Case Note & Summary
The dispute arose from a claim for medical reimbursement by a retired employee of the Haryana Government, who had incurred significant expenses for heart surgery. The respondent, who had served in the Health Department since 1961 and retired in 1988, submitted a bill for Rs. 1,87,907.65 after undergoing treatment at Fortis Hospital, Mohali. The Haryana Government sanctioned only Rs. 1,62,298 based on a circular from 1993. The respondent challenged this decision in the High Court, which ruled in his favor, citing the Punjab Services (Medical Attendance) Rules, 1940, and subsequent circulars recognizing heart disease as a chronic ailment eligible for full reimbursement. The State contended that the High Court erred by not adhering to the reimbursement norms established in earlier circulars. However, the respondent's counsel argued that the later circulars, particularly one from 2003, allowed for full reimbursement of chronic disease treatments. The Supreme Court found no reason to disagree with the High Court's ruling, emphasizing that the later circulars took precedence and mandated full reimbursement for chronic ailments. The court referenced previous judgments affirming the State's obligation to cover medical expenses for employees and concluded that the appeal lacked merit, dismissing it with costs assessed at Rs. 10,000.
Headnote
A) Administrative Law - Medical Reimbursement - Entitlement to Full Reimbursement - Haryana Government Circulars - The High Court held that the respondent was entitled to full reimbursement for medical expenses incurred for heart disease treatment as it was classified as a chronic ailment under the relevant circulars. The Supreme Court upheld this decision, stating that the later circulars superseded earlier ones and mandated full reimbursement for chronic diseases (Paras 4-9).
Issue of Consideration
Whether the respondent was entitled to full reimbursement of medical expenses incurred for treatment of heart disease.
Final Decision
The Supreme Court dismissed the appeal, affirming the High Court's decision to grant full reimbursement for the respondent's medical expenses, with costs assessed at Rs. 10,000.
Law Points
- medical reimbursement
- chronic diseases
- circulars
- employee rights
- policy change
