TARLOCHAN SINGH Vs. UOI

JUDGEMENT

(1.) The present writ petition has been filed by the petitioner praying inter alia for issuance of an appropriate writ or directions to the respondent to reimburse the petitioner for full amount paid by him to the Escort Heart Institute (hereinafter referred to as `the Institute') for a coronary artery by-pass graft surgery conducted on the petitioner, who is a CGHS card holder.

(2.) The undisputed facts of the case are that the petitioner, a retired Central Government employee, is a Central Government Health Scheme (CGHS) card holder and entitled to all the medical benefits under the CGHS. Vide letter dated 20th December, 1999, the petitioner was granted permission by the respondent no.2 for undergoing open heart surgery at the Institute, which is a CGHS recognized super specialty hospital and accordingly he was admitted to the Institute on the same day, as a case of coronary artery disease. On 23rd December, 1999, the petitioner underwent Coronary Bypass Graft surgery and he was discharged on 29th December, 1999 after his post operation care was over. During his hospitalization, the petitioner was advised to undergo certain other tests as he was found to be a high risk case, which the petitioner duly underwent. The said tests were in addition to those included in the package deal and the petitioner informed the respondent no.2. about the same vide his letter dated 8th February, 2000. The petitioner spent a total amount of Rs. 2,06,800/-, out of which he was reimbursed by the respondents for a sum of Rs. 1,26,200/- (of which Rs. 27,000/- was received by the petitioner and Rs. 99,000/- was paid directly to the Institute), leaving a balance outstanding amount of Rs. 80,600/- which the respondent failed to reimburse. Aggrieved by the aforesaid refusal on the part of the respondents in not reimbursing the petitioner for the total amount spent by him on his treatment, the petitioner has filed the present writ petition.

(3.) Counsel for the petitioner submitted that the petitioner being a Government servant, is entitled to treatment free of charge at such a Government hospital or near the place where he fell ill, which in the opinion of the authorised medical attendants, provides necessary and suitable treatment. In this regard, he relied on Rules 3 (1) and (2) and 6 (1) (a) and 6(2) of the Central Services (Medical Attendant) Rules. He further submitted that the Institute is a duly recognized hospital for specialized treatment for cardiac disease and open heart surgery and is an approved hospital as per the Office Memorandum dated 18th September, 1996 and that once the petitioner was permitted to obtain treatment from the Institute, the respondent cannot deny him actual reimbursement of the treatment.