As per case facts, the petitioner, a retired Assistant Engineer, sought complete medical reimbursement for an urgent liver and kidney transplantation. After being diagnosed with kidney and liver ailments, he ...
CWP-26319-2016 (O&M) -1-
IN THE HIGH COURT OF PUNJAB AND HARYANA
AT CHANDIGARH
CWP-26319-2016 (O&M)
Reserved on: 10.12.2025
Pronounced on: 26.02.2026
Uploaded on : 26.02.2026
Parminder Singh ….Petitioner
Versus
State of Punjab and another ….Respondents
CORAM: HON'BLE MR. JUSTICE KULDEEP TIWARI
Present: Mr. Pulkit Jain, Advocate,
for the petitioner.
Mr. T.P.S. Walia, AAG, Punjab.
****
KULDEEP TIWARI, J.
(Oral)
1) The petitioner has been constrained to knock the doors of this
Court by invoking its inherent jurisdiction under Article 226/227 of the
Constitution of India, as his claim for medical reimbursement on account of
liver and kidney transplantation (cadaver donor), was considered and
sanctioned at the rates prescribed by the All India Institute of Medical
Sciences, New Delhi, but rest of the claim was denied, in terms of the
Medical Reimbursement Policy dated 13.02.1995 (Annexure R-2), and
clarification dated 23.01.1998.
2) Succinctly put, the petitioner was retired as Assistant Engineer
from the department of PWD (B&R), Punjab, on 31.03.2016. However, in
the year 2010, he was diagnosed with a kidney ailment, and therefore,
remained under treatment with the Post Graduate Institute of Medical
Education & Research, Chandigarh (PGIMER). Initially, the PGIMER
CWP-26319-2016 (O&M) -2-
issued him a Complicated Chronic Disease Certificate for Chronic Kidney
Disease on 12.01.2011, valid up to 11.01.2014 (Annexure P-1), which was
re-issued/re-validated on 12.01.2014 till 11.01.2019 (Annexure P-2). But,
gradually, the kidney disease led to deterioration of his liver, as well, and
thus, he was issued a Chronic Hepatitis C certificate on 17.05.2013, which
remained in force till 16.05.2015 (Annexure P-3). He continued his
treatment, i.e. medicines, tests and dialysis, with the PGIMER, from 2011
to 2015. Since his health was worsening with each passing day, he was in
emergent need of organ transplant, but could not secure a donor, despite
being registered with the PGIMER. Simultaneously, he also consulted and
remained under treatment with Fortis Hospital, Mohali, from 2012 to 2014.
Having been left with no other option, he got himself registered with other
hospitals pan India, for securing a cadaver donor, including Sir Ganga Ram
Hospital, New Delhi, in the year 2014, where, he also underwent numerous
diagnostic tests and treatment, and his name was placed in a queue.
3) Likewise, he also got himself registered with Apollo Hospital,
Banglore. Ultimately, in the year 2015, he got a call from the Apollo
Hospital, Banglore, that a cadaver donor was available. Since time was of
the essence, he immediately underwent kidney and liver transplant surgery
on 03.01.2015, and remained under observation till 13.01.2015. Thereafter,
all the bills and certificates issued by the said hospital were submitted by
the petitioner with the respondent-State for reimbursement, to the tune of
Rs.31,50,000/- (Annexure P-7). However, upon verification and Ex-post
facto sanction, the Director, Health & Family Welfare, Punjab, vide a
communication dated 12.04.2016 (Annexure P-8), had accorded approval,
but as per the rates of AIIMS, New Delhi/Government rates, i.e.
Rs.8,13,117/-. In the interregnum, the respondent authorities had re-visited
CWP-26319-2016 (O&M) -3-
the claim of the petitioner, when it came to their notice that treatment for
cadaver liver and kidney transplant was available at AIIMS, New Delhi, in
the year 1996, which had fixed the rate of Rs.11,00,000/-, vide letter dated
09.07.2021. Accordingly, claim of the petitioner was revised Ex-post facto,
and was accorded sanction for Rs.13,68,235/- on 20.11.2025, in favour of
the petitioner, and the amount has even been released.
