High CourtDivision Bench2011-03-02Appeal allowed; High Court and Single Judge jud...

State of Rajasthan v. Mahesh Kumar Sharma

Case / Petition Number:Civil Appeal No. 2278 of 2011

Neutral Citation:2011 (3) S.C.R. 489

Case Details & Bench

Court: High Court
Hon'ble Judges: J.M. Panchal
H.L. Gokhale
Judgment Date: 2011-03-02
Court Decision / Holding: Appeal allowed. The High Court’s judgment and the Single Judge’s order are set aside; the writ petition is dismissed. The State will not recover the amount already paid or any amounts paid under Shankarial’s judgment in similar circumstances. The legal position is that Rule 7 applies only to diseases for which treatment is not available in the State, and since heart surgery is available within Rajasthan, full reimbursement cannot be justified. The judgment emphasizes that reimbursements must be in line with the Rules and the recognized Institutes in Appendix II, and notes that Shankarial’s case stands overruled for future cases. Costs: none.
Final Disposition: Appeal allowed; High Court and Single Judge judgments set aside; writ petition dismissed; no costs; government not to reimburse beyond statutory framework; Shankarial’s judgment overruled for future cases

Parties to the Case

Appellants / Petitioners

State of Rajasthan

Respondents

Mahesh Kumar Sharma

Legal Representation & Advocates

Counsels for Petitioners

• Dr. Manish Singhvi
• D.K. Devesh
• Milind Kumar

Counsels for Respondents

• Anupam Mishra
• Jenis V. Francis
• V.J. Francis

Case Synopsis & Summary

This is a Supreme Court Civil Appeal (Civil Appeal No. 2278 of 2011) involving the State of Rajasthan challenging a High Court judgment on medical reimbursement under the Rajasthan Civil Services (Medical Attendance) Rules, 1970. The respondent, a District & Sessions Court employee in Balotra, Rajasthan, suffered a heart ailment while on leave and underwent bypass surgery at Escorts Heart Institute, Delhi. He sought full reimbursement of medical expenses from the State. The State reimbursed only up to Rs 50,000 under the Rules, and the writ petition filed by the employee was allowed by the Single Judge and later affirmed by the Division Bench of the Rajasthan High Court, leading to this Special Leave petition. The core legal issue is whether Rule 6 (medical attendance and treatment outside Rajasthan) or Rule 7 (treatment of a disease for which treatment is not available in the State) governs such cases, and whether full reimbursement can be granted where heart surgery is allegedly available in Rajasthan. The appellant contends Rule 6 applies to treatment outside the State and Rule 7 pertains to unavailable treatment, and that full reimbursement based on Rule 7 is unwarranted. The respondent argues for broader reimbursement, relying on earlier judgments and recognized outside-institutions. The Supreme Court held that treatment of heart surgery is available in Rajasthan, so Rule 7 cannot justify full reimbursement; it overruled Shankarlal’s judgment (which had permitted broader reimbursements) and affirmed that reimbursements must follow the statutory rules and budgetary limits. The appeal is allowed, the High Court’s decision is set aside, the writ petition is dismissed, and there is no order as to costs; the court also clarified that Shankarial’s case stands overruled for future cases and that governments need not recover amounts already paid. The judgment emphasizes that state resources must be allocated within the framework of the Rules and Appendix-II recognition, guiding future reimbursements and expressly declaring that Shankarial’s judgment is overruled for subsequent cases. A final direction states that the government will not recover amounts already paid under the earlier interpretation. The decision thus narrows the scope of medical reimbursement to what is provided in the Rules and applicable Appendix-II recognitions and reinforces financial-resource constraints on such reimbursements.

Provisions of Law Cited

Rajasthan Civil Services (Medical Attendance) Rules, 1970 – Rule 6Rajasthan Civil Services (Medical Attendance) Rules, 1970 – Rule 7Rajasthan Civil Services (Medical Attendance) Rules, 1970 – Rule 6(1)Rajasthan Civil Services (Medical Attendance) Rules, 1970 – Rule 7(1)Appendix II (recognition of institutes) and related office memoranda (25 August, 1989)

Submissions & Arguments

Contentions of Appellants / Petitioners

The State argues that Rule 6 governs medical attendance and treatment outside Rajasthan and Rule 7 applies only to diseases for which treatment is not available in the State. It asserts that the treatment for heart surgery is available in Rajasthan, so full reimbursement under Rule 7 cannot be invoked. The High Court erred by relying on Rule 7(1) and by granting full reimbursement based on Shankarlal’s judgment, which is no longer correct law. Reimbursements must be limited to what is provided by the Rules and the statutory framework, and Appendices recognizing institutes. The government previously reimbursed amounts up to the specified limit and should not adopt broader interpretations that undermine the Rules. Shankarial’s case is overruled and the legal position must be applied prospectively.

