CWP-29586 IN THE 212 Ansuia Devi State of Punjab CORAM: Present : HARPREET SINGH BRAR 1. of the Constitution of India with a prayer for issuance of writ in the nature of mandamus directing the respondents to consider and release the medical reimbursement of Rs.12,80,213/ along with interest @ 18% per annum on delayed payments. 2. husband of the petitioner was employed in the Ayurvedic Unani Office, Gurdaspur, run by State of P Pensioner Health Insurance Scheme (PGEPHIS, hereinafter be referred as ‘scheme’), reimbursement. Unfortunately, husband of the petitioner suffered serious 1 29586-2017 IN THE HIGH COURT OF PUNJAB AND HARYANA AT CHANDIGARH CWP Date of Decision: Ansuia Devi VERSUS Punjab and others HON'BLE MR. JUSTICE HARPREET SINGH BRAR Ms. Ekta Thakur with Ms. Shikha Mr. Vikas Arora, DAG, Punjab. Mr. PIP Singh, Advocate for respondent No.2. Mr. Nikhil Sehrawat, Advocate Advocate for respondent No.3. **** HARPREET SINGH BRAR, J. (Oral) The present writ petition has been filed under Article 226/227 of the Constitution of India with a prayer for issuance of writ in the nature of mandamus directing the respondents to consider and release the medical reimbursement of Rs.12,80,213/- as approved on 30.05.2017 (Annexure P along with interest @ 18% per annum on delayed payments. Learned counsel for the petitioner husband of the petitioner was employed in the Ayurvedic Unani Office, Gurdaspur, run by State of Punjab and as per Pensioner Health Insurance Scheme (PGEPHIS, hereinafter be referred as the husband of the petitioner was entitled to the medical reimbursement. Unfortunately, husband of the petitioner suffered serious HIGH COURT OF PUNJAB AND HARYANA AT CHANDIGARH CWP-29586-2017 Date of Decision: August 21, 2025 .....Petitioner VERSUS .....Respondents HARPREET SINGH BRAR Ekta Thakur with Ms. Shikha, Advocate for the petitioner. Mr. Vikas Arora, DAG, Punjab. PIP Singh, Advocate for respondent No.2. vocate for Mr. Ashwani Talwar, . The present writ petition has been filed under Article 226/227 of the Constitution of India with a prayer for issuance of writ in the nature of mandamus directing the respondents to consider and release the medical ed on 30.05.2017 (Annexure P-1) along with interest @ 18% per annum on delayed payments. Learned counsel for the petitioner inter alia contends that the husband of the petitioner was employed in the Ayurvedic Unani Office, unjab and as per Punjab Govt. Employees and Pensioner Health Insurance Scheme (PGEPHIS, hereinafter be referred as the husband of the petitioner was entitled to the medical reimbursement. Unfortunately, husband of the petitioner suffered serious , 2025 .....Petitioner .....Respondents for Mr. Ashwani Talwar, The present writ petition has been filed under Article 226/227 of the Constitution of India with a prayer for issuance of writ in the nature of mandamus directing the respondents to consider and release the medical 1) contends that the husband of the petitioner was employed in the Ayurvedic Unani Office, Punjab Govt. Employees and Pensioner Health Insurance Scheme (PGEPHIS, hereinafter be referred as the husband of the petitioner was entitled to the medical reimbursement. Unfortunately, husband of the petitioner suffered serious PUNEET CHAWLA 2025.08.28 11:15 I attest to the accuracy and integrity of this document CWP-29586 injuries in a motor vehicular accident and initially he was treated at Amandeep Hospital, Pathankot on 09.12.2016. Thereafter, the condition of husband of petitioner deteriorated and referred to DMC, Ludhiana on 17.12.2016. In spite of providing best trea petitioner died on 30.12.2016 at DMC Hospital, Ludhiana. Due to sudden demise of husband of petitioner, as she was in shock and grief submit the claim of medical reimbursement within 30 days under Clause 11.6 of Scheme. 3. her claim was rejected, however, vide Annexure P for submission of claim of medical reimbu and her claim for medical reimbursement w the medical reimbursement was approved, however she was only paid an amount of Rs.4,46,884/ interest on account of delay in releasing the amount towards medical reimbursement only in a non-empanelled hospital. 