- 1 - HC-KAR NC: 2025:KHC-K:2781 WP No. 201676 of 2023 IN THE HIGH COURT OF KARNATAKA, KALABURAGI BENCH DATED THIS THE 2ND DAY OF MAY, 2025 BEFORE THE HON'BLE MR. JUSTICE N.S.SANJAY GOWDA WRIT PETITION NO. 201676 OF 2023 (S-RES) BETWEEN: RAMACHANDRA, S/O KASHAPPA., AGED 52 YEARS, OCC:LIBRARY ASSISTANT, HIGH COURT OF KARNATAKA KALABURAGI BENCH, R/O:B-1, HIGH COURT STAFF QUARTERS, KALABURAGI-585 103. …PETITIONER (BY SRI. G.V.DESHPANDE., ADVOCATE) AND: 1. THE STATE OF KARNATAKA, REPRESENTED THROUGH ITS UNDER SECRETARY, DEPARTMENT OF PERSONNEL AND ADMINISTRATIVE REFORMS (SERVICE RULES-II), HEALTH AND FAMILY WELFARE, M.S.BUILDING, BENGALURU-560 001. 2. EXECUTIVE DIRECTOR, SUVARNA AROGYA SURAKSHA TRUST, 7TH FLOOR, AROGYA SOUDHA, 1ST CROSS, MAGADI ROAD, Digitally signed by KIRAN KUMAR R Location: HIGH COURT OF KARNATAKA - 2 - HC-KAR NC: 2025:KHC-K:2781 WP No. 201676 of 2023 BENGALURU-560 023. …RESPONDENTS (BY SRI. V.G.BHANU PRAKASH., AAG ALONG WITH SMT. ARATHI PATIL., AGA FOR R-1; SRI.S.H.PRASHANTH., ADVOCATE FOR R-2) THIS WRIT PETITION IS FILED UNDER ARTICLES 226 AND 227 OF THE CONSTITUTION OF INDIA, PRAYING TO QUASH LETTER BEARING NO. ¸ÀASÉå : DPÀÄPÀ/ J¸ï.J.J¸ï.n/JA.Dgï.¹/24995/2022-236 DATED 28.12.2022 ISSUED BY RESPONDENT No.2 WHICH IS AT ANNEXURE-F, ETC. THIS PETITION HAVING BEEN HEARD AND RESERVED FOR ORDERS ON 07.02.2025, COMING ON FOR PRONOUNCEMENT THIS DAY, THE COURT MADE THE FOLLOWING: CORAM: THE HON'BLE MR JUSTICE N S SANJAY GOWDA CAV ORDER 1. The petitioner, who is working as a Library Assistant in this Court, suffered an accident on 13.08.2022 when he was travelling in his two-wheeler, as a result of which, he suffered a fracture of the bicolamal tibia. It is his case that he was partially conscious, and the passersby having noticed his condition called his family members and looking at - 3 - HC-KAR NC: 2025:KHC-K:2781 WP No. 201676 of 2023 the grievous nature of injuries, he was immediately admitted to the nearby hospital, namely Kamareddy Ortho and Trauma Care Hospital, Kalaburgi. 2. On 14.08.2022, that a day after the accident, as per the advice of the Doctor, the petitioner also underwent a surgery and was ultimately discharged on 24.08.2022. 3. The petitioner thereafter submitted an application on 04.11.2022 claiming reimbursement of medical expenses of Rs.1,49,843/- which he had incurred for admission and course of treatment at Kamareddy Ortho and Trauma Care Hospital. This claim has, however, been rejected on the ground that the emergent causes indicated in the Government Order dated 05.11.2014 were not attracted and hence, he could not be reimbursed the medical expenses that he had incurred. - 4 - HC-KAR NC: 2025:KHC-K:2781 WP No. 201676 of 2023 4. The petitioner, therefore, has preferred this Writ Petition challenging the rejection of his claim and also for quashing of the Government Order dated 05.11.2014, on the basis of which his claim has been rejected. 5. During the pendency of this Writ Petition, the State Government had issued a communication to respondent No.2 that it was unable to treat the petitioner’s case as a special case and the Department had also refused to modify the Government Order dated 05.11.2014 in relation to a situation where a Government servant was unconscious and was hence entitled to be treated at a private hospital. 6. The petitioner, by way of an amendment, is also challenging this particular endorsement dated 26.07.2024, which is the basis for the Government Order dated 05.11.2014. - 5 - HC-KAR NC: 2025:KHC-K:2781 WP No. 201676 of 2023 7. The respondent No.2 i.e., Suvarna Arogya Suraksha Trust (“TRUST”) has filed its objections, in which it has stated that the case of the petitioner was evaluated as per the criteria stipulated in the Government Order dated 05.11.2014 and it was found that the petitioner had a fall from a two wheeler resulting in a fracture and there was no mention of loss of consciousness, bleeding from nose/ear, vomiting, alerted sensorium, drowsiness and loss of ocular/verbal motor response and, therefore, he did not fall within Clause 3(1) of the Government Order dated 05.11.2014 and as a consequence, his claim was rejected. 