Dismissed

Union Of India And 3 Others v. K.P. Johny

Telangana HC4 Feb 2021WP/7866/2020

Case brief

AI extract

What is this about?

The High Court dismissed the writ petition challenging the Central Administrative Tribunal's order directing Railways to reimburse a retired employee for 90% cancer treatment costs. The Court held the Tribunal was justified, prioritizing the employee's life over rigid policy restrictions when faced with a fatal disease.

What did the court decide?

The writ petition is dismissed without costs. All pending miscellaneous petitions are closed.

Union Of India And 3 Others Vs K.P. Johny — Medical Negligence | Telangana HC (2021)

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HIGH COURT FOR THE STATE OF TELANGANA

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(Special Original Jurisdiction)

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THURSDAY, THE FOURTH DAY OF FEBRUARY

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TWO THOUSAND AND TWENTY ONE

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PRESENT

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THE HON'BLE SRI JUSTICE A. RAJASHEKER REDDY AND

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THE HON,BLE DT. JUSTICE SHAMEEM AKTHER

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WRIT PETITION NO: 7866 OF 2020

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Between:

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Union of ^lndia, Rep. by its General Manager, South Central Railway, Rail Nilayam, Secunderabad.

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2 The Principle. chief Personnel officer, south central Railway, Rail Nilayam, Secunderabad.

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The Principle chief_ Medical Director, south central Railway, Secunderabad Division, Sanchalan Bhavan, Secunderabad

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The lr,4edical Director, Central Hospital, Lallaguda, Secunderabad

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...PETITIONERS

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AND

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{.P.^{J^q[ny,, S/o K.O. Pylan,occ: Retired Chief Engineer, Rio. H. No. 109,} 1 0-2-273, Keerthy Sudarshan Apts, West I,4arredp5lly, Secunderabad.

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...RESPONDENT

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Petition under Article 226 of lhe constitution of lndia praying that in the circumstances stated in the affidavit filed therewith, the High court may be pleased to issue a wrrt of certiorari, or any other appropriate writ, order or direition calling for the records pertaining to o.A. No. 4ool2o1g Dated. 30101/2020 on the file of central Administrative Tribunal Hyderabad Bench Hyderabad, and quash the same, as illegal, arbitrary a nd. u n-co nstitutional.

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IA NO: 1 OF 2020

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Petition under section 151 cPC praying that in the circumstances stated in the affidavit filed in support of the petition, the High courl may be pleased to suspend the operation of the orders in o.A. No. 40012019 Dated: 30/01/2020 on the file of central Administratrve Tribunal Hyderabad Bench Hyderabad, pending disposal of the above Writ Petition.

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Counsel for the Petitioners: SRI PUSHpTNDER KAUR

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Counsel for the Respondent: SRI K.R.K.V. PRASAD

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The Court made the following: ORDER

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THE HON'BLE SRI JUSTICE A. RAJASHEKER^REDDY

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AND

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THE HON'BLE DT. JUSTICE SHAMEEM AKTHER

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WRIT PETITION No-7866 of 2O2O

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ORDER: (Per Hon'ble Dr,SA,i)

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This Writ Petition, under Article 226 of the Constitution^of India is filed by the^petitioners, wherein, the following^prayeris made:

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"...to issue a writ of certiorari. or any other aPPropriate Writ, order or direction calling for the records^pertaining to O.A.No.211400 of 2019 dated 30.01.2020 on the file of Central Administrative Tribunal, Hyderabad Bench, Hyderabad, and quash the same. as illegal, arbitrary and uncon stitutiona I and pass such orders..,."

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Heard the learned counsel for the^petitioners, learned counsel for the respondent and^perused the record.

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The brief facts of the case are that the respondent/ applicant, is a Retired Railway employee and he^{joined the} Retired Employees Liberalised Health Scheme^(RELHS), which provides medical Facility to retired railway employees. When the respondent/applicant appeared before the^{petitioner No.4-} Hospital for medical check-up, he was diagnosed with^lung cancer and the^petitioner No.4 vide^{proceedingsdated} 21.08.2018 referred the respondent/applicant to Apollo^Hospital, lubilee Hills, Hyderabad for evaluation and management of^the cancer including inpatient service. Accordingly, the^respondent/ applicant got admitted in Apollo Hospital, lubilee^Hills, Hyderabad on 22.08.2018 and the said Hospital vtde letter dated

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'\Rli.J & I)r.S ..t \1.1,.\o.78(,6 ot l{)20