4) Learned counsel for the petitioner contended that there was no
reason, whatsoever, with the State Government to deny the complete
reimbursement, once they had verified that petitioner, indeed, underwent a
liver and kidney transplantation. So much so, the bills were actually raised
by the hospital concerned. He further submitted that the petitioner
remained under treatment, during 2011 to 2015, with the PGIMER,
Chandigarh. However, since no cadaver donor was available, he was
constrained to get himself registered with other hospitals, out of which,
only Apollo Hospital, Banglore, had a cadaver donor. In such a peculiar
situation, he had to undergo organ transplantation surgery at Apollo
Hospital, Banglore, itself. He asserted that a Government employee, during
his lifetime, is entitled for reimbursement on account of medical
expenditure and no fetters can be placed upon such right.
5) While taking his submissions ahead, he contended that the
issue arises for consideration in the instant writ petition has already been
examined by the Hon’ble Supreme Court in Shiva Kant Jha Vs. Union of
India (Writ Petition (Civil) No.694 of 2015, decided on 13.04.2018,
wherein, it was categorically held that medical reimbursement is an
enforceable legal right of an employee, flowing from Service Rules and the
Constitutional Principles. Likewise, he also placed reliance on the decision
dated 25.09.2023, rendered by a Coordinate Bench of this Court in
CWP-26319-2016 (O&M) -4-
CWP-13165-2017 (Subhash Sharma Vs. State of Haryana and others),
to
assert that complete medical reimbursement was ordered in favour of the
petitioner therein.
6) Per contra, learned State counsel, primarily, raised a legal
issue that the Government of Punjab has already framed a Policy to regulate
the claims of medical reimbursement. According to the Policy, the
petitioner is entitled for reimbursement only at the rates prescribed by the
AIIMS, New Delhi, even if, he underwent transplantation from a private
hospital of his choice. He further submitted that, in fact, legality of the
Policy in question has already been put to challenge before the Hon’ble
Supreme Court in State of Punjab Vs. Ram Lubhaya Bagga, 1998 (1) SCT
716, wherein, it was held that the Policy is not hit by Article 21 and 47 of
the Constitution of India, and thus, it is intra vires. So much so, it is well
within the right of the State to amend it, from time to time, under the
changing circumstances, which could not be challenged. It was further
observed that no right can be absolute in a Welfare State, and every
fundamental right is to be within permissible reasonable restriction.
Therefore, the restriction imposed in the instant case was also within the
permissible parameters. He concluded by submitting that all admissible
dues have already been released in favour of the petitioner, as per the rates
prescribed by the AIIMS, New Delhi.
7) This Court has heard the rival submissions advanced on behalf
of the parties, and gone through the record.
8) It is a matter of record that, in terms of the Policy dated
13.02.1995, the employees and pensioners can get treatment in any private
institute/hospital of their choice, within the country, subject to furnishing of
an unambiguous undertaking that he/she will accept reimbursement of
CWP-26319-2016 (O&M) -5-
expenses incurred by him/her on the treatment to the level of expenditure,
as per rates fixed by the Director, Health and Family Welfare, Punjab, for a
similar treatment package or actual expenditure whichever is less. For ready
reference, the relevant part of the Policy is extracted hereinbelow:-
“(b) Treatment in Private Hospitals in the
country. It has been decided that employees and
pensioners should be given freedom to get treatment in
any private institute/hospital (of their own choice), in
the country provided that he/she gives an undertaking
out of his/her free will and in unambiguous terms that
he/she will accept reimbursement of expenses incurred
by him/her treatment to the level of expenditure as per
rates fixed by the Director, Health and Family Welfare,
Punjab for a similar treatment package or actual
expenditure whichever is less. The rate of for a
particular treatment would be included in the advice
issued by the District/State Medical Board. A committee
of technical experts shall be constituted by the Director,
Health and Family Welfare, Punjab to finalize the rates
of various treatment packages and the same rate list
shall be made available in the offices of the Civil
Surgeons of the State.
