Allowed

Shankar Lal Choudhary v. R S R T C and Ors.

Rajasthan HC18 Aug 2023CW/3523/2010

Case brief

AI extract

What is this about?

The High Court held that denying medical reimbursement solely because treatment was received at a private/unrecognized hospital is arbitrary. Relying on Shiva Kant Jha, the court ruled that such claims must be accepted and paid at approved hospital rates.

What did the court decide?

Respondents directed to reimburse medical expenses at approved hospital rates within three months, with 6% interest thereafter.

Shankar Lal Choudhary Vs R S R T C and Ors. — Pension and Retirement Benefits | Rajasthan HC (2023)

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HIGH COURT OF JUDICATURE FOR RAJASTHAN BENCH AT JAIPUR

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S.B. Civil Writ Petition No. 3523/2010

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Shankar Lal Choudhary, S/o Shri Hardeen Choudhary, aged about 60 years, R/o B-8, Nityanand Nagar, Gandhi Path, Queens Road, Vaishali Nagar, Jaipur

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----Petitioner

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Versus

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Rajasthan State Road Transport Corporation, Head Office, Parivahan Marg, Jaipur Through Its Chairman

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Managing Director, Rajasthan State Road Transport Corporation, Head Office, Parivahan Marg, Jaipur.

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Executive Director Administration Rajasthan State Road Transport Corporation, Jaipur.

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----Respondents

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For Petitioner(s) : None For Respondent(s) : Mr. J.K. Singhi, Sr.Advocate with Mr. Tarun Kumar

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HON'BLE MR. JUSTICE ANOOP KUMAR DHAND

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Order

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18/08/2023

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Instant petition has been filed by the petitioner with the following prayer:-

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“it is, therefore, prayed that this writ petition may kindly be accepted and allowed and by an appropriate order or direction, the part of the order dated 16.11.2007, whereby he has been denied the reimbursement of amount incurred in getting the treatment in Tongia Heart and General Hospital, Jaipur on the ground that that is not in accordance with the policy, may kindly be declared to be arbitrary, illegal and unreasonable and the same may kindly be quashed and set-aside and the respondents may kindly be directed to

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[CW-3523/2010]

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(2 of 4)

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reimburse the medical bills submitted by the petitioner at the earliest with interest @ 12% per annum from the date of submission of the medical bills till their realization.

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Any other appropriate order or direction, which this Hon'ble Court may deem just and proper in the facts of the present case, may also be passed in favour of the petitioner.”

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Contents of the writ petition indicates that the petitioner suffered from heart attack on 07.5.2007 for which he took treatment in Tongia Heart and General Hospital, Jaipur. Contents of the writ petition further indicate that in the aforesaid treatment, the petitioner incurred expenses of Rs.1,40,631/-. Contents of the writ petition indicate that after recovery, the petitioner submitted an application for reimbursement of the aforesaid amount but the application filed by the petitioner was rejected by the respondents on the ground that the treatment was taken in the private/unrecognized hospital. By way of filing this writ petition, the petitioner is seeking directions against the respondents to reimburse the amount of expenses incurred by him in the aforesaid treatment.

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Per contra, learned counsel for the respondents opposed the prayer made in the petition and submitted that the treatment was taken by the petitioner in a private/unrecognized hospital, hence, the petitioner is not entitled to get any amount for the treatment taken by him in the private hospital.

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Heard and considered the submissions made at Bar and perused the material available on record.

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[CW-3523/2010]

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(3 of 4)

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This fact is not in dispute that the petitioner suffered from heart attack on the faithful day and in emergent situation, he was admitted in Tongia Heart and General Hospital, Jaipur where the treatment was given to him and in which he incurred expenses of Rs.1,40,631/-. The respondents have refused to make the payment of the aforesaid amount on a technical reason that the treatment was taken in private/un-recognized hospital. This cannot be a ground to deny the entire medi claim of the petitioner. The Hon'ble Apex Court has held in catena of Judgments that if the treatment is taken in private/unrecognized hospitals, the authorities are supposed to make the payment as per the rates applicable in approved hospital.

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6 In Shiva Kant Jha Vs. Union of India (UIO), reported in AIR 2018 SC 1975 (decided on 13.04.2018) the Hon’ble Apex Court has held as under:-

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"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 commonsense, 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 ina 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

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[CW-3523/2010]

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(4 of 4)

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Order. The real test must be the factum of treatment....."

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In view of the ratio laid down by the Hon’ble Apex Court in the case of Shiva Kant (supra), this petition stands disposed of with directions to the respondents to make the payment to the petitioner as per the rates applicable in the approved hospitals within a period of three months from the date of receipt of a certified copy of this order.

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It is made clear that in case compliance of this order is not made within the stipulated time, then the petitioner would be entitled to get interest @ 6% per annum.

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All pending application(s), if any, also stands disposed of.

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No order as to costs.

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(ANOOP KUMAR DHAND),J

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Ashu/110

Shankar Lal Choudhary v. R S R T C and Ors.

Case brief

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Shankar Lal Choudhary v. R S R T C and Ors.

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