Contentions of Respondents

The respondent contends for full reimbursement of medical expenses incurred for heart surgery performed outside the State, arguing that the procedures and recognition (Escort Heart Institute, Delhi) justify outside treatment when necessary. He relies on previous judgments and seeks reliance on prior practice that allowed broader reimbursement. The respondent asserts that the Rules and Appendix-II should be interpreted to permit necessary medical treatment outside the State when required.

Cited Precedents (2)

Case Name	Citation	Treatment	Explanation
Shankarial v. State of Rajasthan	2000 3 WLC (Raj.) 585	Overruled	The judgment overruled the Shankarial decision that had permitted broader medical reimbursements beyond the Rule 6/Rule 7 framework.
State of Punjab and Others v. Ram Lubhaya Bagga and Others	(1998) 4 SCC 117	Positive	Cited to support the principle that government medical facilities are subject to budgetary limits and the rules for reimbursement; the Court follows this approach to limit reimbursements to the statutory framework.

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Extracted Judgment Text

Exact text extracted from official judgment records.

_..,. # ·'[2011) 3 S.C.R 489 ... "· STATE OF· RAJASTHAN · 't · ·· • A _V._ MAHESH KUMAR SHARMA (Civil Appeal No. 2278 of 2011) · MARCH 2, 2011 [J.M. PANCHAL. AND . H.L. GOKHALE, ' . . JJ.] . . ' "· - ' " B , , _Rajasthan Civil Services (Medical Attendance) Rules, 1970: rr._ 6 _and 7_ ·- _Employee of Rajasthan District Court got operated for heart siJrgery_in.Esoorts Heart Institute, New Delhi_ C . - _Claim for re-imbursemerit Of medical expenses_ - _Held: He is entitled to medical expenses to_ a _limited extent permissible_ - _in the rules High Court erred in granting full re-imbursement by relying upon r. 7 since it cannot be said that treatment for heart surgery was not available in_ State _of Rajasthan._ D D The respondent was an employee in the District Court at Balotra, Rajaf:>than. He had gone to Uttaranchal on leave where he suffered a heart ailment. On his way back to Balotra, he got admitted in the Escort Heart Institute in New Delhi and was operated for by-pass E surgery. He claimed reimbursement of the full medical expenses from the State of Rajasthan. The State Government accepted his request to a limited extent and granted him reimbursement upto an amount of Rs. _50,0001·_ which was permissible as per the Rajasthan Civil F the respondent filed a writ petition which was allowed by Services (Medical Attendance) Rules, 1970. Aggrieved, ,. , . the High Court and full re-lmbursement was granted. In the instant appeal, it was contended for the G appellant that 'the High Court had erred In relying upon Rule 7 as against Rule 6 thereof; Rule 6 applies to a situation where an employee goes outside the Sta.te and falls sick; and Rule 7 deals with a situation where a 489 H H - - ## 490 SUPREME COURT REPORTS ## [2011) 3 S.C.R. A Government servant Is not in a position to obtain the necessary medical treatment for the disease In the State of Rajasthan which Is a different situation and In which case he Is permitted the treatment in the hospitals mentioned In Appendlx-11 of the Rules. ## B ## Allowing the appeal, the Court HELD: Rule 7 of the Rajasthan Civil Services (Medical Attendance) Rules, 1970 deals with treatment of a disease for which treatment Is not available In the State C of Rajasthan.·Certalnly It cannot be contended and It Is not so contended by the respondent that treatment for heart surgery is not available in the State of Rajasthan. Rule 7(1) lttelf points out that such Institute can be 0[approached ][for ][surgery ][but ][only for which treatment le ] not available In Rajasthan. The High Court erred In relying upon Rule 7(1) and in granting full reimbursement of the expenses which were incurred by the employee concerned while taking treatment In the Escorts Heart Institute, Delhi. The Government has formulated E necessary rules permitting the reimbursement of medical expenses In certain situations and upto a certain limit. The Government has been reimbursing the necessary expenditure as permitted by the rules uniformly. It will, therefore, not be proper for a Government employee or F for his relatives to claim reimbursement of medical expenees otherwise than what was provided In the RulM. However, the respondent has already been paid the amount which wae directed under the Judgment of