However, this permission would be granted by the
Director, Health and Family Welfare, Punjab on the
advice of State Medical Board in case of the treatment
in private Hospitals outside the State and the District
Medical Board in case of treatment in private hospitals
within the State.”
9) There is no quarrel with respect to the terms and conditions
formulated in the Policy, per which, medical reimbursement would be made
only at the rates fixed by the AIIMS, New Delhi. However, the Policy, in a
way, restricts rights of the petitioner/employee, who is faced with the
CWP-26319-2016 (O&M) -6-
exceptional circumstances, where he was required to undergo immediate
kidney and liver transplant surgery (cadaver donor).
10) Before proceeding further with the matter, it is essential to
comprehend the meaning of cadaver donor. A cadaver donor is a deceased,
usually a brain dead, whose major organs are still functioning on medical
support, and can be retrieved for transplantation with the consent of the
survivors/family members. Likewise, cadaver transplantation is a procedure
of transplanting organ/organs from the legally declared dead person to a
living person/recipient. The most challenging part in the process of such
transplantation is the availability of a cadaver. In the country like ours,
social, cultural and religious sentiments, more often than not, act as barriers
in organ donation of a brain-dead person. Therefore, it is extremely difficult
to identify a brain-dead person, particularly, whose kith and kin are willing
to donate his organs. Even after securing a cadaver donor, immediate
transplantation is not feasible due to lack of infrastructure and logistical
support. In such a complicated situation, it has never been the matter of
choice of a recipient to elect either any empanelled hospital, or a
Government hospital, for the purpose of transplantation, rates of which
correspond with the AIIMS, New Delhi. Moreover, the patient, who needs
organ(s) transplantation, always finds himself/herself surrounded by
emergent circumstances, as it would be the last resort to survive the life
threatening disease.
11) In the backdrop of the abovesaid crucial circumstances, the
Policy (supra), needs to be read in its right earnest, so as to achieve the
desired object. The primary object of the Policy is to regulate the claim of
medical reimbursement of its employees, and not to curtail their pre-
existing rights. Surprisingly, the Policy does not address the exceptional
CWP-26319-2016 (O&M) -7-
circumstances, as the petitioner was faced with. So much so, the stand set
out by the respondent-State is entirely based only upon technicalities,
notwithstanding, the bonafide and genuine claim of the petitioner. If the
Policy is silent on such aspects, it is incumbent upon the Courts to interpret
the same purposively, so as to fill the gaps/lacunae to prevent unjust denial
of legitimate rights.
12) At this juncture, this Court is reminded to refer to a legal
aphorism ‘Ubi Jus Ibi Remedium’; where there is a right, there is a
remedy. This principle signifies that if a citizen’s legal right is breached,
the law must provide remedy. A legal wrong cannot exist without there
being a legal remedy. This principle emphatically denotes that no wrong
should go without redress, and only by this way, the Courts can establish
faith in the rule of law.
13) In Shiva Kant Jha (supra)
, the Hon’ble Supreme Court has
held that a right of medical claim cannot be denied merely because the
name of the hospital is not included in the list of empaneled hospitals. The
real test must be the factum of treatment. The relevant observations made
in the decision read as under:-
“13) It is a settled legal position that the Government
employee during his life time or after his retirement is entitled to get
the benefit of the medical facilities and no fetters can be placed on
his rights. It is acceptable to common sense, that ultimate decision
as to how a patient should be treated vests only with the Doctor,
who is well versed and expert both on academic qualification and
experience gained. Very little scope is left to the patient or his
relative to decide as to the manner in which the ailment should be
treated. Speciality Hospitals are established for treatment of
specified ailments and services of Doctors specialized in a
discipline are availed by patients only to ensure proper, required
and safe treatment. Can it be said that taking treatment in Speciality
CWP-26319-2016 (O&M) -8-
Hospital by itself would deprive a person to claim reimbursement
solely on the ground that the said Hospital is not included in the
Government Order. The right to medical claim cannot be denied
merely because the name of the hospital is not included in the
Government Order. The real test must be the factum of treatment.
