State Can't Deny Medical Reimbursement On Ground That Hospital Charged Amount Exceeding Approved Rates: Delhi High Court

The Delhi High Court has ruled that reimbursement of medical expenses under Central Government (Medical Attendance) Rules, 1944 cannot be denied on the ground that the hospital charged an amount in excess of the approved rates, in a case where the patient is referred to such hospital.Expressing dismay at how a petition seeking reimbursement of only Rs 51, 824 remained pending for past 16 years and was vehemently contested by Delhi government, Justice Chandra Dhari Singh said the beneficiary employee cannot faulted or penalised to pay the excess amount that was charged from him by the Rajiv Gandhi Cancer Institute, when he in the first instance did not even choose the hospital but was referred there.The petitioner, Mahendra Kumar Verma, was serving as a reader in the court of Metropolitan Magistrate in Tis Hazari Court, Delhi. The petitioner claimed medical advances for the medical treatment of his minor child who was suffering from brain tumour. The petitioner was issued a letter from the Drawing & Disbursing Officer, Officers of District and Sessions Judge, Delhi, asking him to deposit a sum of Rs. 51,854 against the medical advance of Rs. 2,34,000 granted to him from time to time for the medical treatment of his son in Rajiv Gandhi Cancer Institute. The representations made by the petitioner, as to why he should not be fully reimbursed for the medical expenses incurred for his son’s treatment, were rejected. Subsequently, the District & Session Judge passed an order for recovery of the amount from the petitioner’s salary. Verma in 2006 filed a writ petition, challenging the deductions made from his salary as well as the order seeking recovery of the amount. The government submitted before the High Court that the petitioner is entitled for medical reimbursement only in terms of the Central Services (Medical Attendance) Rules, 1944 (CS (MA) Rules) as well as the instructions issued by the Government of NCT of Delhi from time to time. The State further argued that after scrutinizing the medical bills submitted by the petitioner and calculating his entitlement as per the CS(MA) rules, it was found that the petitioner was entitled to a grant of only Rs. 1,82,146. Therefore, he was directed to deposit the excess amount of Rs. 51,854 sanctioned to him, the State contended. Verma's counsel contended that right to health is a constitutional right protected under Article 21 of the Constitution of India. Thus, he argued that the government is under a constitutional mandate to reimburse the government servant the legitimate expenses incurred by him on the medical treatment received by him or his dependents. He averred that a government servant is entitled to full reimbursement, adding that reimbursement cannot be restricted to the rates specified in the circulars issued by the government. The petitioner further argued that he cannot be denied full reimbursement if the hospital has charged from him a rate exceeding the package deal rate. Thus, the petitioner contended that he was entitled to be fully reimbursed under the CS (MA) Rules for all the medical expenses incurred by him. Referring to the CS (MA) Rules, 1944, the Court observed that the medical treatment availed by the government servant or his dependants has to be free of charge, and any amount that is paid by him on account of such medical attention or treatment has to be fully reimbursed to him."This Court is of the opinion that the medical attendance rules formulated by Central and State Governments are not merely the rules relating to medical attendance, but are the beneficiary piece of legislation to facilitate good and sound health for all the government employees and their families. It does not stand to reason as to why any impediments are read in the rules which have the tendency to defeat the cherished Constitutional rights for which this Court has always stood as a custodian," said the bench.Referring to the Counter Affidavit filed by the State, the bench held that not even a single provision of law has been cited to justify the deductions made in the petitioner’s claim.Ruling that the petitioner was entitled to be fully reimbursed for the expenses incurred by him in the medical treatment of his minor child. “The Respondents are directed to fully reimburse the Petitioner to the extent of bills raised by both the Hospitals, and to release the amount retained in the FDR, along with interest accrued from time to time, deducted from the salary or allowances of the Petitioner," the court said. Case Title: Mahendra Kumar Verma versus Govt. of NCT of Delhi & Ors. Citation: 2023 LiveLaw (Del) 22 Counsel for the Petitioner: Mr. Rajat Aneja and Ms. Palak Vasisth, Advocates Counsel for the Respondent: Mrs. Avnish Ahlawat, Standing Counsel (Services) with Mr. N. K. Singh, Mrs. Tania Ahlawat and Ms. Laavanya Kaushik, AdvocatesClick Here To Read/Download Order

State Can't Deny Medical Reimbursement On Ground That Hospital Charged Amount Exceeding Approved Rates: Delhi High Court

Parina Katyal

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