Allowed

Janmahmad Aminkhan Sindhi v. State of Gujarat through Additional Chief Secretary

Gujarat HC23 Dec 2021SCA/8121/2020

Case brief

AI extract

What is this about?

This judgment directed the State of Gujarat to reimburse the remaining medical expenses of a retired police officer who underwent life-saving surgery and amputation in private hospitals due to an accident on duty. The court overturned the government's limited sanction and ordered payment of the full claimed amount plus interest.

What did the court decide?

Directed the State to pay remaining medical expenses of Rs.3,94,971/- along with interest at 6% thereafter 9% if not paid within four weeks.

Janmahmad Aminkhan Sindhi Vs State of… — Pension and Retirement Benefits | Gujarat HC (2021)

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C/SCA/8121/2020 JUDGMENT DATED: 23/12/2021

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IN THE HIGH COURT OF GUJARAT AT AHMEDABAD

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R/SPECIAL CIVIL APPLICATION NO. 8121 of 2020

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FOR APPROVAL AND SIGNATURE:

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HONOURABLE MS. JUSTICE SANGEETA K. VISHEN Sd/-

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=== 1	=================================================== Whether Reporters of Local Papers may be allowed to see the judgment ?	==== No
2	To be referred to the Reporter or not ?	YES
3	Whether their Lordships wish to see the fair copy of the judgment ?	No
4	Whether this case involves a substantial question of law as to the interpretation of the Constitution of India or any order made thereunder ?	No

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JANMAHMAD AMINKHAN SINDHI

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Versus

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STATE OF GUJARAT THROUGH ADDITIONAL CHIEF SECRETARY & 3 other(s)

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Appearance:

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MR NASIR SAIYED(6145) for the Petitioner(s) No. 1

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MR KRUTIK PARIKH, ASSISTANT GOVERNMENT PLEADER(1) for the Respondent(s) No. 1,2,3,4

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CORAM: HONOURABLE MS. JUSTICE SANGEETA K. VISHEN

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Date : 23/12/2021 ORAL JUDGMENT

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With the consent of the learned advocates appearing for the respective parties, the matter is taken up for final disposal.

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Issue rule, returnable forthwith. Mr. Krutik Parikh, learned Assistant Government Pleader waives service of notice of rule on behalf of the respondents.

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By this petition, inter alia, under Article 226 of the Constitution of India, the petitioner seeks direction to the respondent authorities

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to reimburse the medical bills of the petitioner to the tune of Rs.5,24,236/- along with interest within a stipulated period.

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4. Tersely stated are the facts:-

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4.1 On 22.1.2010, the petitioner met with an accident which, caused fracture in the left tibia/fibula with left popliteal artery injury and was operated for left knee amputation. According to the petitioner, he was admitted to SAL Hospital, Ahmedabad for the period from 22.1.2010 to 26.1.2010 and thereafter, shifted to Shalby Hospital where he took treatment as indoor patient from 27.1.2010 and remained there till his discharge on 24.2.2010. The petitioner, thereafter, gave an application before the respondent no.4, i.e., the District Superintendent of Police, Banaskantha along with all the necessary medical bills in original for reimbursement, as a special case, on account of non-availability of the requisite medical treatment at the Government hospital. The application of the petitioner, came to be returned on 10.5.2010 for want of fulfillment of certain requirements and therefore, the petitioner submitted another application on 4.6.2010 along with all the medical bills in original with a request to get the needful done.

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4.2. On 11.1.2011, the petitioner submitted another application before the respondent no.4, i.e., District Superintendent of Police, Banaskantha along with all the medical bills in original, together with the certificate dated 1.1.2011 of the Medical Superintendent of General Hospital certifying that neither any orthopaedic surgeon was available at General Hospital, Deesa nor any facilities for providing medical treatment were available. Since nothing was heard from the respondent no.4, the petitioner thought it fit to move the State Government and accordingly, detailed application/representation was made to the State Government explaining each and every aspect, quoting references of the earlier correspondences made to and by the concerned authorities, but to

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no avail. Hence, the present petition.

