospitals beds were occupied and there was large scarcity of beds/oxygen beds and public at large was finding it difficult to get proper medical treatment facilities, the case of petitioner is also squarely covered from the aforementioned ruling of Hon’ble Supreme Court.

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Under the Rules of 2009, Rule 13 talks of relaxation of any of the rules under the Rules of 2009 with the consent of the Finance Department treating the same as a special case. This provision is embodied in the statute to meet out such situation, as the legislature was cautious that any extraordinary situation may crop any time. Respondent No.2 while deciding claim of petitioner for medical reimbursement ought to have invoked Rule 13 of the Rules of 2009 in the facts and circumstances of case, which was not done. Therefore, considering the entirety of facts, particularly unprecedented and extraordinary pandemic situation prevailing all over the country and nonavailability of treatment facilities in the government hospitals or private hospitals for want of beds/oxygen beds etc., which was an extraordinary and exceptional situation, the order impugned (Annexure P-10) passed by respondent No.2 giving strict consideration to the provisions of the Rules of 2009 is not sustainable and it is liable to be set aside.

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In the result, writ petition is allowed in part. Impugned order (Annexure P-10) is hereby set aside. Respondents No.1 & 2 are directed to reconsider claim of the petitioner for

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reimbursement of medical expenses incurred by him in the treatment of his mother who was tested Covid-19 positive and treated in non-listed recognized private hospital, keeping in mind the peculiar circumstances which were prevailing at that point of time due to spread of of Covid-19 pandemic all over the world, in the light of Rule 13 of the Rules of 2009 expeditiously.

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Sd/-

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(Parth Prateem Sahu) Judge

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roshan/-

Suman Kumar Karsh v. State of Chhattisgarh

Case brief

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Suman Kumar Karsh v. State of Chhattisgarh

Case brief

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