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27.08.2O18 recommended Tomotherapy treatment to the respondent/applicant, but the petitioner No.4 did not permit the said treatment as it was not part of Memorandum oF Understanding entered with the said Hospital. However, in view of precarious health condition of the respondent/applicant, the respondent/applicant took treatment in Apollo Hospital from 03.09.2018 to 17.09.2018 and incurred medical expenses of Rs.4,05,000/-. Thereafter, the respondent/applicant submitted claim before the petitioner No.4 on 01.10.2018 encrosing ail the relevant documents, but the petitioner No.2 vide proceedings daled 27.12,2018 sanctioned only an amount of Rs.94,506/instead of full amount of Rs.4,05,000/_. Aggrieved thereby, the respondent/applicant filed an appeal before the petitioner No.3 on 05,01.2019 but no action has been taken by the petitioner No.3. Therefore, the respondent/applicant filed Original Application No.2r/400/2019 before the centrar Administrative Tribunal, Hyderabad Bench (for short.'the Tribunal,,). After hearing both sides, the said O.A. was allowed by the Tribunal vide order dated 30.01.2020 and the petitioners herein were directed to pay the balance amount of Rs.3,10,494l- to the respondent/applicant, within three(3) months from the date of receipt of copy of said order. Aggrieved by the impugned order dated 30.01.2020 passed by the Tribunal, the present Writ Petition is filed.

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The learned counsel for the petitioners would contend that the impugned order dated 30.01.2020 passed in O.A.No.211400/2019 by the Tribunal, is arbitrary and

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IRR.J & Dr.SA.J \.P.\o.?866 of 2020

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-1

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unconstitutional and against the decision rendered by the ThreeJudges Bench of Hon'ble Apex Court in Sfate of Punjab and

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other v. Ram Lubhaya Bagga and othersl, In spite of the letter dated 31.01.2007^yide Ref. No.2005/H/6-4lPolicy-II issued by the Executive Director (Health), Railway Board, the Tribunal, grossly erred in issuing the direction as indicated in the impugned order dated 30.01.2020, There is no lvlemorandum of Understanding in between the petitioners and the Apollo Hospital, Hyderabad to undertake Tomotherapy treatment to the respondent/applicant. The respondent/applicant was directed to take treatment in Basavatarakam Cancer Hospital, Hyderabad, but he did not do so. Without permission to take treatment for cancer in Apollo Hospital, Hyderabad, the respondent/applicant erroneously claimed the full medical expenditure of Rs.4,05,000/-. The reimbursement claim dated 01.10.2018 submitted by the respondent/applicant was received by the petitioner No.4 on 05.10.2018. In terms of letter dated 31.01.2007 vide Ref , No.2005/H/6-4lPolicy-Il dated 31.01.2007, the petitioner No.2 rightly sanctioned an amount of Rs.94,506/to the respondent/applicant on 21.12.2018 towards medical expenses instead of reimbursing full amount. It is further contended that the Hon'ble Apex Court has categorically held that the policies restricting the medical reimbursement cannot be held to be violative of Article 21 or Article 47 of Constitution of India and ultimately prayed to set aside the impugned order and allow the writ petition as prayed for.

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'^{relalr; sor} qo

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ARR.., & I)r.S..,1 \.P.\0.78(,6 rrf 2020

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On the other hand, the learned counsel for the respondent/applicant would submit that the Tribunal is justified in directing the petitioners to reimburse the full medical expenses incurred by the respondent/applicant. The Tribunal, while relying on several decisions of the Hon,ble Apex Court was pleased to pass the impugned order dated 30.01.2020. There is no illegality or perversity in the impugned orcler dated 30.01.2020 passed by the Tribunal and ultimately prayed to dismiss the writ petition.

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The specific case of the petitioners is that the reimbursement of medical expenses is governed by the letter dated 31.01.2007 in Ref.No.2OO1|H/6-4/policy-Il issued by the Railway Board. In terms of the said letter, part payment of Rs.9a,506/- has been sanctioned to the respondent/applicant and the balance of medical claim was declined by the petitioner No.2.

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As per the records placed before this Court, when the respondent/applicant appeared before the petitioner No.4_ Hospital, he was diagnosed with lung cancer and was referred to Apollo Hospital, Jubilee Hills, Hyderabad vide proceedings dated 21.08.2018 for evaluation and management of the cancer including inpatient service. Accordingly, the petitioner took treatment for Tomotherapy in the Apollo Hospital, Hyderabad 03.09.2018 to 17.09.2018, and incurred medical expenses of Rs.4,05,000/-. To substantiate the same, he placed the medical bill dated 28.08,2018 issued by the Apollo Hospital, Jubilee Hills,

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ARR,J & Dr.S,,J W.P.No.7866 of2020