4. submits that the claim of husband of petitioner was considered and settled in accordance with the schem and submits that the petitioner is only entitled to the reimbursement at the rates applicable either CGHS rates and petitioner is not entitled for reimbursement as the treatment has been taken from non private hospital, as such, the amount determined strictly in terms of the 2 29586-2017 injuries in a motor vehicular accident and initially he was treated at Amandeep Hospital, Pathankot on 09.12.2016. Thereafter, the condition of husband of petitioner deteriorated and referred to DMC, Ludhiana on 17.12.2016. In spite of providing best trea petitioner died on 30.12.2016 at DMC Hospital, Ludhiana. Due to sudden demise of husband of petitioner, as she was in shock and grief submit the claim of medical reimbursement within 30 days under Clause 11.6 of Scheme. Learned counsel for the petitioner further submits that initially her claim was rejected, however, vide Annexure P for submission of claim of medical reimbursement on humanitarian grounds and her claim for medical reimbursement w the medical reimbursement was approved, however she was only paid an amount of Rs.4,46,884/- instead of Rs.12,80,213/ interest on account of delay in releasing the amount towards medical reimbursement only for the reason that husband of the petitioner was treated empanelled hospital. On the other hand, learned counsel for the respondent No.3 submits that the claim of husband of petitioner was considered and settled in accordance with the scheme. Further, refers to Clause 11.6 of the scheme and submits that the petitioner is only entitled to the reimbursement at the rates applicable either CGHS rates and petitioner is not entitled for reimbursement as the treatment has been taken from non private hospital, as such, the amount determined strictly in terms of the injuries in a motor vehicular accident and initially he was treated at Amandeep Hospital, Pathankot on 09.12.2016. Thereafter, the condition of husband of petitioner deteriorated and referred to DMC, Ludhiana on 17.12.2016. In spite of providing best treatment, the husband of the petitioner died on 30.12.2016 at DMC Hospital, Ludhiana. Due to sudden demise of husband of petitioner, as she was in shock and grief could not submit the claim of medical reimbursement within 30 days under Clause Learned counsel for the petitioner further submits that initially her claim was rejected, however, vide Annexure P-3, delay was condoned rsement on humanitarian grounds and her claim for medical reimbursement was recommended. Thereafter, the medical reimbursement was approved, however she was only paid an instead of Rs.12,80,213/-, further without any interest on account of delay in releasing the amount towards medical for the reason that husband of the petitioner was treated On the other hand, learned counsel for the respondent No.3 submits that the claim of husband of petitioner was considered and settled in e. Further, refers to Clause 11.6 of the scheme and submits that the petitioner is only entitled to the reimbursement at the rates applicable either CGHS rates and petitioner is not entitled for reimbursement as the treatment has been taken from non-empanelled private hospital, as such, the amount determined strictly in terms of the injuries in a motor vehicular accident and initially he was treated at Amandeep Hospital, Pathankot on 09.12.2016. Thereafter, the condition of husband of petitioner deteriorated and referred to DMC, Ludhiana on tment, the husband of the petitioner died on 30.12.2016 at DMC Hospital, Ludhiana. Due to sudden could not submit the claim of medical reimbursement within 30 days under Clause Learned counsel for the petitioner further submits that initially 3, delay was condoned rsement on humanitarian grounds as recommended. Thereafter, the medical reimbursement was approved, however she was only paid an , further without any interest on account of delay in releasing the amount towards medical for the reason that husband of the petitioner was treated On the other hand, learned counsel for the respondent No.3 submits that the claim of husband of petitioner was considered and settled in e. Further, refers to Clause 11.6 of the scheme and submits that the petitioner is only entitled to the reimbursement at the rates applicable either CGHS rates and petitioner is not entitled for lled private hospital, as such, the amount determined strictly in terms of the PUNEET CHAWLA 2025.08.28 11:15 I attest to the accuracy and integrity of this document CWP-29586 scheme has already been reimbursed and prays for dismissal of the writ petition. 