DR.GEORGE THOMAS Vs. STATE OF KERALA

JUDGEMENT

(1.) The 1st petitioner is working as an Assistant Professor in Catholicate College, Pathanamthitta. On 14/5/2018, the 2nd petitioner, the father of 1st petitioner who is wholly dependent on 1st petitioner sought treatment in General Hospital, Pathanamthitta and was diagnosed with Carcinoma Rectum and was referred to higher center. Accordingly, he was taken to Medical and Surgical Oncology Department of the St. Gregorious Medical Mission Hospital, Pathanamthitta which is a private specialty hospital for Cancer treatment. The Consultant Medical Oncologist opined that the 2nd petitioner has to undergo surgery and accordingly he was operated in the Laparoscopic Department of St. Gregorious Medical Mission Hospital.

(2.) The Government have issued Ext. P2 G.O.(P) No.10/2016/H&FWD dtd. 21/01/2016 empanelling certain private hospitals for treatment to facilitate medical reimbursement benefits under the Kerala Government Servants Medical Attendance Rules, 1960 (the 'Rules', for short). The name of St. Gregorious Medical Mission Hospital, Pathanamthitta (hereinafter referred to as the 'Hospital') appears at serial No. 20 of the Annexure to Ext. P2 order which provides for the list of private hospitals recognised by the Government for treatment under Rule 8 (3) of the Rules and the Departments recommended include Medical and Surgical Oncology. The relevant portion of the Annexure to Ext. P2 order which provides for the list of private hospitals for empanelment is reproduced hereunder:

(3.) According to the petitioners, the 2nd petitioner was initially admitted in the Hospital between 30/5/2018 and 9/6/2018 and during this period, 1st petitioner had incurred an amount of Rs.1,98,311.00 towards treatment of the 2nd petitioner. The 1st petitioner submitted Ext. P3 application seeking reimbursement of Rs.1,98,311.00 with the required proforma issued by the Authorized Medical Attendant and Essentiality Certificate certifying that the medicines prescribed were essential for the recovery of the patient. Out of Rs.1,98,311.00 claimed in Ext. P3, the office of the Director of Health Service found that reimbursement claim for an amount of Rs.1,26,368.00 is admissible.