High Court of Punjab and Haryana, Chandigarh
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Baldev Kishan Khanna v. State of Haryana & Anr - CWP-13968-2004  RD-P&H 2393 (19 April 2006)
CWP No. 13968 of 2004
DATE OF DECISION:25.4.2006
Baldev Kishan Khanna
State of Haryana and another
CORAM:- HON'BLE MR. JUSTICE M.M.KUMAR
HON'BLE MR.JUSTICE M.M.S.BEDI
PRESENT: Mr.DS Rawat, Advocate for the petitioner.
Mr.Harish Rathee,Sr.DAG, Haryana.
In this petition filed under Article 226 of the Constitution the petitioner has prayed for issuance of a writ in the nature of mandamus directing the respondents to reimburse the entire amount of Rs. 1,53,514/- spent on his heart surgery at FORTIS Hospital, Mohali on 22.4.2002.
Admittedly, the petitioner is a retired employee of the respondent- State. He suffered from heart disease and Angioplasty procedure was performed on him at FORTIS Hospital, Mohali. He spent a sum of Rs.1,53,514/-. He submitted his bills for reimbursement but the same were not cleared, which resulted in the filing of C.W.P.No. 14584 of
2002. The order rejecting his claim for medical reimbursement, was quashed by the Division Bench of this Court on 21-8-2003 (Annexure P-5) by issuing a direction to the respondents to scrutinize the case of the petitioner along with other cases in accordance with the rules and judgment as per the law. In pursuance of the aforesaid directions issued by the Division Bench, the respondents have now passed order dated 14.11.2003 (Annexure R-2) and have cleared payment amounting to Rs.69,200/- by confining the payment to the rates admissible to a patient who has been treated by P.G.I. Chandigarh. In other words no payment has admittedly been made over and above the rates admissible by P.G.I. although the petitioner has spent much more.
We have heard learned counsel for the parties and are of the view that while passing order dated 14.11.2003 (R-2) instructions dated 30.11.1993 (annexure P-2) issued by the respondents have not been kept in view which provide that the amount spend on heart disease if exceed the rates of All India Institute of Medical Sciences , New Delhi/ P.G.I. would be reimbursed to the extent of 75% and rest of the amount of 25% has to be borne by the employee himself. The matter is no longer res integra as the Division Bench of this Court in CWP No.6462 of 1999 decided on 29.7.1999 has taken a view that the employee like the petitioner would be entitled to reimbursement at the rates admissible by All India Institute of Medical Sciences,New Delhi plus 75% of the expenditure in excess thereof in accordance with the policy adopted by the respondent State. In that case also the defence pleaded was that the surgery had not been performed by a recognized institution. A similar objection has been pressed before us that FORTIS Hospital is not a recognized institution and, therefore, the clause concerning payment of 75% is not applicable to the case of the petitioner.
The aforementioned contention cannot be accepted in view of the aforementioned decision taken by the Division Bench of this Court. In any case, the respondents have now recognized the FORTIS Hospital, Mohali as is evident from letter dated 31.10.2002 (Annexure R-3).
In view of the above discussion, we allow the writ petition and direct the respondents to pay to the petitioner the balance 75% of the amount over and above the rates admissible by the All India Institute of Medical Sciences, New Delhi in accordance with the policy instructions (Annexure P2) and the judgment of the Division Bench of this Court in CWP No. 6462 of 1999 (Supra). The fact that the petitioner had not gone to a recognized institution can not constitute a ground for rejection of his claim. The payment shall now be released to the petitioner within a period of two months from the date a certified copy of this order is received by the respondents, failing which the petitioner would also be entitled to interest @ 10% per annum.
( M.M.KUMAR )
( M.M.S. BEDI )
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