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4.3 The respondent no.1, has also filed the reply narrating in detail the factual aspects and the movement of file from one department to another. It has been stated that the office of the respondent no.1, has passed an order dated 30.9.2021, sanctioning the medical reimbursement of Rs.1,29,265/- in favour of the petitioner as per the applicable rules and policies, governing the grant of medical reimbursement to the government employee. It is the stand of the respondent no.1 that the medical reimbursement has been sanctioned on a simple receipt of the bills, without any accompanying vouchers, as the original application has been lost. It has also been stated that upon receipt of the order dated 30.9.2021, the respondent no.4, has sent a communication dated 8.10.2021 to the office of the Accountant General seeking approval for reimbursement in favour of the petitioner. It is urged that nothing is further required to be done at its end.

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Mr. Nasir Saiyed, learned advocate appearing for the petitioner has submitted that owing to the accident and faced with an emergent situation, the petitioners was admitted to SAL Hospital, Ahmedabad, where he took treatment for the period from 22.1.2010 to 26.1.2010; however, since the condition of the petitioner deteriorated, he was shifted from SAL Hospital to Shalby Hospital as indoor patient and remained there for the period from 27.1.2010 till 24.2.2010.

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5.1 It is submitted that the office of the Director General of Police, Gandhinagar has addressed a letter dated 12.5.2011 to the Additional Chief Secretary, Home Department, requesting, inter alia, to consider the case of the petitioner as a special case in view of the circular dated 1.4.2000 of the Health & Family Welfare Department and to sanction the medical expenses. Factum of accident of the petitioner, while performing the duties, has also been narrated. It

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has been stated that only with a view to saving his life, the petitioner has availed of the treatment at private hospitals, and during the treatment, the left leg of the petitioner has been amputated for which, approximately Rs.5,24,236/- has been spent. It is submitted that thereafter, on 19/21.4.2014, the office of the Superintendent of Police, Banaskantha at Palanpur, addressed a communication to the Director General of Police to sanction the medical expenses of Rs.5,24,236/- in favour of the petitioner. Along with the letter, relevant papers with respect to the reimbursement to be made to the petitioner, were forwarded, however, no decision was taken.

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5.2 It is submitted that the petitioner since was not keeping well through his brother, submitted an application dated 3.5.2016 under the Right to Information Act, 2005 seeking information as regards action taken by the concerned authorities upon the application of the petitioner for reimbursement of the medical bills. The Information Officer, office of the Superintendent of Police, vide communication dated 9.5.2016, provided the information. It is submitted that the reply is very vague, as it only says that internal correspondences are being exchanged between the authorities concerned.

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5.3 It is submitted that the office of the Director General of Police, Gandhinagar has addressed a further communication dated 14.6.2016 to the Additional Chief Secretary, inter alia , requesting that under the programme of Gatisheel Gujarat – 2015-16 and with a view to achieving the specified target of reimbursing the medical bills (as a special case), proposals be sanctioned. Vide said letter, concern was also raised to the effect that medical expenses of the applicants therein have not been sanctioned coupled with a request to do the needful in the matter at the earliest.

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5.4 It is submitted that the said letter was followed by another

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letter dated 17.1.2017 by the Superintendent of Police, addressed to Director General of Police, reiterating the earlier request of sanctioning the bills for medical reimbursement, as the proposal was pending since 2011. The petitioner also followed up the matter is adhering the communication dated 20.4.2018 reiterating the request of reimbursement of the medical bills incurred by the petitioner in tune with the government policy.

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5.5 It is further submitted that the petitioner, since was not keeping good health, through his son, made an application before the respondent authorities. In response whereof, the Home Department, addressed a communication dated 7.1.2019 to the Additional Chief Secretary, Home Department to look into the matter and to dispose of the same at the earliest. On 8.1.2019, the District Superintendent of Police, Banaskantha addressed the letter to the Director General of Police, Gujarat State, Gandhinagar, reiterating the earlier request of sanctioning the bills of the petitioner.

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5.6 It is therefore, vehemently submitted that though the application was filed by the petitioner in the year 2011, except the movement of file inter-departmentally and intra-departmentally, no action has been taken by the respondent authorities for granting the medical reimbursement or rejecting the medical reimbursement and hence, the petitioner has approached this Court under Articles 226 and 227 of the Constitution of India, seeking direction to the respondent authorities to reimburse the medical bills of the petitioner to the tune of Rs.5.24.236/- along with interest.

