NARENDRA PAL SINGH Vs. UNION OF INDIA

JUDGEMENT

(1.) This petition is directed against the respondents for issuance of a writ.in the nature of certiorari for quashing the Order dated 4th December, 1997 made by the Government of India, Office of the Additional Director, Central Government' Health Scheme (Annexure-E to the petition) rejecting the case of the petitioner for reimbursement of the medical claim. The petitioner has further prayed for a writ of mandamus commanding the respondents to reimburse him the amount of Rs.93,870.00 with interest at the rate of 24% from the date of discharge from hospital i.e. 22nd February, 1996 to the date of payment. The petitioner retired on 31st July, 1988 as Assistant Engineer(Mechanical) from Government of India, Security Paper Mill, Hoshangabad, M.P.-461005. He was admitted in Mayo Hospital Savli Road, Harni,Vadodara-390022 due to severe Chest Pain and Coronary Angiography was conducted on 12th February, 1996. The relevant report is filed as Annexure-A to the writ petition. The petitioner was operated for Coronary Artery By-pass, Grafting (CABG) as per diagnosis-Tripple Vessel Disease (Ischemic Heart Disease) on 14th February, 1996 and he was discharged on 22nd February, 1996. It is stated that the petitioner had to undergo the aforesaid operation, in an emergent situation and the requisite certificate dated 29th February, 1996 issued from Mayo Hospital is filed as Annexufe-C to the writ petition which reads as follows:-

(2.) The petitioner incurred a total expenditure of Rs.93,870.00 . The petitioner submitted his medical reimbursement claim to respondent no.3 but the said respondent has declined to reimburse on the ground that the treatment was taken in a non-C.G.H.S. covered area. The affidavit filed by Dr.P.K.Baliar Singh, Joint Director (R&H), Central Government Health Scheme, New Delhi has been filed to deny the claim of the petitioner. Paragraph 5 of the said affidavit reads as follows:-

(3.) The petitioner has admittedly suffered the ailment and required urgent and immediate treatment in an emergency. The plea of the. Government that he has not taken prior sanction for treatment in non-C.G.H.S. Hospital is clearly erroneous and cannot be entertained. Moreover, the law does not require that prior permission has to be taken in such situation where the survival of the person is the prime consideration. It is always open for the Government to grant ex-post facto sanction subject to verification of the claim which has not been denied in the present case. Reference may be made to the judgment of the Supreme Court reported as Surjit Singh Vs. State of Punjab and others AIR 1996 SC 1388. Paragraph 11 of the judgment reads as follows:-