SHANKER LAL MATHUR Vs. STATE OF RAJASTHAN

JUDGEMENT

(1.) THIS writ petition under Article 226 of the Constitution of India has been filed by the petitioner on 9. 8. 2001 against the respondents with the prayer that by an appropriate writ, order or direction, the respondents be directed to reimburse the expenses incurred by the petitioner in his Coronory Artery By Pass Surgery at Escort Heart Institute and Research Centre, New Delhi (for short "escort Institute") on 30. 4. 1999.

(2.) THE case of the petitioner as put forward by him in this writ petition is as follows:- On 26. 3. 1999, the petitioner suffered with a heart attack while he was holding the post of the Chief Medical and Health Officer, Sikar. THE petitioner was immediately admitted as indoor patient at Government Hospital, Sikar where he suffered second heart attack on 1. 4. 1999 and therefore, he was immediately shifted to Santokh Ba Durlabhji Hospital, Jaipur on 1. 4. 1999 itself and thereafter, he was shifted to SMS Hospital, Jaipur on 5. 4. 1999 as indoor patient. On 11. 4. 1999, chest pain was re- occurred to the petitioner and therefore, on 12. 4. 1999, his angiography was done at SMS Hospital, Jaipur. THEreafter, the Cardiologist through his letter dated 13. 4. 1999 (Annex. 1) made a request to the Principal and Controller, SMS Medical College and attached Hospital, Jaipur to constitute a Medical Board as the petitioner was to undergo coronary artery by-pass grafting surgery at New Delhi. THEreafter, the Principal & Controller, SMS Medical College and attached Hospitals, Jaipur through letter Annex. 2 dated 15. 4. 1999 constituted a Medical Board consisting of Dr. R. K. Madhok as its Convenor, Dr. R. K. Saxena and Dr. K. K. Kashuwah as its members. THE further case of the petitioner is that the Medical Board constituted through order Annex. 2 dated 15. 4. 1999 examined the petitioner on 19. 4. 1999 and recommended for coronary artery by- pass grafting surgery at All India Institute of Medical Sciences, New Delhi (for short "aiims") through Annex. 3 dated 19. 4. 1999. THE further case of the petitioner is that he first approached the authorities of AIIMS for surgery, but there was a huge waiting list and the health of the petitioner was not permitting to wait so long and therefore, in above circumstances, since he was facing serious cardiac ailment, therefore, he opted for Escort Institute at New Delhi where he was admitted on 27. 4. 1999 under the treatment of Dr. Naresh Trihan and the coronary artery by-pass grafting surgery of the petitioner was done on 30. 4. 1999 at Escort Institute, New Delhi. THE further case of the petitioner is that he paid Rs. 1,68,100/- to the Escort Institute, New Delhi for the above treatment/surgery and the statement of payment made by the petitioner to Escort Institute is marked as Annex. 4. THE further case of the petitioner is that after being discharged from the hospital, he moved an application claiming reimbursement of medical expenses incurred by him for coronary artery by-pass grafting surgery at Escort Institute, New Delhi, but surprisingly, the Chief Medical and Health Officer, Sikar through letter dated 6. 6. 2000 (Annex. 5) informed the petitioner that the State Government vide its letter dated 9. 5. 2000 (Annex. 6) denied reimbursement of medical expenses incurred by him on the ground that the case of the petitioner for coronary artery by-pass grafting surgery was recommended and referred to the AIIMS, New Delhi by the Medical Board, but he had undergone coronary artery by-pass grafting surgery at Escort Institute, New Delhi without prior permission of the Government. THE further case of the petitioner is that thereafter, he made several representations to the respondents claiming reimbursement of medical expenses incurred by him in coronary artery by-pass grafting surgery and copy of one of the representations is marked as Annex. 7 dated 16. 10. 2000. THE further case of the petitioner is that thereafter, through letter dated 15. 5. 2001 (Annex. 8), the Addl. Director, Medical and Health Services, Jaipur informed the petitioner finally that he was not entitled to reimbursement of medical expenses as he had undergone bypass surgery at Escort Institute, New Delhi without prior permission of the Government. In this writ petition, Annex. 8 has been challenged by the petitioner on various grounds and the main case of the petitioner is that since he was confined to bed, therefore, it was not possible for him to seek prior permission from the Government and apart from this, first he approached the AIIMS, Hospital, New Delhi for by-pass surgery, but there was huge waiting list and health of the petitioner was not permitting to wait so long and therefore, he had undergone by-pass surgery at Escort Institute, New Delhi, which is also recognized as referral hospital for treatment of heart outside the State of Rajasthan and thus, in these circumstances, denial of reimbursement of medical expenses incurred by the petitioner on his by-pass surgery at Escort Institute, New Delhi on the ground that he did not seek prior permission for by-pass surgery at Escort Institute, New Delhi is wholly arbitrary and unreasonable. Hence, this writ petition with the prayer as stated above. A reply to the writ petition was filed by the respondents and their case is that the case of the petitioner for by-pass surgery was recommended and referred to the AIIMS, New Delhi by the Medical Board, but he had undergone by-pass surgery at Escort Institute, New Delhi and for that, he did not seek prior permission from the State Government. Thus, since the petitioner had moved to Escort Institute, New Delhi at his own will though he was advised for treatment at AIIMS, New Delhi, therefore, he was not entitled to reimbursement of medical expenses incurred by him for his by-pass surgery at Escort Institute, New Delhi. Hence, the writ petition filed by the petitioner be dismissed.

(3.) THERE is also no dispute on the point that through Annex. 2 dated 15. 4. 1999, a Medical Board was constituted and through Annex. 3 dated 19. 4. 1999, the Medical Board recommended and referred the case of the petitioner for by-pass surgery to AIIMS, New Delhi.