HIMMAT SINGH Vs. STATE OF RAJASTHAN AND OTHERS

JUDGEMENT

(1.) Petitioner has retired from the Government service on attaining the age of superannuation on 28.2.1998. Petitioner been regular subscriber of the Rajasthan Pensioners Medical Fund, has been a member of the Rajasthan State Pensioners Medical Concession Scheme. The petitioner suffered a major heart attack on 18.9.2002 around 8.00 A.M. The members of the family of the petitioner took the petitioner to SMS Hospital, Jaipur immediately, however, in absence of any immediate response, in emergent circumstances, the family members took the petitioner to the nearby Tongia Heart & General Hospital. After getting immediate respite coronary Angiography and Angioplasty was done in the Tongia Heart and General Hospital on the very next day and subsequently, the petitioner was discharged from the hospital on 19.9.2002. The reimbursement of the amount of medical treatment expenditure incurred in the above ailment has been refused by the respondents only on the ground that the treatment was not received from any Government hospital. Hence, the present petition for getting necessary directions from this Court for reimbursement of the medical expenditure so incurred.

(2.) There is no dispute that under the Rajasthan State Pensioners Medical Concession Scheme financial assistance is provided at the rate of 80% of the hospital expenditure or Rs. 1,20,000.00 whichever is less, where no treatment is available in any Government Hospital in the State of the particular disease. However, a condition has been imposed that the treatment should have been taken in a hospital/public institution either out side the State or within the State recognised by the State Government and only after recommendations of the Principal of a Medical College/Director of Medical and Health Services as per the opinion of the Medical Board. Similar benefit has been given in case of heart ailment also.

(3.) After having considered the submissions of learned counsel for the parties, I have carefully gone through the material on record, relevant provisions of the Scheme as also the judgments referred at the Bar.