ANOOP SINGH JAIN Vs. STATE OF HARYANA

JUDGEMENT

(1.) By this writ petition, the petitioner claims medical reimbursement of expenses incurred by him in kidney transplantation in Lahore (Pakistan). Admittedly, the petitioner was a patient of chronic renal failure. None of his relatives, as specified in the (sic)gan(sic)splantation (sic) Act, was ready to donate a kidney for him. He consequently found a donor in Pakistan (where no such restriction is there as in India) and went to Lahore and got the kidney transplanted by incurring a total expenditure of Rs. 9,56,000/- odd on the treatment. On return, he claimed re-imbursement which was declined to him on the ground that treatment from abroad cannot be reimbursed. Consequently, the present writ petition was filed.

(2.) The petitioner has restricted his claim only to the reimbursement of expenses at PGI/AIIMS rates. In reply to this, again the stand taken by the respondents is that treatment from abroad cannot be reimbursed. Under the policy of medical re-imbursement followed by the State of Haryana, there are three situations envisaged. The first is where an employee gets treatment from a government hospital, he is entitled to full medical re-imbursement. The second situation is where an employee gets treatment from a government approved hospital, he gets re-imbursement at PGI/AIIMS rates plus 75% of the remaining amount charged by such an approved hospital. The third situation deals with treatment from an unapproved hospital. As per the policy, if an employee gets emergency treatment from an un-approved hospital (and that treatment is certified to be an emergency treatment by the Civil Surgeon), he is entitled to reimbursement at PGI/AIIMS rates. In Smt. Shail Bala Mittal v. The State of Haryana and Ors., passed in CWP No. 10745 of 2007, decided on 19.02.2009, this Court further extended the re-imbursement at PGI/AIIMS rates and held that even if a person gets treatment from an unapproved hospital and the same has not been certified as emergency but is otherwise a necessary treatment, such an employee would be entitled to reimbursement at PGI/AIIMS rates. The said judgment has become final as no appeal has been filed.

(3.) It is not disputed that in another Division Bench decision of this Court in Mahipal Singh v. State of Haryana and others, 2008 2 SCT 592, it was held as follows:--