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5.7 To substantiate the grievance, reliance is placed on various orders passed by this Court in the cases, viz. :-

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(i) Barot Girishkumar Babulal vs. State of Gujarat rendered in Special Civil Application No.15309 of 2010;

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(ii) Chandrakant Kantilal Dave vs. State of Gujarat rendered in Special Civil Application No.2736 of 2013;

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(iii) Jayantilal Bhikhalal Shah vs. State of Gujarat rendered in Special Civil Application No.22812 of 2006;

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(iv) Jaswantsinh C. Gohil vs. Commissioner of Medical Services (Health) rendered in Special Civil Application No.9001 of 2000.

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On the other hand, Mr.Krutik Parikh, learned Assistant Government Pleader, while adverting to the policy for medical reimbursement, submitted that the State Government, has framed a policy, namely, the Gujarat State Service (Medical Treatment) Rules, 1988 (hereinafter referred to as the ‘Rules of 1988’). It is submitted that as per Rule 15(6) of the Rules of 1988, a government employee along with his family members, who have taken the medical treatment at private hospital, would be eligible for medical reimbursement at par with the fees charged by the Government hospital and Government empaneled hospitals for similar medical treatment as a special case. Vide Government Resolution dated 26.10.2005 various hospitals have been empanelled for reimbursement for the treatment taken at private hospitals in the case of emergency. It is submitted that, in the year 2015, the Government has framed a policy for medical reimbursement whereby, the earlier Rules have been modified. As per Rule 23 of the Gujarat State Services (Medical) Rules, 2015 (hereinafter referred to as the ‘Rules of 2015’), in a special case, a Government employee has been held to be eligible for the medical reimbursement to the tune of Rs.2 lakhs to Rs.10 lakhs to be sanctioned by the Committee consisting of higher officers of the State Government and finally to be approved by the Health Minister. It is submitted that Rule 23, came to be further clarified vide Government Resolution dated 30.8.2016. Moreover, Rule 2 of the Rules of 2015 prescribes that if an employee covered under the said Rules undergoes treatment at any private hospital in an emergency situation involving serious ailments relating to heart, kidney, liver, brain; ailments relating to cancer; serious accidents and cases that

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involve a life and death situation of a patient, then the employee would be entitled to a reimbursement of the expenses incurred as an indoor patient. It is submitted that considering the provision of the Rules of 2015, medical reimbursement of Rs.1,29,265/- has been sanctioned in favour of the petitioner by the Home Department vide order dated 30.9.2021; considering the rates prevailing at Civil Hospital, Ahmedabad for similar treatment. It has also been strongly denied that the petitioner is eligible for medical reimbursement of Rs.5,24,236/- as claimed in the present writ petition.

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Heard the learned advocates appearing for the respective parties.

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Undisputed facts are to the effect that the petitioner while on duty met with an accident causing a fracture in left tibia/fibula with left popliteal artery injury. The petitioner was profusely bleeding and owing to severe bleeding, the petitioner fell unconscious and with the help of 108 services, the petitioner was shifted to Civil Hospital; however, owing to lack of infrastructure facilities, so also the availability of the Orthopedic Surgeon, after giving primary treatment and considering the condition of the petitioner, he was referred to SAL Hospital, Ahmedabad and was admitted on 23.1.2010. The petitioner was operated and had remained there for a period from 23.1.2010 to 26.1.2010. The leg of the petitioner got infected and was recommended treatment by surgeon, dealing with the infection and as advised, the petitioner was admitted to the Shalby Hospital for taking further treatment on 27.1.2010. The petitioner was operated twice and during the treatment and as advised, the left leg of the petitioner was amputated to save his life. During the course of treatment, the petitioner remained as an indoor patient at the SAL Hospital for the period of 23.1.2010 to 26.1.2010 and thereafter, at the Shalby Hospital for the period from 27.1.2010 to 24.2.2010 and the expenses incurred were to the tune

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of Rs.5,24,236/-. Pertinently, after the discharge, the hospital has issued the discharge summary and certificate, both dated 24.02.2010. From the discharge summary, it is more than clear that the petitioner had undergone operation. The relevant extracts of the discharge summary dated 24.02.2010, are reproduced hereinbelow:

