REPORTABLE
IN THE SUPREME COURT OF INDIA
CIVIL APPELLATE JURISDICTION
CIVIL APPEAL NO. 4384 OF 2009
(Arising Out of SLP (C) No.25258 of 2004)
The Secretary to the
Government of Haryana & Ors. ... Appellants
Versus
Vidya Sagar ... Respondent
JUDGMENT
S.B. Sinha, J.
1. Leave granted.
2. The sole respondent was an employee of the State of Haryana. He has
since retired. He was serving in the `Health Department’ of the State having
joined services on 26.11.1961. He retired on 7.9.1988 on health grounds.
3. He suffered an heart attack on 15.8.2002. He was treated in the Post
Graduate Institute of Medical Sciences and Research, Chandigarh. He
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underwent a bye-pass surgery at Fortis Heart Institute and Multi-Speciality
Hospital, Mohali. It is on the recognized panel of the hospitals of the State
of Haryana. He submitted a bill for a sum of Rs.1,87,907.65 towards
medical expenses borne by him for its reimbursement.
Relying on or on the basis of a circular issued by the State of Haryana
dated 30.11.1993, the Department sanctioned payment for a sum of
Rs.1,62,298/- only.
4. Aggrieved by the said order, the respondent filed a writ petition before
the High Court of Punjab and Haryana. The said writ petition was allowed,
holding:
“We have heard learned Counsel for the parties.
Shri W.R. Dua, learned counsel for the petitioner
drew our attention to the Punjab Services (Medical
Attendance) Rules 1940, as applicable to the
Haryana employees/pensioners and the instructions
issued by the Haryana Government vide circular
letter No. HD.HR. No.2/82/98-IHB-III dated
31.10.2002 to show that Fortis Hospital, Mohali
has been recognized by the Haryana Government
for the treatment of Haryana Government
employees/Pensioners/Family Pensioners. He then
referred to the instructions issued vide letter dated
11.8.1992 (Annexure P.5/A) to show that heart
disease has been treated as one of the chronic
ailments and argued that the petitioner is entitled to
full medical reimbursement in terms of the
3instructions issued by the Government vide letter
dated 25.8.2003.
Learned Assistant Advocate General could not put
forward any tangible argument to controvert the
submissions of Shri W.R. Dua.
Having considered the entire matter, we are
convinced that the Petitioner is entitled to
reimbursement of the entire expenses incurred by
him in his treatment at Fortis Hospital, Mohali and
the decision of the Respondents to pay only 75%
thereof is legally unsustainable.”
5. Mr. Manjit Singh, learned counsel appearing on behalf of the State,
contended that the High Court committed a serious error in so far as it failed
to give effect to the circulars issued by the State laying down the norms for
reimbursement of the medical bill.
6. Mrs. Nanita Sharma, learned counsel appearing on behalf of the
respondent, on the other hand, urged that the heart disease having been
considered to be one of the chronic diseases, the circular letter dated
28.5.2003 would prevail.
7. The Commissioner and Secretary of the state of Haryana, Health
Department, by a circular dated 30.11.1993 directed as under :
“I have been directed to invite your attention to the
Haryana Government letter No.2/296/86-H.R.II-III
dated 19.11.1985 (sic 1986) and to say that the
4decision for granting recognition to Nivedic
Prosyek Centre Daulat Singh Zirakpur (Punjab)
Batra Hospital New Delhi for taking special
treatment to serving Haryana Govt.
officers/officials/pensioners/family pensioners and
members of their family and dependants subject to
the condition that the conditions that the
officers/officials/pensioners who would undergo
for treatment in those approved institutions will get
reimbursement at the rates of All India Institute of
Medical Sciences (AIIMS) New Delhi/PGI. The
75% of the excess expenditure in comparative to
AIIMS will also be re-imbursed and the rest of
25% will be borne by the claimant himself. If a
Patient avails extra comfort as single room instead
of double occupy room facilities, as such the
whole expenditure will be borne by the claimant
himself.
2. This has the concurrence of the finance
department vide their memo No.56/80A/86-6 Fin.
Deptt. TT/229-1532-2297 dated 13.10.93.
3. This order will come into force from the
date of issue.”
8. However, it appears that on or about 28.5.2003, the same authority,
referring to an earlier memo dated 11.8.1992, directed as under :
“I have been directed to draw your attention on the
above subject to the memo No.2/160/89-1 H.B. III
dated 11.8.1992 whereby reimbursement on the
out door treatment of chronic diseases upto
maximum of Rs.6,000/- to the Haryana Govt.
employees/officers/pensioners/family members of
pensioners used to be allowed. The matter
regarding removing the maximum limit for
reimbursement of expenses incurred on the
5treatment of chronic diseases has been under
consideration of the Government keeping in view
the interest of employees and pronouncements
delivered by the Courts in this respect. Now the
Government has decided that in view of
instructions dated 11.8.1992 reimbursement of all
the expenses incurred on the treatment of chronic
diseases outdoor as well indoor shall be allowed.
All the other conditions issued on 11.8.92 shall
remain in force.
These instructions will take effect from the issue of
this letter.
The concurrence of the Finance Department has
been obtained vide their endst. No.70/20/2000-6
H.A. III/1450 dated 28.5.2003.”
9. The High Court, as noticed hereinbefore, was of the opinion that heart
disease having been treated to be one of the chronic ailments in terms of the
circular letter dated 11.8.1992, the respondent was entitled to reimbursement
of the medical bill in its entirety.
We see no reason to differ with the views of the High Court.
Although the circular dated 28.5.2003 does not expressly supersede the
circular letter dated 30.11.1993, but the latter having been issued subsequent
to the former and in relation to a particular category of disease, namely, the
chronic diseases, shall prevail over the earlier general circular letter. The
said circular letter dated 28.5.2003 brings within its umbrage not only the
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expenses incurred for the treatment of chronic disease outdoor but also
indoor. In that view of the matter, the impugned judgment must be
sustained.
10. Mr. Singh had relied upon a decision of this Court in State of Punjab
& Ors. v. Ram Lubhaya Bagga & Ors. [(1998) 4 SCC 117] to urge that
obligation on the part of the State to foot the medical bill of its employee can
be restricted by framing appropriate rules and/or by issuance of requisite
circular. No exception to the dicta laid down therein can be taken.
However, the said decision is itself an authority for the proposition that the
State can change its policy decision from time to time. Once the State in its
magnanimity adopted a decision that the medical bills in their entirety in
connection with the heart diseases shall be reimbursed, the authorities of the
State being bound thereby were obligated to comply therewith.
11. The question has also been considered by this Court in State of
Karnataka & Anr. v. R. Vivekananda Swamy [(2008) 5 SCC 328] in the
following terms :
“24. In view of the aforementioned settled
principles of law there cannot be any doubt that the
Rules regarding reimbursement of medical claim
of an employee when he obtains treatment from a
hospital of his choice can be made limited. Such
Rules furthermore having been framed the proviso
7to Article 309 of the Constitution of India
constitute conditions of service in terms whereof
on the one hand the employee would be granted
the facility of medical aid free of cost from the
recognized government hospital and on the other
he, at his option, may get himself treated from
other recognized hospitals/institutions subject of
course to the condition that the reimbursement by
the State therefor would be limited.”
12. For the reasons aforementioned, there is no merit in the appeal. It is
dismissed accordingly with costs. Counsel’s fee assessed at Rs.10,000/-
(Rupees ten thousand only).
……………………….J.
[S.B. Sinha]
`
………………………..J.
[Deepak Verma]
New Delhi;
July 16, 2009