1 2025:CGHC:58479 NAFR HIGH COURT OF CHHATTISGARH AT BILASPUR WPS No. 2256 of 2023 1 - Rajendra Prasad Tiwari S/o Lt. Uma Prasad Tiwari Aged About 52 Years Designation - Asi (Radio), Unit - Bhilai Zone, At - Police Radio Headquarter, New Raipur Chhattisgarh ... Petitioner(s) versus 1 - State Of Chhattisgarh Through Director General Of Police, Police Headquarters Atal Nagar, Naya Raipur Chhattisgarh 2 - Additional Director General Of Police Police Headquarters, Atal Nagar, Naya Raipur Chhattisgarh 3 - Superintendent Of Police (Telecommunication) Bhiali Zone, Bhilai, District Durg Chhattisgarh ... Respondent(s) (Cause-title is taken from Case Information System) For Petitioner : Mr. Lukesh Kumar Mishra, Advocate For State : Mr. Devesh G. Kela, Panel Lawyer SB- Hon'ble Shri Justice Amitendra Kishore Prasad Order on Board 02/12/2025 1. The petitioner has filed this writ petition seeking following reliefs :- “10.1 Kindly pass appropriate order(s) and direct the Respondents to release the reimbursement sought by the petitioner at the earliest. 10.2. Any other relief/direction that the Court may deem fit in the facts and circumstances of the case.” Digitally signed by SHAYNA KADRI 2 2. Facts of the case, in a nutshell, are that the petitioner is a Government employee presently serving as ASI (Radio) at Unit Bhilai, Police Radio Headquarters, under the respondent authorities. In 2015, the petitioner’s daughter suffered severe injuries in a road accident and initially underwent prolonged treatment at Raipur; however, despite years of medical intervention, her condition failed to improve satisfactorily. Consequently, the petitioner submitted an application on 27.05.2019 seeking permission to take his daughter to Yashoda Hospital, Hyderabad, for advanced treatment. Respondent No. 3, vide communication dated 30.05.2019, forwarded the petitioner’s application to the Joint Director-cum-Superintendent of Dr. Bhimrao Ambedkar Hospital for necessary consideration. It is noteworthy that Yashoda Hospital, Hyderabad, from where the petitioner sought treatment for his daughter, is duly included in the State Government’s approved list of hospitals situated outside Chhattisgarh. Further, acting on the petitioner’s request, the Civil Surgeon of the District Hospital issued a certificate on 04.09.2019 recommending and approving treatment expenditure amounting to Rs. 3,31,380/-. Despite these facts, the respondent authorities arbitrarily refused to grant medical reimbursement on the ground that the treatment obtained by the petitioner’s daughter did not qualify as an “emergency,” overlooking the petitioner’s timely application and the prior approvals granted by competent authorities. Aggrieved by the unjust denial, the petitioner has approached this Court by way of the present writ petition. 3. Learned counsel for the petitioner submits that, in terms of the medical reimbursement policies governing State Government employees, the 3 petitioner is fully entitled to reimbursement of the medical expenses incurred for the treatment of his daughter. It is urged that the petitioner, being a low-wage employee, has suffered severe financial hardship solely due to the unjustified inaction of the respondent authorities. Despite the fact that Yashoda Hospital, Hyderabad is duly included in the State Government’s list of approved hospitals outside the State, the respondents have arbitrarily rejected the petitioner’s legitimate claim. Learned counsel for petitioner further submits that this Court, in Khuku Biswas v. State of Chhattisgarh, WPS No. 6240/2021, has reiterated that the right to health is an integral part of Article 21 of the Constitution, and that provisions relating to medical reimbursement must be interpreted liberally to ensure access to affordable and life- saving treatment. The Court in that case held that even in the absence of prior intimation within the prescribed 48 hours, post-facto sanction must be considered where the circumstances indicate an emergency or urgent medical necessity. Drawing strength from the said judgment, learned counsel for the petitioner argues that the petitioner’s daughter was in a critical condition, had not responded to prolonged treatment in Raipur, and therefore required immediate specialized treatment at Hyderabad, for which the petitioner had duly informed the respondents and obtained requisite recommendations from competent authorities. However, without appreciating the urgency of the situation and the certificate issued by the Civil Surgeon approving the treatment cost, the respondents mechanically rejected the reimbursement claim. Such an action, it is contended, is arbitrary, unreasonable and violative of the petitioner’s fundamental right to health under Article 21 of the Constitution. 