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Case Number
Disposition

allowed

Judges
  • Justice S.B. Majmudar
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Cited by
Citation Codes
Equivalent Citations
citation codes
Case Number
Disposition

allowed

Judges
  • Justice S.B. Majmudar
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Smart Summary

Factual and Procedural Background

The matter is an appeal in which leave was granted. The dispute concerns medical reimbursement for a government employee under a new policy that came into effect on 13-2-1995. The respondent suffered a heart attack on 20-7-1995 and underwent bypass surgery on 29-7-1995. The High Court had granted the respondent an additional amount beyond the All India Institute of Medical Sciences (AIIMS) rates on the ground that the new policy was not sufficiently published. The appellants challenged this before the Supreme Court.

Legal Issues Presented

  1. Whether, for treatment undertaken after 13-2-1995, the respondent’s entitlement to medical reimbursement is restricted to AIIMS rates under the new policy.
  2. Whether the High Court’s grant of an additional amount on the ground that the new policy was not sufficiently published is sustainable.

Arguments of the Parties

Respondent's Arguments

  • There was a long queue for bypass surgery at AIIMS and the respondent’s case was an emergency, necessitating treatment at another hospital.
  • The respondent, being a Teacher, could not afford the significant medical expenses incurred due to the delay at AIIMS.
  • The appellants were requested to consider the respondent’s grievance on compassionate grounds.

Table of Precedents Cited

Precedent Rule or Principle Cited For Application by the Court
State of Punjab v. Ram Lubhaya Bagga, (1998) 4 SCC 117 When an employee requires medical treatment after the new policy dated 13-2-1995 comes into operation, reimbursement is governed by the new policy at AIIMS rates. The Court held that the respondent, whose treatment occurred after 13-2-1995, is entitled only to reimbursement at AIIMS rates. Any additional amount awarded by the High Court on other grounds is unsustainable.

Court's Reasoning and Analysis

The Court noted that the issues are squarely covered by the three-Judge Bench decision in State of Punjab v. Ram Lubhaya Bagga. It was undisputed that the respondent’s treatment occurred after the new policy came into effect on 13-2-1995. Under the binding precedent, reimbursement for such post-policy treatment must be at AIIMS rates.

While the respondent’s counsel submitted that the respondent faced an emergency and a long queue at AIIMS, compelling treatment at another hospital, the Court held that, in light of the governing precedent, reimbursement remains confined to AIIMS rates. The Court further found that the High Court’s grant of an additional amount on the ground that the new policy was not sufficiently published cannot be sustained. At the same time, the Court observed that the respondent may submit a representation on compassionate grounds and expressed confidence that the appellants would consider such a representation sympathetically on its own merits.

Holding and Implications

APPEAL ALLOWED; HIGH COURT JUDGMENT MODIFIED.

Holding: The respondent is entitled to medical reimbursement only at AIIMS rates under the new policy effective 13-2-1995. The High Court’s award of any additional amount on the basis that the policy was not sufficiently published is unsustainable. No costs.

Implications: The immediate effect is that the respondent is limited to reimbursement at AIIMS rates, which has already been paid. The Court did not create a new rule but applied the existing precedent in Ram Lubhaya Bagga. The respondent may submit a representation on compassionate grounds, which the appellants are expected to consider sympathetically, but any such relief is administrative and outside the Court’s ruling.

Show full summary ...

    State Of Punjab And Others v. Mohan Lal Jindal .

    Order

    1. Leave granted.

    2. We have heard learned counsel for the parties. The questions involved in the present proceedings are squarely covered by a judgment of three-Judge Bench of this Court in the case of State of Punjab v. Ram Lubhaya Bagga (1998) 4 SCC 117. The view taken in the said decision is that when an employee requires medical treatment after the new policy dated 13-2-1995 had come into operation, he will be entitled to medical reimbursement on the basis of the new policy at AIIMS rate. It is not in dispute between the parties that the respondent suffered a heart attack on 20-7-1995 and underwent bypass surgery on 29-7-1995. According to learned counsel for the respondent as there was a long queue of patients at AIIMS Hospital for bypass surgery and his case was of emergency, he had to go to other hospital. It may be so. However, in the light of the reported decision, the medical reimbursement available to the respondent will be at the AIIMS rates, which has already been paid to him. The additional amount which he has claimed was granted by the High Court on the ground that the new policy was not sufficiently published. The said view of the High Court cannot be sustained. Consequently, the appeal is allowed by observing that the respondent will be entitled to medical reimbursement in the light of the new policy i.e at AIIMS rates. It was however, vehemently submitted by learned counsel for the respondent that exception deserves to be made in this case as the respondent who was a Teacher could not afford such huge medical expenses which had to be incurred by him due to long queue for bypass surgery in the AIIMS Hospital and he had to go to other hospital. It is further submitted by learned counsel for the respondent that the appellants may consider his grievance. He may submit such a representation on compassionate grounds. We have no doubt that such a representation will be sympathetically considered by the appellant authorities on its own merits. The judgment of the High Court will stand modified to the extent indicated herein. No costs.

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    Comments

    State Of Punjab And Others v. Mohan Lal Jindal .
    (Oct 26, 1998)