RATI RANJAN BHOWMIK Vs. STATE OF TRIPURA

JUDGEMENT

(1.) The petitioner has challenged the communication dated 01.04.2019 issued by the Medical Superintendent, Regional Cancer Centre, Agartala by which the petitioner's claim for medical reimbursement of a sum of Rs.4,41,387/- has been rejected. The petitioner has prayed for a direction to the respondents to pay the said amount with interest.

(2.) The petition arises in following background. The petitioner is serving under State of Tripura as a Youth Organiser. By virtue of his employment he is entitled to medical reimbursement as per the rules and Government policy for himself and his family members. The petitioner's wife developed a tumor in the breast. With such complaint she had attended the Govt. hospital at Agartala where after biopsy it was detected that she was suffering from breast cancer which would require a surgery. Such sudden developments left the family into distress. Under advice they, therefore, rushed to CMC hospital at Vellore for further investigation and treatment in the month of August, 2018. The investigations revealed that the wife of the petitioner was suffering from "Carcinoma Right Breast CT C & I MO (IDC Grade III)". A surgery was performed on 28.08.2018, removing tumor from right breast of the petitioner's wife. Intermittently for about seven months the petitioner's wife was treated for post operative care at Vellore. The petitioner submitted the bill of Rs.4,41,387/- for medical treatment as well as other charges. This was supported by bills and vouchers. The bill was, however, rejected by the impugned communication dated 01.04.2019 on the ground that the wife of the petitioner had taken treatment from outside the State without obtaining referral certificate from the Standing Medical Board, AGMC & GBP hospital, Agartala.

(3.) Counsel for the petitioner submitted that it was on account of the dreaded disease which was detected that the wife of the petitioner was rushed to the hospital at Vellore for further investigation and correct line of treatment. The petitioner did not have time to apply for prior approval from the medical board. On subsequent occasions the petitioner had applied for referral orders and which were also granted by the medical board, which itself shows the genuineness of the petitioner's claim.