4 4. Learned State counsel opposes the submission made by learned counsel for petitioner and would submit that the petition is devoid of merit and liable to be dismissed at the threshold. It is pointed out that although the petitioner’s daughter sustained injuries in a road accident in 2015 and received treatment at Raipur for nearly four years, the petitioner chose to obtain further treatment outside the State, at Yashoda Hospital, Hyderabad, only in 2019. While the Civil Surgeon approved a part of the medical bill, reimbursement cannot be released without post-facto sanction under Rule 11 of the Chhattisgarh Civil Services (Medical Attendance) Rules, 2013. The petitioner’s case was duly examined by the Specialist Committee constituted under the Rules, which found no emergency circumstances justifying out-of-State treatment after a prolonged period of local treatment, and therefore declined post-facto sanction. The decision was communicated in 2019 and reaffirmed in 2022 upon further verification. In absence of the mandatory post- facto sanction, the petitioner is not entitled to any reimbursement, and the present petition deserves dismissal. 5. I have heard learned counsel for the parties and perused the material available on record. 6. The foundational facts are undisputed. The petitioner’s daughter suffered grievous injuries in a road accident in 2015 and remained under continuous treatment at Raipur for nearly four years without satisfactory improvement. The petitioner thereafter applied on 27.05.2019 seeking permission for advanced treatment at Yashoda Hospital, Hyderabad, an institution duly included in the list of approved hospitals recognized by the State Government. The 5 petitioner’s application was duly forwarded by the department on 30.05.2019, and subsequently, the Civil Surgeon issued a certificate dated 04.09.2019 approving the treatment and certifying medical expenditure of Rs. 3,31,380/-. Despite these undisputed facts, the respondents refused reimbursement solely on the ground that the case did not constitute an “emergency” as contemplated for post-facto sanction under Rule 11 of the Chhattisgarh Civil Services (Medical Attendance) Rules, 2013. The Specialist Committee rejected the petitioner’s claim on the premise that treatment outside the State, after several years of local treatment, could not be considered emergent. 7. This Court finds such reasoning to be arbitrary, mechanical, and contrary to the spirit of the Rules as well as binding constitutional principles. The material on record clearly demonstrates that the petitioner had duly informed the authorities, sought permission in advance, and obtained the Civil Surgeon’s recommendation approving the treatment as also the quantified expenditure. When the competent medical authority of the State certifies the treatment and its necessity, the subsequent administrative refusal on a hyper- technical interpretation is wholly unjustified. 8. Furthermore, this Court in Khuku Biswas v. State of Chhattisgarh, WPS No. 6240/2021, has categorically held that the right to health is inseparable from Article 21 of the Constitution, and that claims for medical reimbursement must be examined with a liberal and humane approach, keeping in view the financial vulnerability of Government servants and the imperative of life- saving treatment. 6 9. It was further held that post-facto sanction cannot be denied merely due to procedural lapses when the medical condition itself reflects urgency or the need for specialized treatment not available locally. In the present case, the petitioner’s daughter had remained under treatment at Raipur for four years without improvement, clearly indicating the necessity for specialized treatment outside the State. The respondents have not disputed the seriousness of her condition, the necessity of referral, or the fact that Yashoda Hospital is a recognized institution. Once the petitioner fulfilled the substantive requirements and the competent medical authority approved the expenditure, denial of reimbursement on the rigid ground that the situation did not constitute an “emergency” is not only irrational but defeats the very purpose of Rule 11, which exists precisely to ensure that genuine cases are not denied relief due to technicalities. The Specialist Committee’s conclusion is therefore held to be unsustainable in law. Its approach fails to appreciate that emergencies in medical matters are not confined to sudden events but also include situations where a patient’s prolonged suffering and lack of recovery necessitate immediate specialized intervention. The denial of post-facto sanction and consequent reimbursement in such circumstances is contrary to constitutional guarantees and settled judicial principles. 10. In view of the above analysis, this Court is of the considered opinion that the refusal of post-facto sanction and the consequent denial of medical reimbursement to the petitioner is arbitrary, unreasonable, violative of Article 21, and cannot be sustained. 11. Accordingly, the writ petition is allowed. 7 12. The communication denying post-facto sanction and reimbursement is hereby quashed. The respondents are directed to release the reimbursable medical amount of Rs. 3,31,380/-, as approved by the Civil Surgeon in certificate dated 04.09.2019, within a period of 60 days from the date of receipt of this order. In the event the amount is not released within the stipulated time, the petitioner shall be entitled to interest at the rate of 6% per annum from the date of this judgment until actual payment. No order as to costs. Sd/- (Amitendra Kishore Prasad) Shayna JUDGE