Before any medical claim is honoured, the authorities are bound to
ensure as to whether the claimant had actually taken treatment and
the factum of treatment is supported by records duly certified by
Doctors/Hospitals concerned. Once, it is established, the claim
cannot be denied on technical grounds. Clearly, in the present case,
by taking a very inhuman approach, the officials of the CGHS have
denied the grant of medical reimbursement in full to the petitioner
forcing him to approach this Court.
14) This is hardly a satisfactory state of affairs. The relevant
authorities are required to be more responsive and cannot in a
mechanical manner deprive an employee of his legitimate
reimbursement. The Central Government Health Scheme (CGHS)
was propounded with a purpose of providing health facility scheme
to the central government employees so that they are not left
without medical care after retirement. It was in furtherance of the
object of a welfare State, which must provide for such medical care
that the scheme was brought in force. In the facts of the present
case, it cannot be denied that the writ petitioner was admitted in the
above said hospitals in emergency conditions. Moreover, the law
does not require that prior permission has to be taken in such
situation where the survival of the person is the prime
consideration. The doctors did his operation and had implanted
CRT-D device and have done so as one essential and timely.
Though it is the claim of the respondent-State that the rates were
exorbitant whereas the rates charged for such facility shall be only
at the CGHS rates and that too after following a proper procedure
given in the Circulars issued on time to time by the concerned
Ministry, it also cannot be denied that the petitioner was taken to
hospital under emergency conditions for survival of his life which
requirement was above the sanctions and treatment in empanelled
hospitals.”
CWP-26319-2016 (O&M) -9-
14) While following the ratio laid down in Shiv Kant Jha (supra),
a Coordinate Bench of this Court in Subhash Sharma (supra), has granted
the relief of complete medical reimbursement incurred on the treatment, to
the petitioner therein, who underwent a liver transplant surgery. The
respondent-State allowed the medical claim as per the instructions/policy
dated 06.05.2005, and he was granted medical reimbursement only to the
extent of Rs.10,00,000/-, whereas, the actual expenses on account of
treatment were Rs.24,00,000/:-
“It is a conceded position that though, initially the
medical claim of the petitioner for reimbursement was not
entertained by the respondents but thereafter, upon
reconsideration, the respondents have allowed the medical claim
of the petitioner under the instructions dated 06.05.2005 issued
by the Government of Haryana. Under the said instructions, out
of the total claim of Rs.24. lacs, a sum of Rs.10 lacs has been
reimbursed to the petitioner as a full and final payment on the
basis of fact that had the petitioner undertaken the said treatment
from PGIMER, Chandigarh, he would have incurred an amount
of Rs.10 lacs on the treatment in question hence, as per the
instructions dated 06.05.2005, in case treatment has been
undertaken from an unapproved hospital in emergent situation,
reimbursement can only be made as per the PGIMER,
Chandigarh rates and not beyond that.
xx xx xx xx
Respondents are directed to reconsider the claim of the
petitioner for remaining amount of Rs.14 lacs keeping in view the
observations of this Court in the order and for whatever amount
the petitioner is entitled for qua medical facilities and procedure
for the liver transplantation, the same be reimbursed to him.
With regard to the payment for room rent rates etc., the same
will be given as per the PGIMER, Chandigarh rates only.”
15) Similarly, in Kamla Devi Vs. State of Haryana and others,
2024, NCPHHC 8924, a Coordinate Bench of this Court has held:-
CWP-26319-2016 (O&M) -10-
“11. Learned counsel for the respondents submits that the
claim of the petitioner has been considered as if, the surgery is
presumed to have been undertaken at PGIMER, Chandigarh.
12. Said argument is also fallacious. Once the liver
transplant surgery was not available at PGIMER, Chandigarh,
the question of presuming the same to be undertaken at
PGIMER, Chandigarh so as to decide the claim of the petitioner
for medical reimbursement is totally artificial and has no basis
and hence, reimbursement of medical claim on the basis of the
PGIMER rates cannot be accepted in the facts and circumstances
of the present case.”