8. In short, the Trust states that in order to be eligible for reimbursement, as per the Government Order, an employee should have been unconscious at the time of the accident and for an emergency treatment, the public or passersby had taken him to a private hospital and since the petitioner had stated that he - 6 - HC-KAR NC: 2025:KHC-K:2781 WP No. 201676 of 2023 was partially conscious, his admission and treatment at a private hospital cannot be accepted for reimbursement. 9. The right of a Government servant including an employee of a High Court to claim medical coverage is governed by the Karnataka Government Servants’ (Medical Attendance) Rules, 1963 (“RULES”). These Rules entitle a Government servant to free medical treatment at a Government Hospital. A ‘Government Hospital’ has been defined under the Rules to also include the authorized hospitals, as indicated in Schedule I and II of the Act. 10. Basically, the medical attendance i.e., the medical coverage for Government servant under these Rules are to be determined with reference to the place where the Government servant falls ill and whether that is a place of his permanent residence, a place of his casual stay or a place where he is spending his - 7 - HC-KAR NC: 2025:KHC-K:2781 WP No. 201676 of 2023 leave. Even if a Government servant (Rule 4) is outside the State, he can, nevertheless, receive the medical attendance in any Government Hospital of his choice or any Hospital if there is no such Government Hospital and then recover the cost incurred in accordance with the Rules (Rule 6). 11. The Rules basically entitle the Government servant to be treated free of charge to a treatment in the Government Hospital and in case he were to incur certain expenditure even while being treated in the Government Hospital, he is entitled to claim reimbursement in accordance with the Rules. 12. The Rules, therefore, basically enable a Government servant to be treated free of charge at a Government Hospital (including an authorized institution) and in the event he were to incur any expenditure, he would also be entitled to claim reimbursement in accordance with the Rules specified. - 8 - HC-KAR NC: 2025:KHC-K:2781 WP No. 201676 of 2023 13. Rule 31 of the Rules, however, provides for ‘Relaxation of the Rules.’ In exercise of this power, the Government has issued the Government Order dated 05.11.2014, whereby principally the cap of ‘Rs.1,00,000/-’ was increased to ‘Rs.2,00,000/-’ whenever a Government servant is treated in private hospitals by treating it as a special case. The Government Order also stipulates that this reimbursement claim could be upto Rs.5,00,000/-, but this would be subject to the approval of the Hon’ble Chief Minister. 14. This entitlement to reimbursement upto either Rs.2,00,000/- or Rs.5,00,000/- is subject to certain conditions stipulated in clause 3. In this case, we are concerned with sub-clause (1) and hence reference is being made only to sub-clause (1) of clause 3 which reads as follows – “3. ¸ÀPÁðgÀzÀ ¥ÀæzsÁ£À PÁAiÀÄðzÀ²ð/PÁAiÀÄðzÀ²ðUÀ¼ÀÄ ªÉÄîÌAqÀ C¢üPÁgÀ ¥ÀævÁåAiÉÆÃd£ÉAiÀÄ£ÀéAiÀÄ ¸ÀPÁðgÀ¢AzÀ - 9 - HC-KAR NC: 2025:KHC-K:2781 WP No. 201676 of 2023 ªÀiÁ£ÀåvÉ ¥ÀqÉAiÀÄzÀ SÁ¸ÀV D¸ÀàvÉæUÀ¼À°è aQvÉì ¥ÀqÉzÀÄ gÁdå ¸ÀPÁðj £ËPÀgÀgÀÄ ªÀÄgÀÄ¥ÁªÀwUÁV ¸À°è¸ÀĪÀ J¯Áè PÉèêÀÄÄUÀ¼À£ÀÄß AiÀiÁAwæPÀªÁV ¥ÀjUÀt¸ÀzÉà C¥ÀªÁzÁvÀäPÀªÁzÀ ¥ÀæPÀgÀtªÁV ¥ÀjUÀt¹, ¸ÀPÁðj £ËPÀgÀgÀ ªÀÄvÀÄÛ CªÀgÀ PÀÄlÄA§zÀ ¸ÀzÀ¸ÀågÀ fêÀ£ÀägÀtzÀ ¸À¤ßªÉõÀzÀ°è ºÁUÀÆ F PɼÀPÀAqÀ vÀÄvÀÄð ¸ÀAzÀ¨sÀðUÀ¼À°è ªÀiÁ£ÀåvÉ ¥ÀqÉAiÀÄzÀ SÁ¸ÀV D¸ÀàvÉæUÀ¼À°è aQvÉì ¥ÀqÉzÀAvÀºÀ ¥ÀæPÀgÀtUÀ¼À£ÀÄß ªÀiÁvÀæ ¤AiÀĪÀÄ ¸Àr°¸À®Ä ¥ÀjUÀt¸ÀĪÀÅzÀÄ:-ªÉ 1. ¸ÀPÁðj £ËPÀgÀgÀÄ CxÀªÁ CªÀgÀ PÀÄlÄA§ ¸ÀzÀ¸ÀågÀÄ C¥ÀWÁvÀQÌÃqÁV ¥ÀæeÁջãÀ ¹ÜwAiÀÄ°èzÁÝUÀ, ¸ÁªÀðd¤PÀgÀÄ CxÀªÁ ¸ÉßûvÀgÀÄ vÀÄvÀÄð aQvÉìUÁV ºÀwÛgÀzÀ SÁ¸ÀV D¸ÀàvÉæAiÀÄ°è aQvÉìUÁV ¸ÉÃj¹zÀ ¸ÀAzÀ¨sÀð;” 15. As could be seen from the above, the Order contemplates that in the case of an accident if the Government servant is unconscious and the passersby or friends, in order to provide emergency medical assistance, take him to a private hospital, the sums incurred are entitled to be reimbursed, subject to the aforementioned outer limit. - 10 - HC-KAR NC: 2025:KHC-K:2781 WP No. 201676 of 2023 16. However, in order to attract this particular clause, the requirement according to the State is that the Government servant should be unconscious. 