Dalip Rai Nayyar vs The Chief Secretary, Govt. of Haryana

Augustine George Masih, J.—Petitioner has approached this Court claiming the reimbursement of his medical bills, which expenses he incurred while getting treatment from Fortis Hospital, Mohali, which is a Haryana Government Panelled Hospital. He being a heart patient takes treatment from there and remained admitted there as an indoor patient in January, 2008 because of shortage of sodium chloride/phosphates and again in February, 2008, for prostrate operation because of urine trouble. He had earlier been admitted in Fortis Hospital when he suffered a massive heart attack on 26.08.2006 for which treatment is continuing at the Fortis Hospital as an outdoor patient. Petitioner is a widower and has only one daughter who came to him while he was admitted in the Fortis Hospital. She resides in Delhi and because of the indifferent health of her husband, she had to go back to Delhi where she is also working and is on deputation to Delhi Administration w.e.f. 01.03.2003. Petitioner was not in a good financial position to engage a nurse to take care of him in his house at Chandigarh and faced with this situation, he had to shift to his daughter''s house at Delhi because of which, he could not submit his claim within a period of six months. As a matter of fact, after complete recovery, he submitted his medical bills on 24.07.2009 (Annexure P-1A). The claim of the petitioner has not been considered and rather rejected on the ground that the same has been submitted by the petitioner after an inordinate delay and the claim is barred by the instructions dated 11.12.2003 (Annexure P-5). The orders dated 2/3.3.2010 and 25.05.2010 rejecting the claim of the petitioner are appended as Annexures P-2 and P-4. Petitioners, therefore, faced with this situation, approached this Court by way of the present writ petition claiming the benefit that because of the circumstances beyond his control, he could not submit the bills within the time stipulated under the instructions dated 11.12.2003. Counsel for the petitioner contends that the instructions dated 11.12.2003 (Annexure P-5) do not bar the claim merely on the ground that it is submitted beyond the period of 12 months. The instructions themselves provide for an exception to be carved out in circumstances which genuinely indicate difficulties faced by a claimant and under these instructions, the claim of the petitioner clearly falls and thus, the rejection of the claim of the petitioner on the basis of it being time barred cannot be accepted. Counsel for the petitioner has placed reliance upon a Division Bench judgment of this Court passed in Baljinder Kaur v. State of Punjab and others,1 2008 (5) SLR 16, to contend that a technical objection with regard to the limitation cannot be taken as a ground to reject a genuine claim when the same has not been said to be a bogus one. He, accordingly, prays that the present writ petition be allowed.

On the other hand, counsel for the respondents submits that there is an inordinate delay in submitting the bills by the petitioner. As a matter of fact, petitioner has submitted the bills after a period of almost one year and 4 months and as per the instructions dated 11.12.2003, the claim of the petitioner could not be accepted and has rightly been rejected.

I have considered the submissions made by the counsel for the parties and have gone through the records of the case.

The facts, as stated above, are not in dispute. The only question, which requires determination by this Court, is whether the instructions dated 11.12.2003 (Annexure P-5) would bar a claim submitted for reimbursement of medical expenses beyond the period of 12 months of a claimant or not?

For decision on this issue, reference to the instructions and the contents thereof would facilitate, the relevant portion thereof reads as follows:-

The matter regarding time limit for preferring claims for reimbursement of medical expenses incurred by the government employees/officers on their own treatment or on the treatment of their dependents has been further considered by the Government and it has been decided that the Secretary of the Administrative Department concerned shall be competent to sanction medical claims submitted after 6 months but within a period of 12 months from the date of completion of treatment without referring the same to the Health Department. The medical claims submitted after a period of 12 months from the date of completion of treatment shall be referred to the Health Department in order to curb the tendency of unnecessary delay in submission of medical claims. The Health Department will entertain such medical claims only after strict scrutiny and in such exceptional cases where there are genuine mitigating circumstances i.e. like the death of the employee resulting in delay in submitting claims etc. These instruction shall come into force with immediate effect.

A perusal of the above would show that the sanction by the Administrative Department can be granted of the medical expenses on its own on the submission of the medical bills within a period of six months and if submitted within a period of 12 months from the date of completion of treatment without referring the same to the Health Department. If the claim is made beyond a period of 12 months, the matter has to be referred to the Health Department in order to curb the tendency of unnecessary delay in submission of medical claim. The Health Department also has not been restrained under these instructions to entertain the medical claims where there are certain exceptional cases and genuine mitigating circumstances for the delay in the claim submitted by a Government employee. This would clearly spell out that if in the given facts and circumstances of the claim, the reasons have been assigned which appeared to be justified and reasonable, the claim cannot be rejected merely because it; has been submitted beyond a period of 12 months. This is such a case where the petitioner has put forth a genuine reason for non-submission of the medical bills prior to the prescribed time for submission of claim. Therefore, the stand of the respondents that the claim of the petitioner cannot be entertained in the light of the instructions dated 11.12.2003, cannot be accepted. Accordingly, the impugned orders dated 02/03.03.2010 and 25.05.2010 (Annexures P-2 and P-4) cannot sustain and deserve to be quashed.

Further, the Division Bench of this Court in the case of Baljinder Kaur (supra) has also, in genuine cases, accepted the exception and has stated that technical objection should not be made a ground for denying the reimbursement claim of the employees who are otherwise entitled to the same. The only stand, which has been taken by the respondents for rejecting the claim of the petitioner for medical reimbursement is that the same is beyond the period of limitation prescribed under the instructions dated 11.12.2003. The genuineness of the claim made by the petitioner has not been disputed.

In the above facts and circumstances, the present writ petition deserves to be allowed by quashing the impugned orders dated 02/03.03.2010 and 25.05.2010 (Annexures P-2 and P-4 respectively).

Ordered accordingly.

Counsel for the petitioner submits that the original medical bills of the petitioner have been returned to him by the department and he states that the same shall be re-submitted by the petitioner within a period of 10 days from today. A direction is issued to the respondents to release the reimbursement claim of the petitioner within a period of two months from the date of submission of medical bills.