Single G Judge of the High Court and that the respondent has subsequently retired from the service. The relmburetment was done In view of the then prevalent Interpretation of the relevant rules in *Shanlcarllal'• c•••· In the facts and circumstances of the case, th• appellant H - - . . STATE OF RAJASTHAN _v._ MAHESH "KUMAR 491 .. . . . . SHARMA.. . ' ; goverrnrtent Y,111 not recover 'the amount .which hai been. A. paid to the respondent, nor will the government recover any amount which has been similarly paid to other employees seeking such medical reimbursement under *Shankarlal's judgment which was prevalent so far. [Paras 7, 8 and 10] [493-E-G; 494-F-G; 495-B·D] B _Shankarial v. State of Rajasthan_ 2000 3 WLC (Raj.) 585 .:.. overruled. · · _State of Punjab and Others v. Ram Lubhaya Baggs and_ C _Othera_ (1998) 4 SCC 117 - referred to. , . Case Law .Reference: 2000 3· WLC .(Raj.) 685 overruled Para 5 (1998) 4 sec 117 referred to Para 8 O CIVIL APPELLATE JURISDICTION : Civil Appeal No. 2278 of 2011. From the Judgment & Order dated 05.09.2007 of the High Court of Judicature for Rajastha at Jodhpur in 0.8. Civil Special E Appeal No. 749 of 2007. Dr. Manish Singhvi, D.K. Devesh, Milind Kumar for the · Appellant. F- Anupam Mishra, Jenis V. Fancis, V.J. Francis for .the Respondent. The Judgment of the Court was deliv~red by ## GOKHAl,..E, J, 1. I-eave granted. ~. This 1;1ppe.Etl ~Y $PE!Oial le~ve by the Sl~te of Rajasthan is preferred. against ~h~ judgment dated 6t'1 September, 2007 of a Division Bench c:>f the High Court of Judicature for Rajasthan at Jodhpur in O.B. Civil Special Appeal No. 749 of H -- ## 492 SUPREME COURT REPORTS [2011) 3 S.C.R. A 2007 dismissing the appeal filed by the appellant against the judgment and order passed by a learned Single Judge of that Court dated 12th September, 2006 in Civil Writ Petition No. 2611 of 2006. ## B 3. The facts giving rise to the present appeal are thus:- The respondent was an employee working in the District & Sessions Court at Balotra, Rajasthan. He had gone to Uttaranchal on leave where he suffered a heart ailment. On his way back to Balotra, he suddenly fell ill and got admitted in the C Escort Heart Institute in New Delhi and was operated for bypass surgery. He claimed the reimbursement of the full medical expenses from the State of Rajasthan. The State Government accepted his request to a limited extent and granted him reimbursement upto an amount of Rs. 50,000/- which was D permissible as per the Rules. 4. The respondent felt aggrieved and hence filed a writ petition which was allowed by the learned Single Judge and the appeal therefrom was dismissed by the Division Bench and E hence this appeal by special leave by the State of Rajasthan. 5. The Division Bench as well as the Single Judge have relied upon a judgment of a Division Bench of the Rajasthan High Court viz Shankarial Vs. State of Rajasthan reported in 2000 3 WLC (Raj.) 585. What had happened in that case was F that the.wife of the appellant had similarly gone along with him outside Rajasthan where she had suffered a heart problem. She was taken to Escort Heart Institute in New Delhi where she was operated. The reimbursement of the expenditure of her surgery was declined by the Government. She filed a writ G petition which was allowed by the Division Bench. 6. The learned counsel for the appellant points out that the Division Bench of the High Court had erred in relying upon Rule 7 of the Rajasthan Civil Services (Medical Attendance) Rules, H 1970 as against Rule 6 thereof. He points out that the Rule 6 ## STATE OF RAJASTHAN _v._ MAHESH KUMAR 493 SHARMA [H.L. GOKHALE, J.] of those rules is the relevant rule which applies to a situation where an. employee goes outside the state and falls sick. Rule 7 deals·with a situation where a Government servant is not in a position to obtain the necessary medical treatment for the desease in the State of Rajasthan which is a different situation and in which case he is permitted the treatment in the. hospitals which are mentioned in Appendix-1 t of the Rules. Rule 6(1), according to him, is the relevant rule which reads as under:. " A B . 