17. To put it differently, if a Government servant, who has suffered an accident is conscious or even partially conscious, and if he is rushed to a private hospital, the stand of the Government is that such a claim cannot be reimbursed. 18. In my view, this interpretation of clause 3(1) is not only irrational but patently absurd. In the case of an accident, any victim including a Government servant would be in shock and in pain. In such a traumatic situation, to expect the Government servant to request the passersby or his friends or his family members to take him to a Government Hospital or to an authorized hospital is wholly unrealistic and is clearly inconceivable. Immediately after an accident, when a victim is under severe pain and trauma, the - 11 - HC-KAR NC: 2025:KHC-K:2781 WP No. 201676 of 2023 expectation of the victim, even if it were to be a Government servant would be that he should be taken to the nearest hospital as his life would be in danger and if he is not treated immediately, the consequences of the injury would be severe or even fatal. In such a scenario to expect a Government servant to take a rational decision, in accordance with Rules to be taken to either a Government Hospital or authorized Hospital would be completely absurd. 19. It must also be kept in mind that even if the Government servant is partially conscious, such as in this case, the decision to shift such a victim would always be with the passersby or immediate family members. The decision to approach a hospital is the only thought that would be running in the minds of the victim and that decision in almost all cases would be taken by passers by or by family members. The Government cannot and should not expect an - 12 - HC-KAR NC: 2025:KHC-K:2781 WP No. 201676 of 2023 accident victim to take a conscious decision to the hospital to which he is entitled to go in order to secure free treatment. 20. When a victim is suffering from a grievous injury, the decision taken by wellwishers to rush him to the nearest hospital will have to be honoured and the Government cannot judge this decision and insist that the Government servant was not unconscious, and therefore it would be entitled to deny his claim for reimbursement. 21. If the ultimate objective of the State is to ensure that its employee is medically treated free of charge is kept in mind, the imposition of such conditions that a Government servant should be unconscious in order to entitle him to free treatment or reimbursement if he is treated at a private hospital would be arbitrary and irrational. - 13 - HC-KAR NC: 2025:KHC-K:2781 WP No. 201676 of 2023 22. The Parliament, in fact, amended Section 162 of the Motor Vehicles Act1 in the year 2019 which mandated that the Insurance Companies carrying on the business of general insurance to ensure that accident victims are treated in accordance with the provisions of the act and the schemes made under the Act, including during the golden hour. In fact, the Central Government is mandated to prepare a scheme for the cashless treatment of the victims of a motor vehicle accident during the golden hour. This statutory provision, therefore, indicates that there is legal obligation to provide immediate treatment to a victim of a motor vehicle accident. Surely, if this is the intent of the law, there cannot be a Government 1 “162. Scheme for golden hour. – (1) Notwithstanding anything contained in the General Insurance Companies (Nationalisation) Act, 1972 (57 of 1972) or any other law for the time being in force or any instrument having the