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“Janmohamad A. Sindhi

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MEDICO LEGAL CASE

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			Name of Patient: Janmohamad A. Sindhi IP No: 7013225
			DOA: 27/01/2010 DOD:24/02/2010
SHALBY HOSPITALS Opposite Karnavati Club S.G. Highway, Ahmedabad			Bed No: / ICU: 314 Name of Admitting consultant: Dr.Hasmukh Nagwadia
			Date: 24/02/2010
IP NO			Discharge Summary
7 0 1	3	2	2 5

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Principal Diagnosis on admission:

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Operated external fixator elsewhere without treated arterial injury for comminuted fracture upper ¼ the left tibia/fibula with popliteal artery injury same side with wet gangrene with septicemia with Diabetes Mellitus. [ICD Code:T12]

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Discharge diagnosis: 1. Principal discharge diagnosis:-

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Operated left AK Amputation and interpositional vein graft for fracture tibia/fibula left side with popliteal artery injury with control of diabetes Mellitus and treatment of septicemia.

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Consultations: (Include name and specialty)

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Name Specialty

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Dr. Minesh Mehta Intensivist

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Procedures/Surgeries

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SR. No.	Date	Procedure carried out by	Procedure	CPT Code
1	27/01/10	Dr.Sandeep Agarwala & Dr. Bhavin Desai	Repair of left popliteal artery by using SVG [interpositional graft]
2	30/01/10	Dr. Hasmukh Nagwadia	Amputation of left leg above knee	“

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Similarly, certificate has also been issued by the hospital, which

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reads thus:

“

Shalby Hospitals

Opp. Karnavati Club, S.G. Highway, Ahmedabad-380015, GUJARAT (INDIA) Tel. No. (079) 40203000 | Fax (079) 40203109 Website: www.shalby.org | Email: [email protected]

SHALBY

HOSPITALS

Date: 24/02/2010

TO WHOM IT MAY CONCERN

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This is to certify that Mr.Janmohamad A. Sindhi, aged 48 years, was admitted at Shalby Hospital on date 27/01/2010. (I.P. No. 7013225) He was having fracture left Tibia/Fibula with left popliteal artery injury with wet gangrene with septicemia with Diabetes Mellitus. During hospitalization, he was treated by Dr. Minesh Mehta (Intensivist), Dr. Sandip Agarwal & Dr. Bhavin Desai (Vascular Surgeons) and Dr. Hasmukh Nagwadia (Orthopedic trauma Surgeon). He is operated for left above knee Amputation for the same. Now, he is discharged on today date 24/02/2010.

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He is advised to take rest for about 3 months from date of accidental injury.

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(A Medico-Legal case No. 294)”

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Evidently, the petitioner could not get sufficient medical facilities at Deesa, and as per the recommendation of the doctor, the petitioner was shifted to SAL Hospital and as the leg of the petitioner got infected, he was shifted to Shalby Hospital for further treatment for infection. Since the infection was spreading, a decision was taken to amputate the left leg only with a view to saving his life. Pertinently, there was no option left for the petitioner to have taken or waited for the decision to be admitted in the Civil Hospital/Government Hospital at Deesa or at Ahmedabad for treatment. Accordingly, the petitioner having taken the requisite treatment from two private hospitals, have incurred the expenditure of Rs.5,24,236/-.

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Thereafter, the petitioner submitted an application, which was

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considered by the office of the Director General of Police (Administration), Gandhinagar who in turn has addressed a communication dated 12.5.2011 to the Additional Chief Secretary, Home Department, Gandhinagar, inter alia, requesting that as petitioner has incurred the expenses towards the medical treatment, as per the Circular dated 1.4.2000 of the Health & Family Welfare Department, the expenses be sanctioned. On 19/21.4.2014, another letter was issued by the Superintendent of Police, Banaskantha sending a reminder for sanctioning the bill of the petitioner. Again on 14.6.2016, a letter was addressed by the office of Director General of Police, Gandhinagar to the Additional Chief Secretary, Home Department, requesting it to sanction the bill under the Gatisheel Gujarat – 2015-16, so as to achieve the specified target of sanctioning the reimbursement bill of the police staff (as a special case). The case of the petitioner, was also recommended, by letter dated 17.1.2017 by the office of the Superintendent of Police, Banaskantha addressed to the Director General of Police, Gandhinagar, requesting for sanctioning the amount of Rs.5,24,236/-, as a special case, request was also made to expedite the application of the petitioner. Once again on 7.1.2019, the office of the Superintendent of Police, Banaskantha addressed a letter, reiterating the request of sanctioning the medical expenses of the petitioner.

