Gujarat High Court reiterates right to medical claim cannot be denied merely because the name of the hospital is not included in the Government Order; Reimbursement directed

Gujarat High Court: Biren Vaishnav, J. allowed a petition reiterating that a Government employee is entitled to avail the benefits of medical facilities without any fetters, and that their claim for reimbursement should not be denied by the State mechanically.

The petitioner prayed that he had undergone Angioplasty, and was entitled to full reimbursement of Rs.,1,76,757/-.

Counsel for the petitioner drew the attention of the Court to a representation made by the petitioner on 23-01-2019 to the Regional Information Officer(Respondent 3). The Petitioner had incurred an expense of Rs.,1,76,757 for her medical treatment. She claimed that part reimbursement worth Rs.62,100 for her surgery at Rajasthan Hospital was misconceived. It was submitted that the petitioner should be reimbursed the remaining amount of Rs.1,14,656/-.

Assistant Government Pleader for the respondents vehemently opposed the stand of the petitioner for reimbursement of the balance amount of Rs.1,14,656/- .

The Court relied on the Coordinate Bench judgment of this Court in the case of Chanrakant Kantilal Dave v. State of Gujarat, Special Civil Application No.2736 of 2013, decided on 18-09-2018 which had similar set of facts and its decision was based on the judgment principles of Shiva Kant Jha v. Union of India, (2018) 16 SCC 187. The Court reiterated:

“The right to medical claim cannot be denied merely because the name of the hospital is not included in the Government Order. The real test must be the factum of treatment. Before any medical claim is honoured, the authorities are bound to ensure as to whether the claimant had actually taken treatment and the factum of treatment is supported by records duly certified by Doctors/Hospitals concerned. Once, it is established, the claim cannot be denied on technical grounds.”

Keeping in mind the abovementioned case laws and principles the petition was allowed with a direction to respondents to reimburse the balance amount of Rs.1,14,656/- to the petitioner together with the interest @ 9% p.a. from the date of filing of petition till its realization within a period of ten weeks.

[Gulamkadar Kasambhai Shaikh v. State of Gujarat, R/Special Civil Application No. 6345 of 2019, decided on 18-07-2022]

Advocates who appeared in this case :

Mr Nayan D Parekh, Advocate, for the Petitioner 1;

Mr Utkarsh Sharma, AGP, Advocate, for the Respondent 1,2,3.

*Suchita Shukla, Editorial Assistant has reported this brief.