force of law, the insurance companies for the time being carrying on general insurance business in India shall provide in accordance with the provisions of this Act and the schemes made under this Act for treatment of road accident victims, including during the golden hour. (2) The Central Government shall make a scheme for the cashless treatment of victims of the accident during the golden hour and such scheme may contain provisions for creation of a fund for such treatment.” - 14 - HC-KAR NC: 2025:KHC-K:2781 WP No. 201676 of 2023 order which imposes conditions for reimbursement of medical expenses incurred by a Government as a result of a motor vehicle accident. 23. In my view, therefore, clause 3 of sub-clause (1) which provides for reimbursement in respect of a Government servant who undergoes medical treatment in a private Hospital immediately after the accident will have to be quashed as being patently irrational and arbitrary. 24. Consequentially, a direction is issued to the Government to grant the claim of the petitioner for the treatment that he underwent in Kamareddy Ortho and Trauma Care Hospital within a period of one month from the date of receipt of a copy of this order. 25. Before parting with the case, it would also be necessary to issue directions to the Government to - 15 - HC-KAR NC: 2025:KHC-K:2781 WP No. 201676 of 2023 ensure that no Government servant is put to harm by virtue of the Government’s lop sided policy. 26. As stated above, the clear objective of the Rules framed by the Government is to ensure that its employees are given free treatment at a Government Hospital or at an authorized Hospital. Thus, the State has undertaken an obligation to ensure that the medical needs of its employees are taken care of, free of cost so as to assure them with a sense of social security. If this is the overwhelming object of the State, the framing of the Rules which defeat the very object of free treatment to its employees would be defeated. 27. It is to be kept in mind that the Hospitals established by the Government are essentially to cater to the needs of the lowest strata of Society who cannot afford private medical care. In this age and time, where medical care has become prohibitively - 16 - HC-KAR NC: 2025:KHC-K:2781 WP No. 201676 of 2023 expensive, the facilities that the Government provides in its hospitals should necessarily be available only to the lowest strata, who cannot afford medical care at private hospitals. 28. Judicial notice can also be taken of the fact that every hospital established by the Government is overwhelmed with demand by the poorest strata of the Society and the facilities, on offer, are also inadequate to meet the needs of our vast population. If, in such a situation the Government has, in fact, recognized this problem and has also included Hospitals, other than Government Hospitals, as authorized hospitals under the Rules, it becomes clear that the Government has candidly admitted that the facilities that it has established are not sufficient to cater to the needs of all its employees. 29. If the State Government has acknowledged this fact and has permitted its employees to take treatment at - 17 - HC-KAR NC: 2025:KHC-K:2781 WP No. 201676 of 2023 authorized hospitals, the State Government would also have to take the next step and ensure that its employees are given the freedom to choose the hospitals of their choice. 30. It has to be kept in mind that an employee of the Government can never be construed as belonging to lowest strata and by all standards, Government servants are reasonably well paid and are capable of leading a decent life style. The Government servants can, therefore, afford to contribute to their own healthcare, and not be entirely dependent only on the treatment provided by the State Government in its Hospitals. 