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Hyderabad. There is no dispute with regard to the respondent/applicant taking treatment in Apollo Hospital, lubilee Hills, Hyderabad, being reFerred by the petitioner No.4.. The letter dated 21,08.2018 issued by the petitioner No.4, reveals that the respondent/applicant was referred by Dr.pooja Datta to the Apollo Hospital, Hyderabad, for further evaluation and Management and it was valid for 15 days. On being referred to the Apollo Hospital, Hyderabad, the respondent/applicant took treatment and got cured for fatal disease of lung cancer. While dealing with the issues raised before the Tribunal, the learned Tribunal was of the opinion that the lung cancer is a fatal disease and the complications of the said disease are unpredictable and life threatening. In those circumstances, the respondent/ applicant preferred to take treatment in Apollo Hospital and was treated Stereotactic body radiation therapy to right lung with Tomo Helical technique on Tomotherapy Machine, which is evident from the discharge summary given by the Apollo Hospital dated 17.09.2018.

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B. It is pertinent to state that the primary object is to ensure that the health of employees is taken care of. in case of chronic diseases like lung cancer, the Government concerned should come to the rescue of the employees to save their lives. The learned Tribunal while acceding to the prayer of the respondent herein/applicant has relied on the decisions of the Hon.ble Apex Court in State of Karnataka v. R.Vivekananda Swamt', wherein. it was held that it is important to bear in mind that self' lzooe;^{s scc :ze}

ARR,J & Dr.SA,J '!.P.No.7866 of2020

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preservation or one,s liFe is the necessary concom,tant of the rrght to rife enshrined in Article 21 0f the constitution of India; in Shiva Kant Jha v. llnion of India3, wherein it was held that it is a settled legal position that the Government employee during his life time or after his retirement is entired to get the benefit of the med,cal facilities and no Fetters can be placed on his rights. The real test must be the factum of treatment; that before any medicar craim 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; that once, it is established, the claim cannot be denied on technical grounds. In S.fagannath v. tlnion of Indiaa, it was held that if the Government servant has suffered an ailment which requires treatment at a specialized approved hospital and on reference whereat the Government servant had undergone such treatment therein, it is but the duty of the State to bear the expenditure incurred by the Government servant.

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The learned counsel for the petitioners placed reliance on the decision rendered by the Three_Judges Bench of Hon,ble Apex Court in Stafe of punjab,s case (1 supra), wherein it was held that the policies restricting the medicar reimbursement cannot be held to be violative of Article 2I or Article 47 of Constitution of India.

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,^{Wflt Petrt,on (Crvrt)No.694 ot 2Ut5} 1997(2) SCC 87

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,\RR.J & Dr.SA,J \.P.\0.1866 0f2020

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lO.Intheinstantcase,firstly,therespondent/applicantwas diagnosed with^{lungcancer and was referred to Apollo Hospital'} lubilee Hills,^{Hyderabadvide proceedingsdated 21 08'2018for} evaluation and^{managementof the cancer includinginpatient} service. As^{per the said letter, the petitioners have undertaken} to^pay all the^{medical bills' Thereafter, when the estimation of} the dlsease^{was put to Rs.4,05,OOO/-,the petitionersdirected} the respondent/applicant^{to take treatment in Basavatarakam} Cancer Hospital,^{Hyderabad.The cancer being a deadlydisease'} the respondent/applicant^{did not take chance and shiftedto} Basavatarakam^{Cancer Hospitalfor treatment' The respondent/} applicant was in^{need of immediate medical attention' The} proposed shiFting may be fatal^{to the respondent/applicant'} Moreover, the Apollo^{Hospital,where the respondent/applicant} has taken treatment,^{is in the approved list of hospitals'}

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ll.ThelearnedTribunalfurther,whlledealingwiththesubject matter of the O.A,^{also relied upon the decisions of Hon'ble Apex} Court in State of^{Puniab and others v' Mohinder Singh} Chawala and otherss^{and Vice Chancellor,BanarasHindu} university v. Shrikanf ,^{whereinsimilar circumstances arose'}

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So, in view^{of the peculiar circumstances of the instant} case, the decision^{relied upon by the learned counselfor the} petitioners, is distinguishable.^{The learnedTribunal is iustifiedin} reimburse the^{balanceamount of} directing the Petition^{ers to} Rs.3,70,494/- to the^{respondent/applicantThere is no illegality}

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'(1997)2^{scc 83} " 2006( 11) SCC⁴²

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8 ARR,J & Dr.SA.J W.P.No.7866 of 2020

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or perversity in the impugned order dated 30.01.2020 passed by the learned Tribunal. AII the contentions raised by the petitioners do not merit consideration. The writ petition is devoid of merits and liable to be dismissed.

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