Uttam Kumar Kosariya v. State Of Chhattisgar..., Chhattisgarh High Court, Judgment, Law, casemine.com

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Case Number

Writ Petition (S) No. 4868 of 2021

Attorney(S)

Mr. R.K. Kesharwani, Advocate
Ms. Sunita Jain, Government Advocate

Judges

Sanjay K. Agrawal, J.

Acts

ARTICLE 21 A CONSTITUTION OF INDIA
ARTICLE 21 CONSTITUTION OF INDIA
Rule 11 of the Rules
Rule 11(1) of the Rules
Rule 10(7) of the Chhattisgarh Civil Services (Medical Attendance) Rules, 2013 (hereinafter called as Rules of 2013).2.
sub-rule (1) of Rule 11
provisions contained in sub-rules (2) to (5) of Rule 11 of the Rules
sub-rule (7) of Rule 10 of the Rules

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Smart Summary

Factual and Procedural Background

This writ petition challenges the order dated 11.2.2021 passed by respondent No. 2 rejecting the petitioner’s medical bill reimbursement claim. The rejection was on the ground that the petitioner failed to inform the competent authority within 48 hours from the commencement of treatment, as required under Rule 10(7) of the Chhattisgarh Civil Services (Medical Attendance) Rules, 2013 (“Rules of 2013”). The petitioner seeks setting aside of this order and directions for post-facto sanction of the medical reimbursement claim.

Legal Issues Presented

Whether non-intimation of commencement of medical treatment within 48 hours under Rule 10(7) of the Rules of 2013 precludes the petitioner from obtaining reimbursement of medical expenses.
Whether the competent authority is empowered and obliged to grant post-facto sanction under Rule 11(1) of the Rules of 2013 in cases of urgent medical treatment where prior intimation was not possible.

Arguments of the Parties

Petitioner’s Arguments

The petitioner relied on a prior decision of this Court in Khuku Biswas v. State of Chhattisgarh (Writ Petition (S) No. 6240/2021), where in similar circumstances the Court directed the competent authority to consider and decide the claim for reimbursement despite delay in intimation.
The petitioner contended that the failure to inform within 48 hours was due to the emergency nature of the medical treatment and that the competent authority should grant post-facto sanction under Rule 11(1) of the Rules of 2013.

Respondents’ Arguments

The respondents submitted that the petitioner’s claim will be considered and decided expeditiously by the competent authority.

Table of Precedents Cited

Precedent	Rule or Principle Cited For	Application by the Court
Khuku Biswas v. State of Chhattisgarh, Writ Petition (S) No. 6240/2021	Consideration of medical reimbursement claims despite delay in intimation; post-facto sanction under Rule 11(1) of the Rules of 2013	The Court relied on this precedent to direct the competent authority to consider the petitioner’s claim on its merits and grant post-facto sanction within 45 days.
In Re: The Proper Treatment of Covid 19 Patients and Dignified Handling of Dead Bodies in the Hospitals etc., Suo Motu Writ Petition (Civil) No. 7/2020	The right to health as a fundamental right under Article 21 of the Constitution of India	The Court cited this to emphasize that the right to health includes affordable treatment and that reimbursement provisions must be construed liberally.
Surjit Singh (Supreme Court decision referenced)	Right to health as a fundamental right under Article 21	Used to reinforce the principle that medical treatment reimbursement rules should be interpreted in a manner that protects the fundamental right to health.

Court's Reasoning and Analysis

The Court analyzed the petitioner’s claim in light of the fundamental right to health guaranteed under Article 21 of the Constitution of India, as recognized by the Supreme Court in the cited precedents. It observed that emergency medical treatment, such as the petitioner’s surgery for canal stenosis (a spinal cord surgery), justifies liberal construction of the reimbursement rules. The Court noted that while Rule 10(7) requires intimation within 48 hours, Rule 11(1) provides for post-facto sanction by the competent authority in cases where such intimation is not possible due to urgent circumstances.

The Court emphasized that failure to notify within 48 hours should not automatically bar reimbursement claims if post-facto sanction can be granted. It relied heavily on the precedent in Khuku Biswas, which held that the competent authority must consider such claims on their merits and grant post-facto permission under Rule 11(1) within a stipulated time frame. Accordingly, the Court set aside the impugned order rejecting the claim and remitted the matter to the competent authority for fresh consideration in accordance with the provisions of Rule 11(1) and sub-rules (2) to (5).

Holding and Implications

The Court’s final decision is to set aside the impugned order rejecting the medical reimbursement claim and to remit the matter to the competent authority for consideration of the claim for post-facto sanction under Rule 11(1) of the Rules of 2013. The competent authority is directed to decide the matter on its own merits and in accordance with law within 45 days from receipt of the order.