16) While dealing with a somewhat similar issue, a Division
Bench of this Court in Shakuntla Vs. State of Haryana, 2004 (1) SLR 563,
held that in case, where a treatment is taken in emergency from a hospital
other than the approved hospitals, the State cannot deny the medical
reimbursement:-
7. The petitioner is an employee of Government of
Haryana and that the child is her dependent, as such, for the
treatment of the child, she is entitled to reimbursement of the
medical expenditure in pursuant to the Punjab Service (Medical
Attendant) Rules, 1940, which are applicable to the State of
Haryana. So far as the availability of the medical facilities at the
institutes like AIIMS, New Delhi, normally the operation waiting
period is so much that the emergency patients most of the times
cannot be entertained and they are referred to other hospitals. It
may be noticed that it is only in dire emergency that a person
reaches the hospital where immediate treatment can be given. In
a case where the life of a human being is at stake, it is too
technical to require such a person to hunt for a list of the
approved hospitals and then decide which hospital to go to.
Sometimes the said hospital may not be able to accommodate the
patient. Such situation has been dealt with by the apex Court in
Surjit Singh v. State of Punjab, 1996(1) RSJ 845. It may be
noticed that Government of Haryana has already included Sir
CWP-26319-2016 (O&M) -11-
Ganga Ram Hospital in the list of approved hospitals and that
the sald notification/instructions have been issued on October 31,
2002. De hors of this, in the case of saving a human life at a
given point of time, it is not expected of an attendant to look into
the list and then hunt for the hospital which is contained therein.
Such procedures should not be expected to be followed in an
emergency by the attendant of the patient. If such regulations are
applied so strictly, the end result may be disastrous and in that
situation the patient may die. If the death occurs, in that
eventuality the responsibility of the State cannot be washed out.
No doubt, in normal circumstances the procedures prescribed
should be followed but the procedure should not be made so
cumbersome that one may get frustrated in adhering to such
procedures. Emergency knows no law and no procedures. The
emergency act when required to be committed should not be
weighed in terms of money especially when human life is at
stake.
8. The authorities prescribed under the rules have also to
apply their mind in a conscious and cautious manner in dealing
with such kind of situations. Saving the life of near and dear, a
person may have to commit any act which includes the selling of
one's jewellery, borrowing money at exorbitant rate of interest or
subject himself/herself to every and any condition. No hospital,
private or Government would entertain the patient without the
amount having been deposited, it is at that juncture,
circumstances and situations, the attendant of the patient
becomes so vulnerable that except for saving the life of near and
dear nothing seems to be more important. Thus, gravity of the
situation has to be understood by the Government in a far more
positive manner that applying the normal mathematics. The
situations may arise and generally do arise when the attendant of
the patient may not have or be possessed with the money or the
jewellery for saving the life of near and dear. Can we not think of
better solutions for providing facilities to the patient in such a
given situation? This needs to be examined by the concerned
quarters who are not only meant for ruling but for serving the
society. For rendering service to the society the necessary
expenditures are not to be curbed but at the same time the action
CWP-26319-2016 (O&M) -12-
should be such that it may not open a possible wasteful tap in the
State exchequer. Thus, the answer has to be provided by the
persons who have been sitting at the helms of affairs of the State
and have been facing such situations. According to us, the
situation should be dealt with by the persons as if he or she is
involved in the situation himself or herself. We never know that
the situation which is being dealt with may fall upon that person
as well.
9. In the given case, saving the life of the child was
paramount for the mother, i.e. the petitioner and she had no
option but to get the child in the first instance admitted in the
Saxena Nursing Home, Rewari but upon their advice, for
performing the operation, she had to weigh as to which
institution is better equipped for saving the life of the child and
as per her statement, she had been advised to take the child to Sir
Ganga Ram Hospital, New Delhi. Fortunately, the child survived
with efforts of the Doctor and, of course, the credit went to the
Institution. No doubt, the expenditure incurred may be far more
than what is prescribed in the Government. Hospital or in a
recognised hospital. The Government has recognised some of the
hospitals and so far as rates are concerned, for administering
medical help they, vary from one institution to the other. The only
measuring law is that in case of grave emergency which hospital
comes to the mind of the attendant and which hospital is
considered best for saving the life of the patient. These decisions
sometimes become crucial for saving the life of an individual.
