AMRIK SINGH Vs. STATE OF H.P.

JUDGEMENT

(1.) The applicant herein has claimed the relief that the respondents may be directed to pay a sum of Rs. 28,000/ - to him as medical reimbursement which is due for payment to him with interest on the delayed payment at the rate of 18% per annum.

(2.) The case of the applicant, in brief, is that he retired as Divisional Magistrate, H.P. State Forest Corporation, on 31.7.2003. On 14.4.1989, he had undergone heart surgery from All India Institute of Medical Sciences, New Delhi and when he again suffered from some heart problem in the year, 1998, he was advised heart surgery for which the Health Department of the Government of Himachal Pradesh permitted him to take treatment in Batra Hospital, New Delhi. The applicant was operated on 18.12.1998 at Batra Hospital and thereafter, he applied for medical reimbursement to the respondents -Department, in February/March, 1999. Respondent No.3 asked for sanction for payment for Rs. 1,45,000/ - to the applicant by respondent No.1 vide Annexure A -2. However, respondent No.1 vide Annexure A -3 sanctioned a sum of Rs. 1,15,000/ - only. Vide Annexure A -4 the applicant represented to respondent No.1 against sanction of lesser amount. The respondents however, took up the matter with General Manager, Batra Hospital, to refund the excess amount to the applicant and the applicant was also asked to take up the matter with the said Hospital authorities. The applicant, vide Annexure A -7, wrote to the General Manager of the said Hospital for reimbursement of Rs.30,000/ - charged in and also made a further request in this regard vide Annexure A -8. On communication Annexure A -9, the applicant sent required papers to Batra Hospital vide Annexure A -10. Finally, the said Hospital refunded a sum of Rs.2,000/ - to the applicant stating that it was charged extra but refused to refund any other amount on the plea that in fact a sum of Rs.30,000/ - is charged for Redo Bypass Surgery. In these circumstances, the applicant vide Annexures A -12 wrote to respondent No.1 for sanctioning the balance amount of Rs. 28,000/ -. However, he was informed vide Annexure A -13 that the reimbursement to the maximum limit had already been made to him. The applicant then made a representation to the Chief Minister which was rejected by respondent No.1 vide Annexure A -15. Hence, this original application by the applicant on the ground that denial to pay the due amount to him is arbitrary, mala -fide and against the Principles of Natural Justice.

(3.) The respondents contested the claim of the applicant. While admitting the grant of sanction to get himself treated in Batra Hospital by the applicant, submission of bill by him but payment of only Rs.1,15,000/ - and non -payment of Rs.30,000/ - charged for Re -do surgery, the claim for the remaining amount has been denied on the ground that the reimbursement of medical claim as in hand is done with the prior approval of the Health and Finance Department of the Government which sanctioned only the amount which has already been paid to the applicant and the release of balance amount of Rs.30,000/ - as taken by the Department with the Health Department for approval was not approved on the ground that as per the instructions maximum limit for medical reimbursement was Rs.1,15,000/ -. It is also claimed that the Hospital authorities have not adhered to the terms of the package deal entered into with them which has put the applicant in financial hardship, therefore, it was requested to refund the excess amount to the individual and that it be ensured that the charges are restricted as per package deal. The applicant was also directed to claim the amount from the Hospital authorities. The further representation of the applicant was examined by the Department and his case was once again sent to the Health Department for approval which was again rejected because of absence of any provisions to allow medical claim over and above the package deal as fixed by the Government with the concerned Hospital. In these circumstances, the claim of the applicant has been denied by the respondents.