GAJENDRASINH G SOLANKI Vs. STATE OF GUJARAT

JUDGEMENT

(1.) THE present petition has been filed by the petitioner for the prayer that the respondent -Authorities may be directed to sanction and pay Rs.64,821/ -, which the petitioner has incurred for his medical treatment by way of reimbursement on the grounds set out in the petition.

(2.) THE facts of the case briefly summarised are that the petitioner was in the service of the State Government and has retired on attaining the age of superannuation in July -1993. At the time of the retirement, he was working in the cadre of Accounts Officer (Class -I) and was posted as District Assistant Examiner, Local Fund Accounts, Ahmedabad. It is also averred that on 17th July, 2007, the petitioner had severe problem with his left leg and therefore, he was immediately taken to Sterling Hospital, Ahmedabad by the family members. On investigations, it was found that there was a blockage on vein causing obstruction in the blood circulation and therefore, as per the medical advise, by -pass surgery was required to be performed urgently and therefore, on the next day, i.e. on 18th July, 2007, by -pass surgery was performed on the left leg of the petitioner. It is the case of the petitioner that he was hospitalised upto 24th July, 2007 in the general ward and he paid total amount of Rs.64,821/ - to the hospital under different heads like operation charges, room charges, medicines, investigations, etc., as mentioned in detail in the bill. Accordingly, the petitioner claimed the said amount from the Government on 31st July, 2007 by submitting an application in the prescribed format to the Treasury Office. However, the claim of the petitioner has been turned down by the respondent - Authorities. In support of the petition, the petitioner has produced the bills of Sterling Hospital and also Government Resolution dated 9th September, 2005.

(3.) AN affidavit -in -reply has been filed by the Additional Director, Medical Services, Health and Family Welfare Department, respondent No.2, contending inter alia that in the year 1988, the Government has framed the Rules known as 'Gujarat State Service (Medical Treatment) Rules, 1988' ('the Rules' for short) for the employees of the State of Gujarat for providing medical treatment. It provides a list of hospitals from where the Government employee like the petitioner can take the medical treatment, which is permissible for reimbursement. It is also contended that in the present case, the petitioner has taken the treatment of 'peripheral angiography' and 'popliteal vein by -pass surgery' for the left leg from Sterling Hospital at Ahmedabad. Such treatment is available at V.S. Hospital and Civil Hospital at Ahmedabad. It is, therefore, contended that the petitioner is not entitled for reimbursement of the expenses of such treatment. It is also reiterated and stated that such persons, who take the treatment from the hospitals approved by the State Government, are entitled for reimbursement of the medical expenses. It has been clarified that the State Government has approved certain hospitals for taking the treatment for some special ailments like heart ailment, cancer, kidney, etc. and Sterling Hospital is one of the hospitals approved for the treatment of the heart ailment. However, it is contended that the petitioner has taken the treatment of 'popliteal vein by -pass surgery' on the left leg, which is not included in the Resolution dated 9th September, 2005. It has also been contended that the petitioner has taken the treatment of 'popliteal vein by -pass surgery' which was operated on the left leg and the petitioner has not taken heart surgery (coronary artery by -pass surgery) and therefore, the claim of the petitioner has been turned down. Therefore, the petitioner is not entitled to get any amount as per the Government Resolution dated 9th September, 2005. Further, it has been contended that as per the Resolution of the Finance Department dated 24th February, 1988, the expenses incurred in taking the treatment from the private hospital in exceptional circumstances is permitted. Another circular dated 1st April, 2000 is also issued by the Health and Family Welfare Department for the purpose of reimbursement and the procedure is also prescribed for such exceptional circumstances. It is also contended that in this case, the petitioner has to submit a proposal to the Finance Department through proper channel and the Finance Department has to take approval of the Health and Family Welfare Department for the purpose of reimbursement.