10. The cumulative effect while considering the claims of
all the petitioners is that the individual cases of all the petitioners
need to be dealt with expeditiously because at the time of meeting
out the medical expenditures in the hospitals, the payment is
raised by taking loans upon interest, by sale of jewellery or
liquidating their movable or immovable assets including the
Fixed Deposits, if any. Such acts sometimes involve the life time
saving of an employee. Thus, the question of dealing with such
kind of payments does leave a healthy impression with an
employee. Generally speaking, the employer is expected to look
after his employees though as per the terms and conditions spelt
out in the terms of employment or the rules framed in respect
CWP-26319-2016 (O&M) -13-
thereof. Wherever the rules prescribe the reimbursement to be
made to the employees, the unnecessary delays should be
avoided. The facts spelt out in all these cases relate to such kind
of delays and thereby the petitioners have faced the unnecessary
harassments. We are of the view that the impugned orders vide
which the claims of the petitioners have been rejected are not
sustainable under law, as the plea set up is that the hospitals are
not recognised or not contained in the list approved by the
government, which does not stand the test of law. Thus, the case
of all the petitioners deserve to be scrutinised in accordance with
the rules and so also the Judge made law. Therefore, we grant a
writ of certiorari and quash the impugned orders of rejection in
respect of the claims of each of the petitioners which have been
impugned before us and we also command the Government by
issuing a writ of mandamus that the cases of all the petitioners be
dealt with in accordance with the rules and the Judge made law
within a period of three months. It is clarified that the petitioners
may substantiate their claims, if so required, within 15 days from
the date of receipt of a certified copy of this judgment and that
the aforestated period of three months shall in addition to 15
days and wherever the additional pleas or the additional
documents are not required to be submitted, the aforestated
period of 15 days shall not be available to either side. It is
further directed that upon deciding the cases of the petitioners
within the aforestated period, the payment due and payable to the
petitioners shall be made within one month falling which the
Government shall be liable to pay interest at the rate of 12% per
annum after the expiry of the period of one month as prescribed.
The Interest ith thereafter, amount so payable shall be deducible
from the salary of the officer(s) concerned and responsible for
dealing with and for not making the payment within the
aforestated period and that the said amount shall not be
reimbursible by the Government under any head. It is clarified
that for any such delay beyond the aforestated period the interest
accrued thereon shall be paid by the Government in the first
instance and the deductions shall be made after the liability has
been fastened by the concerned quarters.”
CWP-26319-2016 (O&M) -14-
17) On the similar lines, in Hari Chand Vs. State of Punjab and
others, 2016 (1) PLR 712, a Coordinate Bench of this Court has held that
if a treatment is not available in the empanelled hospital of the State
Government, even then, the policy in this regard has to be read clearly in
favour of the petitioner therein:-
“
11. The question presently arising is that Live Liver
Transplant facility was not available at AIIMS, New Delhi when
the treatment was taken. If it is not available at AIIMS, New
Delhi then the policy dated February 13, 1995 has to be read
clearly in favour of the petitioner to bring his entire balance
claim to his pocket since there is no fixed point of assessment
incurred towards medical expenses. Therefore, the treatment at
Indraprastha Apollo Hospital, New Delhi was in the nature of a
medical emergency and the expense package in the final bill lies
no matter what in the province of life and death. In other words,
the situation arising was do or die, take it or leave it. The choice
between the two poles can be easily imagined and needs no
forensic reasoning. There is also no bar contained in the 1940
Rules or in the instructions issued from time to time, including
the one under consideration, which could result in disallowing
the claim altogether. It is, therefore, not open to the State to
penny-pinch and decline the request for the remaining half of the
expenses incurred in the treatment which was not available in
Punjab or at premier medical institute at AIIMS, New Delhi. This
was a Hobson's choice.”