6. Medical attendance and treatment outside Rajasthan:- c ' (1) A Government servant including members of his family posted to a station or sent on duty or spending leave or otherwise at a station outside Rajasthan in India and who falls ill shall be entitled to free medical attendance and treatment as an. indoor and outdoor patient in a hospital D maintained by the Central Government or other .State Government on the scale and conditions which would be admissible to him under these rules, had he been on duty · or on leave in Rajasthan. E 7. As stated above, Rule 7 deals with the treatment of a desease for which treatment is not available in the State of Rajasthan. Certainly it cannot be contended and it is not so contended by the respondent that treatment for a heart surgery is not available in the State of Rajasthan. The learned counsel for the respondent contended that the Escort Heart Institute, New Delhi has been included in the Appendix 11 by the office memorandum dated 25th August, 1989 and has been approved and recognized by State of Rajasthan. Rule 7(1) itself points out that such institute can be approached for surgery but only for which treatment is not available in Rajasthan. Rule 7(1) reads as under: F G 7. Treatment of a disease for which treatment is not available in the State :- :. H - - 494 SUPREME COURT REPORTS [2011) 3 S.C.R. - A (1) A Government servant and the members of his famlly suffering from a disease for which treatment is not 8"allabla in any Government Hospital in the State shall be entiUed to medical attendance and treatment to the extent Indicated In sub rule (2) of this rule in a Hospital/Institution - B outside the State recognised by the Government, provided that it is certified by the Principal of a Medical College/ Director of Medical & Health Services on the basis of opinion of the Authorised Medical Attendant to the effect that the treatment of a particular disease from which the - c patient is suffering is not available in any Government hospital in the State and it is considered absolutely essential for the recovery of the patient to have treatment at a hospital outside the State. This being the position, in our view, the learned Single D Judge as well as the Division Bench and the earlier Division Bench which decided _Shankarial's_ case (supra) erred in relying upon Rule 7(1) and granting full reimbursement of the expenses which were incurred by the employee concerned while taking treatment in the Escort Heart Institute, Delhi. E 8. In this connection it will be profitable to refer to the judgment of a Bench of three Judges of this Court in _State of Punjab and Others Vs. Ram Lubhaya Bagga and Others_ reported in (1998) 4 SCC 117 where the Bench has laid down F that the Government would be justified in limiting the medical facilities to the extent it is permitted by its financial resources. In the instant case, the Government has formulated necessary rules permitting the reimbursement of medical expenses in certain situations and upto a certain limit. The Government has G been reimbursing the necessary expenditure as permitted by the rules uniformly. It will, therefore, not be proper for a Government employee or for his relatives to claim reimbursement of medical expenses otherwise than what was provided in the Rules. H 9. In the circumstances, we allow this appeal and set aside STATE OF RAJASTHAN _v._ MAHESH KUMAR 495 SHARMA [H.L. GOKHALE, J.] .. ' . the Judgment rendered by the DiVision Bench as well as by the A · , .Slngte Judge, :The writ,petitior1 filed by;the ·respondentwill'stand ; cUsmissed.ri: . · · · . · . _:_ ' _: ":_ ·' · · ' ·· · c. •! ··. . . ·. _:_ . .'. f. ·~:·~ ··.,.~· • . . ' 1 O. Although, this appeal· is being allowed, we. ere informed ·that the respondent has already been paid the amount which 8 was directed under the Judgment dated 12.9.2006 of the Single Judge in January, 2008 and that the respondent has subsequently retired from the service. It is clear that the reimbursement was done in view of the then prevent interpretation of the relevant rules in _Shankarilal's_ case (supra). C This being the position, in the facts and circumstances of the case, the appellant government will not recover the amount which has been paid to the respondent, nor will the government recover any amount which has been similarly paid to other employees seeking such medical reimbursement under Shankarial's judgment which was prevalent so far. However, it D is now made clear that the judgment in Shankarial's case does not lay down the correct law, and stands over-ruled. The legal position as explained herein above shall apply hereafter. 11. The appeal is allowed and disposed of accordingly. However, there spall be no order as to the costs. E D.G. Appeal allowed.