CHHAGAN LAL MATHUR Vs. STATE OF RAJASTHAN

JUDGEMENT

(1.) Briefly stated facts of the case are that the petitioner suffered from a cardiac problem and was taking treatment at Mathura Das Mathur Hospital, Jodhpur admitted on 5/5/2013. Thereafter, he was referred to 'higher centre urgent CABG for needful' and was discharged on 7/5/2013. After being discharged, the petitioner went to Jaipur Heart Institute, wherein he was operated on 8/5/2013 and he remained admitted from 7/5/2013 to 16/5/2013. A sum of Rs.1,48,179.00 was incurred as expenses for the treatment underwent by the petitioner. The petitioner submitted reimbursement claim for medical bills through an application dtd. 14/11/2013. The respondents pursuant to the petitioner's application for reimbursement, sent a cheque of Rs.44,000.00. Aggrieved by partial acceptance of the claim, the petitioner has preferred the present writ petition.

(2.) Learned counsel for the petitioner submitted that the petitioner was referred to 'higher centre urgent CABG for needful' by Mathura Das Mathur Hospital, Jodhpur. Since, the petitioner undertook treatment at an approved hospital as per Appendix-1 of the Rajasthan Civil Services (Medical Attendance) Rules, 2008 (hereinafter referred to as the 'Rules of 2008'), the claim for reimbursement of medical bills ought to have been accepted in toto. Reliance was placed on the judgments rendered by this Court in the cases of Smt. Usha Mehta v. State of Rajasthan and Ors. (S.B. C.W. No. 6401/2006) and State of Rajasthan and Ors. v. Smt. Usha Mehta (D.B. S.A.W. No. 1309/2014)

(3.) Per contra, learned counsel for the respondents submitted that the claim of the petitioner was partially accepted in consonance with the Rules of 2008. It was further submitted that though the Jaipur Heart Institute is an approved hospital, the reimbursement is to be made on recommendation of Health Benefit Advisory Committee as mandated by circular of the finance department dtd. 16/12/2009 and Rule 4 of the Rules of 2008. Reliance was placed on the judgment rendered by the Hon'ble Supreme Court in the case of State of Rajasthan v. Mahesh Kumar Sharma reported in 2011 (4) SCC 257.