ROOP CHAND Vs. STATE OF HARYANA

JUDGEMENT

(1.) The petitioner retired from the department of Excise and Taxation on 31.07.2009 after attaining the age of superannuation. On 26.10.2010 he had gone to Delhi to see his relatives where he felt sudden pain in his chest. He was immediately rushed to Bhagwati Hospital, Sector 13, Rohini, Delhi where he remained admitted for two days. He was diagnosed with Diabetes Mellitus with hypertension Coronary Artery Disease-Triple vessel disease with acute MI-delayed presentation with swear MR with swear LV dysfunction. He was discharged from the said hospital on 28.10.2010. After that he was admitted to Max Heart and Vascular Institute, Saket, New Delhi where he had to undergo coronary Artery Bypass Graft (Heart Surgery) on 30.10.2010 and was discharged on 08.11.2010. Thereafter the petitioner submitted three forms for medical reimbursement along with the bills amounting to Rs. 3,55,355/- for the expenditure incurred by him on his treatment. Out of the three claims, claim for Rs. 2985/- and for Rs. 24,000/- for the period 26.10.2010 to 28.10.2010 was to be approved by respondent No. 4 only. The said claim has not been reimbursed to the petitioner till now. The third claim form amounting to Rs. 3,28,370/- for the period 28.10.2010 to 8.11.2010 was to be approved by respondent No. 3. Some objections were raised by respondent No. 2 which were complied with by the petitioner but he has not been issued even the emergency certificate by the respondent No. 6 i.e. Chief Medical Officer, Rohtak. The petitioner has been running from pillar to post for the reimbursement of the amount but the respondents have been raising frivolous objections one after the other. He has also made various representations in this context but to no avail. Hence the present petition. The stand taken by the respondents is that the surgery undergone by the petitioner was not an emergency surgery; that the treatment was not taken from an approved hospital; that the petitioner did not submit complete papers so that the opinion by the Civil Surgeon could be given as to whether the surgery undergone by him was emergent or not and that the petition is liable to be dismissed being premature.

(2.) Learned counsel for the petitioner states that even if full reimbursement cannot be granted, yet reimbursement at the AIIMS/PGI rates should be granted to the petitioner.

(3.) Learned AAG has argued that since the medical reimbursement policy does not envisage grant of any reimbursement in the event of treatment taken from an un-approved hospital except in the case of emergency as certified by Civil Surgeon, the petitioner is not entitled to any payment.