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The request of the petitioner, was considered by the State Government, and the State Government as late as in the year 2021 decided the case of the petitioner, sanctioning an amount of Rs.1,29,265/-. The State Government, has also set out in detail the procedure which was observed for sanctioning the bill. Over and above the procedure, the State Government has also relied upon the policy for medical reimbursement for the State employees, i.e. the Rules of 1988. According to the State Government, as per subrule (6) of Rule 15 of the Rules of 1988, Government employee

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along with his family members, who have taken the treatment at private hospital, would be eligible for medical reimbursement at par with the fees charged by the Government hospitals and Government empanelled hospitals for similar medical treatment. As aforesaid, the State Government, during the pendency of the writ petition, has passed the order dated 30.9.2021, sanctioning the bill for an amount of Rs.1,29,265/- as against the medical expenses incurred to the tune of Rs.5,24,236/-. The order, contains the details of the expenditure incurred and the expenses admissible to the petitioner. The said tabular form is reproduced hereunder for ready reference.

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Sr. No.	Name of the Hospital	Particulars	Expenses Incurred (Rs.)	Entitled Approximat e Expenses (Rs.)
1	SAL Hospital, Ahmedabad	Medicines- Consumable/ Implant expense	17329	5299
		Room expense	4700	150
		Laboratory/ Radiology expense	17470	2810
		Operation expense	42500	120
		Other expenses	19507	00
2	Shalby Hospital, Ahmedabad	Medical- Consumable expense	146566	118288
		Room expense	34100	1088
		Laboratory/ Radiology expense	8360	670
		Operation/ Procedure expense	162600	840
		Other expenses	71004	00
		Total Rs.	5,24,236/-	1,29,265/-

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At item No.2, the charges have been set out of the actual expenses and admissible expenses. So far as the expenses towards operation procedure is concerned, the actual expenses, were

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Rs.1,62,600/- whereas, as per the admissible expenses, the amount is only Rs.840/-. Similarly, if one sees the other expenses, the admissible amount is on lower side compared to the actual expenses.

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Apt is the judgment of the Apex Court in the case of Shiva Kant Jha vs. Union of India reported in (2018) 16 SCC 187. In the case before the Apex Court, the issue was with regards the claim under the Central Government Health Scheme. The petitioner therein had submitted bills for reimbursement on account of his treatment in the private hospital. One of the bills was rejected by the Technical Standing Committee on the ground that CRT-D implant was not required. The petitioner had made repeated efforts for the purpose of sanctioning of the bill, however, certain amount was credited in the bank account of the petitioner without any intimation. In the second bill, the petitioner’s claim was curtailed to the tune of Rs.94,885/-. So out of total claim, the petitioner was denied an amount of Rs.4,96,343/- from the first claim and Rs.3,03,212/- from the second set of claim. The petitioner, being aggrieved, preferred the petition under Article 32 of the Constitution of India before the Apex Court. It has been held and observed that the Government employee during his life time or after his retirement is entitled to get the benefit of the medical facilities and no fetters can be placed on his rights. It has been further observed that it is acceptable to common sense, that ultimate decision as to how a patient should be treated vests only with the doctor, who is well versed and expert both on academic qualification and experience gained and that very little scope is left to the patient or his relative to decide as to the manner in which the ailment should be treated. Specialty hospitals are established for treatment of specified ailments and services of doctors specialized in a discipline are availed by patients only to ensure proper, required and safe treatment. The Apex Court has also observed that taking treatment in specialty hospital by itself

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would not deprive a person to claim reimbursement solely on the ground that the said Hospital is not included in the government order. The real test must be the factum of treatment. Before any medical claim is honoured, the authorities are bound to ensure as to whether the claimant had actually taken treatment and the factum of treatment is supported by records duly certified by doctors/hospitals concerned and once it is established, the claim cannot be denied on technical grounds. The Apex Court has explained the right of the Government employee. The employee during his life time or after his retirement is entitled to get the benefit of medical facilities and no fetters can be placed on his rights. Paragraph 13 reads thus:-