18) Likewise, in Shri D.D. Guglani Vs. Haryana State
Electricity Board through its Executive Engineer, Suburban Division,
HSEB, a Coordinate Bench of this Court has unequivocally interpreted
that statutory regulations must be so read that would sub-serve the cause
of justice and if need be, tempered with human compassion:-
“ 3. I have gone through the file. The plaintiff's
contention was that the treatment caused at the hospital at Delhi
CWP-26319-2016 (O&M) -15-
which was actually approved hospital by the Central
Government and that further treatment at PGI, Chandigarh was
undertaken only when the doctor who treated the plaintiff
counselled that there were no facilities in any hospital in the
State of Haryana at the relevant time for hemo-dialysis for
kidney allment. The appellate Court had relied on the Haryana
Government circular that directed the Government employee to
take treatment only in Government approved hospitals and not in
hospitals outside. The appellate Court, while reserving the
judgment of the trial Court that provided for medical
reimbursement, had observed that the civil court is a court of law
and it cannot be swayed by compassion. It must be remembered
that the law is not sapped dry of all human compassion. Rules
and statutory regulations must be so read that would sub-serve
the cause of justice and if need be, tempered with human
compassion. The Government instructions that an employee shall
not take treatment other than th approved hospital is a point well
taken. In this case, the doctor, who had given treatmen to the
petitioner was stated to be dead at the time when the trial had
taken place. There was therefore only an oral assertion of the
plaintiff that the doctor had told him that there was no facility for
hemo-dialysis. There was not as if the plaintiff had taker
treatment in some hospital for mere fancy. He was in a serious
terminal condition where he secured treatment at PGI and at the
Central Government approved hospital at Delhi. would take the
evidence of the plaintiff itself as sufficient that he had taken
treatment at the above two hospitals only because similar
facilities were not available in any approved hospital in the State
of Haryana. The treatment caused at the Central Government
approved hospital or at PGI cannot be said to be unrealistically
high in comparison to the medical costs at Haryana. There was
no justification for the appellate Court to reverse the finding of
the trial Court by wooden application of rules without minding
the fact that the best the Government could have sought for
information regarding the treatment whether costs at the State
hospital in Haryana was in someway lower than the cost
Incurred at PGI or at the hospital at Delhi. With no such specific
evidence available, I would hold that the petitioner would be
CWP-26319-2016 (O&M) -16-
entitled to full reimbursement of the cost incurred by him. I
restore the trial Court's findings and decree the suit as prayed
for. The substantial question of law raised is answered as above.
The suit is decreed and the second appeal is allowed with costs
throughout.”
19) On the anvil of the abovesaid legal position, this Court too
has found that the Policy in question ought to have been interpreted
purposively, so as to ensure achievement of the desired intent.
Concededly, the petitioner remained under treatment at PGIMER from
2011 to 2015, but he did not get any cadaver donor for kidney and liver
transplantation. In such circumstances, a person cannot be left in a lurch
to wait for an indefinite period for a cadaver donor in the empanelled
hospitals of the State, or the hospitals where the corresponding rates of
AIIMS, New Delhi, are applicable. In a situation like the present one, the
patient, who is at the brink of his life, must be granted the freedom to
enroll himself with any hospital within the country, which can offer him
treatment, at the earliest. Conversely, the Policy does give the freedom to
the employees to choose a hospital for getting treatment, but it imposes a
restriction of reimbursement of medical claim, strictly, as per the rates
fixed by the AIIMS, New Delhi. In the matter at hand, it is worth
reiteration that the petitioner had undergone a liver and kidney transplant
surgery at Apollo Hospital, Banglore, not by choice but out of
compulsion, as no other hospital ever responded to his
registration/enrollment for a cadaver donor. In such circumstances, the
first and foremost factor for a patient and his family is to get a cadaver
donor from any of the hospitals throughout the county. And, whenever
such a donor is available, the surgery must be undertaken without losing
CWP-26319-2016 (O&M) -17-
much time, to save the patient from the clutches of the life threatening
disease.
20) In the wake of the position sketched out above, the instant
writ petition is allowed. The respondent authorities are directed to
release the balance amount, in terms of the claim raised by the petitioner,
within 08 weeks from the receipt of a certified copy of this order.
( KULDEEP TIWARI)
JUDGE
26.02.2026
Ak Sharma
Whether speaking/reasoned Yes
Whether reportable Yes/No
Legal Notes
Add a Note....