The direct effect of this decision is that the petitioner’s claim must be reconsidered without being barred by the delayed intimation, reflecting the principle that the right to health and access to medical reimbursement should be protected in emergency situations. The judgment does not establish a new precedent but follows and applies existing principles and prior decisions to the facts at hand.

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Uttam Kumar Kosariya v. State Of Chhattisgarh, Through Its Secretary, Department Of Veterinary And Animal Husbandry And Others

Sanjay K. Agrawal, J.:— This writ petition is directed against the order dated 11.2.2021 (Annexure P-1) passed by respondent No. 2 by which the petitioner's medical bill for reimbursement has been rejected by the competent authority on the ground that it has not been informed within 48 hours from the commencement of treatment of the petitioner in accordance with Rule 10(7) of the Chhattisgarh Civil Services (Medical Attendance) Rules, 2013 (hereinafter called as ‘Rules of 2013’).

2. Mr. R.K. Kesharwani, learned counsel appearing for the petitioner, would submit that the issue involved in this writ petition came-up for consideration before this Court in Writ Petition (S) No. 6240/2021 (Khuku Biswas v. State of Chhattisgarh), decided on 13.1.2022, in which in similar circumstances the Court has directed the competent authority to consider and decide the claim. Therefore, the impugned order be set-aside and the matter be remitted to the competent authority for grant of post-facto sanction under Rule 11(1) of the Rules of 2013 within the stipulated time.

3. On the other hand, Ms. Sunita Jain, learned Government Advocate appearing for the respondents/State, would submit that the petitioner's claim will be considered and decided expeditiously.

4. I have heard learned counsel for the parties, considered their rival submissions made hereinabove and also went through the records with utmost circumspection.

5. This Court in Khuku Biswas (supra) held as under:—

“17. Recently, the Supreme Court in the matter of In Re: The Proper Treatment of Covid 19 Patients and Dignified Handling of Dead Bodies in the Hospitals etc. Suo Motu Writ Petition (Civil) No. 7/2020, decided on 19-6-2020. has held that right to health is a fundamental right guaranteed under Article 21 of the Constitution of India. Right to health includes affordable treatment.

18. Following the principles of law laid down by their Lordships of the Supreme Court in the aforecited cases (supra), it is quite vivid that right to health is a fundamental right under Article 21 of the Constitution of India as held by the Supreme Court in Surjit Singh (supra) and consequently, the provisions relating to reimbursement of medical treatment has to be construed liberally. The petitioner had right to take steps in self-preservation of her own life which is a facet to right to health and thus, she immediately got herself admitted in the hospital for medical treatment (Canal Stenosis), but on account of urgent medical need she or her family members could not intimate the fact of such emergency situation as envisaged under sub-rule (7) of Rule 10 of the Rules of 2013 and therefore her case could have been considered for grant of post-facto permission/sanction by the competent authority as envisaged under sub-rule (1) of Rule 11 of the said Rules; non-intimation of commencement of treatment within 48 hours would not preclude her to recover the amount of medical reimbursement from the respondents, as Rule 11 of the Rules of 2013 takes care of that situation and under Rule 11(1), post-facto sanction can be granted by the competent authority. Since the surgery which the petitioner had undergone was admittedly, a surgery related to spinal cord i.e. canal stenosis and that surgery can be said to be an emergent surgery in emergency situation, therefore, Rule 11(1) of the Rules of 2013 can certainly be invoked into by the competent authority and failure of the petitioner or her family member in intimating the authorities within the time limit of 48 hours from the commencement of treatment would not debar the competent authority to consider the case of the petitioner under Rule 11(1) treating the surgery i.e. canal stenosis which is a surgery to spinal cord as an urgent circumstance/situation. Accordingly, the competent authority is directed to consider the case of the petitioner for grant of post-facto sanction under Rule 11 of the Rules of 2013 and it has to be considered by the competent authority as per the provisions contained in sub-rules (2) to (5) of Rule 11 of the Rules of 2013. Such consideration will be made within 45 days from the date of receipt of a copy of this order on its own merit in accordance with law, expeditiously.”

6. In that view of the matter, the impugned order is set-aside and the matter is remitted to the competent authority to consider the case of the petitioner for grant of post-faction sanction under Rule 11(1) of the Rules of 2013 and it has to be considered by the competent authority as per the provisions contained in sub-rules (2) to (5) of Rule 11 of the Rules of 2013. Such consideration will be made within 45 days from the date of receipt of a copy of this order on its own merit in accordance with law, expeditiously.

7. The writ petition is allowed to the extent indicated herein-above. No order as to cost(s).

Uttam Kumar Kosariya v. State Of Chhattisgar...