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“13. It is a settled legal position that the Government employee during his life time or after his retirement is entitled to get the benefit of the medical facilities and no fetters can be placed on his rights. It is acceptable to common sense, that ultimate decision as to how a patient should be treated vests only with the Doctor, who is well versed and expert both on academic qualification and experience gained. Very little scope is left to the patient or his relative to decide as to the manner in which the ailment should be treated. Speciality Hospitals are established for treatment of specified ailments and services of Doctors specialized in a discipline are availed by patients only to ensure proper, required and safe treatment. Can it be said that taking treatment in Speciality Hospital by itself would deprive a person to claim reimbursement solely on the ground that the said Hospital is not included in the Government Order. The right to medical claim cannot be denied merely because the name of the hospital is not included in the Government Order. The real test must be the factum of treatment. Before any medical claim is honoured, the authorities are bound to ensure as to whether the claimant had actually taken treatment and the factum of treatment is supported by records duly certified by Doctors/Hospitals concerned. Once, it is established, the claim cannot be denied on technical grounds. Clearly, in the present case, by taking a very inhuman approach, the officials of the CGHS have denied the grant of medical reimbursement in full to the petitioner forcing him to approach this Court.”

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In the present case, it is undisputed that the petitioner, met with an accident while on duty and owing to severe condition of the petitioner, the petitioner was recommended by the local doctor to

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SAL Hospital and thereafter to Shalby Hospital. It is also not in dispute that owing to the infection spread, the decision was taken to amputate the left leg of the petitioner.

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Further, in the case of Barot Girishkumar Babulal (supra), this Court after referring to the judgment of the Apex Court in the case of Shiva Kant Jha (supra), has observed in paragraphs 10 and 11 thus:-

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“10. Thus, the Apex Court has observed that very little scope is left to the patient or his relative to decide as to the manner in which the ailment should be treated. Speciality Hospitals are established for treatment of specified ailments and services of Doctors specialized in a discipline are availed by patients only to ensure proper, required and safe treatment. If an employee has been taken to a hospital under emergency condition for survival of his life, which requirement was above the sanctioned and treatment in the empanelled hospitals, the respondent-State has to pay the amount of reimbursement. It is further held that the right to medical claim cannot be denied merely because the name of the hospital is not included in the Government Order. The real test must be the factum of treatment. Thus, the respondent-State cannot deny the full medical reimbursement, and only restrict to it to the rates equivalent to the rates charged by the Civil Hospital, Ahmedabad. The petitioner was taken to the Jupiter Hospital, Mumbai, which had the specialty to treat the medical condition of the petitioner. He was under an emergency condition taken to such hospital for the survival of his life.

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Under the circumstances and in light of the forgoing observations, the respondent authorities are directed to pay the remaining amount towards the medical reimbursement of Rs.1,11,378/- within a period of two months from the date of receipt of the writ of the order of this Court. The writ petition stands allowed. Rule is made absolute. Direct service is permitted.”

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In the case of Chandrakant Kantilal Dave (supra), the petitioner therein underwent Coronary Artery Bypass Surgery (CABG) for which, a medical bill of Rs.1,76,000/- was issued. As against this, the State Government has sanctioned an amount of Rs.66,000/-. The petitioner, aggrieved, approached this Court. This Court, while allowing the writ petition, took note of the undisputed fact that the petitioner has undergone bypass surgery at the age of 74 years and

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having fallen seriously ill, was advised for immediate and urgent bypass surgery. The petitioner therein, under medical advise, was taken to SAL Hospital for such treatment and considering the seriousness, was operated and remained as an indoor patient in the hospital. The hospital, issued the bill of Rs.1,76,000/-. The State Government following the resolution dated 9.9.2005, reimbursed the amount of Rs.66,000/-. While taking note of the judgment of the Apex Court, this Court directed the respondent authorities to pay the balance amount together with interest @ 9% from the date of the filing of the writ petition to the petitioner therein within a period of four weeks.

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In the case of Jaswantsinh C. Gohil (supra), this Court, observed that there was no dispute either of genuineness of the medical bill or the status of Apollo Hospital, Chennai, being a recognized hospital. Since the petitioner has undergone bypass surgery on the advice of the doctor, and when there is advice, nobody would wait to go through the procedure of getting certificate from authoritised doctor or for permission from the competent authority. This Court, held that when the genuineness of the medical bill is not doubted, and when there was a requirement to get the treatment outside the State recognized hospital, the claim of the Government servant could not have been rejected, simply on the ground that nonproduction of the recommendation from the authorised Medical Officer. It has also been observed that the scheme for medical reimbursement is floated with a specific purpose to see that Government servant genuinely requiring immediate treatment from the recognized hospital outside the State, may be fully helped by the Government itself in the matter of taking full reimbursement. If such is a benevolent purpose behind the Government Resolution, then by now granting the full reimbursement of the medical expenses when genuineness of the bill is not doubted, the very purpose of providing full reimbursement of the medical expenses

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would be frustrated. This Court, allowed the writ petition and directed the respondent to pay the amount as claimed.