31. In fact, the Central Government, taking into consideration the difficulties faced by its employees, has formulated a Scheme called Central Government Health Scheme (CGHS), whereby the employees also contribute for their medical care and this has - 18 - HC-KAR NC: 2025:KHC-K:2781 WP No. 201676 of 2023 resulted in the employees of the Central Government having the option of choosing hospitals of their choice with minimal restrictions and get themselves treated. The opportunity of Government employees to get treated at Private hospitals in which they bear the part of the burden would, in fact, benefit the State financially by reducing its financial cost and would also result in reducing the pressure on its scarce medical resources. 32. It is to be borne in mind that the Government employees are a class of people, who can contribute to their own healthcare and, therefore, by calling upon them to contribute to the medical care and giving them an opportunity to choose a medical care of their choice, the Government would in reality be achieving its objective of granting its employees a complete sense of social cover and security. - 19 - HC-KAR NC: 2025:KHC-K:2781 WP No. 201676 of 2023 33. It is also to be borne in mind that the Medical Attendance Rules were framed in 1963 i.e., in a situation where there was hardly any private medical facility available in the country. Over a long passage of time i.e., nearly six decades, judicial notice can be taken of the fact that since the framing of Rules of 1963, private medical infrastructure and facilities have increased by leaps and bounds and a rule which provided for free treatment at the Government Hospital would have to be adopted and amended to meet the present needs. The medical facilities available in the Government Hospital and the medical facilities available in the private hospitals are at times incomparable and the Government servant should have the choice of choosing a medical care of his choice and he should not be forced to avail of any services at the Hospital. 34. If an employee is prepared to contribute to his medical care in part, as suggested above, the overall - 20 - HC-KAR NC: 2025:KHC-K:2781 WP No. 201676 of 2023 interest of both the Government as well as that of its employee to be taken care of, it would be necessary to direct the Government to evolve a Scheme, whereby the Government servant also contributes towards his medical expenses in the same manner as has been provided under the CGHS Scheme. In fact, adopting the CGHS scheme, which has been a tried and tested scheme would solve a host of issues and reduce the dependence of the Government servants on Government medical infrastructure and resources. 35. In the alternative, the State Government should provide for the Government employees to buy an insurance policy for whatever the sum he desires, in which the Government would undertake to pay the premium for a base amount and the balance premium for remaining amount chosen by the Government servant should be borne by the Government servant. - 21 - HC-KAR NC: 2025:KHC-K:2781 WP No. 201676 of 2023 36. For example, if the Government is prepared to reimburse the medical expenditure to an extent of Rs. 5,00,000/- (or any sum which the State deems desirable), the State should pay 50% of the premium for a policy which covers medical expenses upto 5 lakhs and the Government servant would pay the remaining premium and would also have th option of buying a policy for a higher sum and bear the liability of paying premium of the higher sum. 37. This kind of a Scheme would, in fact, enable the employee to buy a higher cover by paying his own premium and thereby assuring himself of a better quality of health care for himself and his family members. 38. The Government is directed to ensure such a policy is framed in either of these lines suggested above within a period of three months from the date of receipt of a copy of this order. - 22 - HC-KAR NC: 2025:KHC-K:2781 WP No. 201676 of 2023 39. This Writ Petition is, accordingly, allowed. 40. In view of the disposal of the petition, all pending interlocutory applications, if any, stand disposed of. Sd/- (N S SANJAY GOWDA) JUDGE HNM