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Pertinently, and not disputed, the petitioner had met with an accident and considering the serious condition of the petitioner, the local doctor advised the family members for immediate surgery, for which, the petitioner, was directed to get himself admitted in the SAL Hospital. The team of specialized surgeons, namely, Orthopedician, Diabetician and Physician was required and as the same team was not available, the petitioner was referred to SAL Hospital. The doctors were of the opinion that if the surgery is not carried out, it is likely that the infection may spread all over the body. The petitioner was shifted to Shalby Hospital where, ultimate decision was taken of amputating his left leg. Therefore, there is not an iota of doubt that the petitioner was required medical treatment on emergent basis. To expect from the person in serious condition or family member to take conscious decision to find out Government hospital and get himself admitted for treatment would be too much to expect.

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Also, numerous communications have been exchanged interdepartmentally and intra departmentally by the respective offices, clearly recommending that the medical bill of the petitioner for an amount of Rs.5,24,236/- be sanctioned as a special case. Indeed, in one of the communications, the recommendation is also made to sanction the bill under the programme of Gatisheel Gujarat – 201516 to meet the specified target in relation to the medical reimbursement of the police staff (special case). Therefore, the common thread running through all the communications is that the medical bills of the petitioner be sanctioned as a special case. Therefore, there was no reason available to the respondent State not to accept the request of the department so also the petitioner for sanctioning the bill of Rs.5,24,236/-.

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Quite apart, the present, is a case of inaction on the part of the respondent State. Though, various communications have been exchanged inter-departmentally and intra-departmentally, no concrete decision was taken at the level of the State Government. The petitioner was made to run from pillar to post begging for his legitimate dues. The accident had taken place in the year 2010 followed by applications after applications seeking the disbursement of the medical expenses. By now, 11 years have been passed and the petitioner has also retired from service, unfortunately, the petitioner kept on struggling for his bills. As a last resort, the petitioner has filed the present writ petition, seeking reimbursement of the amount incurred towards the medical expenses.

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During the pendency of the writ petition, the order dated 30.9.2021 has been passed, sanctioning the bill of the petitioner for an amount of Rs.1,29,265/-. Comparing the actual expenses vis-avis the estimated expenses, apparently, the estimated expenses are on a lower side. This Court, does not for a moment suggest that in every case, the Government should sanction the bills as raised. When the petitioner was struggling to save his life, in the exceptional situation like the present one, what was expected of the State Government was to have extended the expenses. Also it is not disputed that the petitioner has not incurred the expenses towards his treatment. Considering the peculiar facts of the present case, there was no reason available to the State Government not to accept or sanction the bill of the petitioner and reject the same only on the ground that it would be impermissible as per the policy.

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In view of the peculiar facts of the present case, the respondent State is directed to disburse the remaining amount of Rs.3,94,971/to the petitioner.

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Notably, the amount of Rs.5,24,236/- has remained unpaid to the petitioner for almost 11 years causing the petitioner mental

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C/SCA/8121/2020 JUDGMENT DATED: 23/12/2021

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agony, harassment and hardships and therefore, in view of the delay in disbursing the amount of medical reimbursement, the petitioner is entitled for interest at least for a period of three years prior to the filing of the writ petition. The total amount claimed by the petitioner is Rs.5,24,236/- out of which, Rs.1,29,265/- was credited to the account of the petitioner on 30.09.2021. The said amount shall carry the interest @ 6% for the period prior to three years of the filing of the writ petition till the same is paid (i.e. 30.09.2021). The respondent State is also directed to pay interest @ 6% on the remaining amount of Rs.3,94,971/- from three years prior to filing of the writ petition till the payment is made. The amount shall be paid within a period of four weeks from the date of receipt of the copy of this order, failing which, the amount of Rs.3,94,971/shall carry interest @ 9%.

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