5. judgment of Hon’ble Suprem India passed in Writ Petition (C) No.694 wherein it was held that during the treatment from the non hospital, if amount spent on the treatment is required to be released. Further, learned counsel submits that urgency in admitting the patient in hospital, claim of petitioner cannot be denied because the hospital is point of time the preservation of the human life was of the paramount consideration. 6. record with their able assistance. 7. had met with an accident and remained admitted in two different hospitals. The controversy involved in the present case is of non differential medical reimbursement because the pe admitted in private hospitals which were not empanelled. The condition of the husband of the petitioner was serious and it was the case of emergency. It is not the case of the respondents that the claim of the husband of petitioner is not supported by the hospital record. reimbursement ought not to be dismissed merely because the claimant underwent treatment and admitted in a non 3 29586-2017 scheme has already been reimbursed and prays for dismissal of the writ In rebuttal, learned counsel for the petitioner relies upon the judgment of Hon’ble Supreme Court in Shiva Kant Jha Versus Union of India passed in Writ Petition (C) No.694 wherein it was held that during the treatment from the non hospital, if based on genuine reasons, the medical reimbursement of the amount spent on the treatment is required to be released. Further, learned counsel submits that urgency in admitting the patient in hospital, claim of petitioner cannot be denied because the hospital is point of time the preservation of the human life was of the paramount consideration. I have heard learned counsel for the parties and perused the record with their able assistance. It is not in dispute that unfortunately husband of the petitioner had met with an accident and remained admitted in two different hospitals. The controversy involved in the present case is of non differential medical reimbursement because the pe admitted in private hospitals which were not empanelled. The condition of the husband of the petitioner was serious and it was the case of emergency. It is not the case of the respondents that the claim of the husband of s not supported by the hospital record. reimbursement ought not to be dismissed merely because the claimant underwent treatment and admitted in a non scheme has already been reimbursed and prays for dismissal of the writ In rebuttal, learned counsel for the petitioner relies upon the Shiva Kant Jha Versus Union of India passed in Writ Petition (C) No.694-2015, decided on 13.04.2018 wherein it was held that during the treatment from the non-empanelled on genuine reasons, the medical reimbursement of the amount spent on the treatment is required to be released. Further, learned counsel submits that urgency in admitting the patient in hospital, claim of petitioner cannot be denied because the hospital is not empanelled, as at that point of time the preservation of the human life was of the paramount I have heard learned counsel for the parties and perused the It is not in dispute that unfortunately husband of the petitioner had met with an accident and remained admitted in two different hospitals. The controversy involved in the present case is of non-payment of differential medical reimbursement because the petitioner had remained admitted in private hospitals which were not empanelled. The condition of the husband of the petitioner was serious and it was the case of emergency. It is not the case of the respondents that the claim of the husband of s not supported by the hospital record. The claim for medical reimbursement ought not to be dismissed merely because the claimant underwent treatment and admitted in a non-empanelled. In such cases, the scheme has already been reimbursed and prays for dismissal of the writ In rebuttal, learned counsel for the petitioner relies upon the Shiva Kant Jha Versus Union of 2015, decided on 13.04.2018, empanelled on genuine reasons, the medical reimbursement of the amount spent on the treatment is required to be released. Further, learned counsel submits that urgency in admitting the patient in hospital, claim of not empanelled, as at that point of time the preservation of the human life was of the paramount I have heard learned counsel for the parties and perused the It is not in dispute that unfortunately husband of the petitioner had met with an accident and remained admitted in two different hospitals. payment of titioner had remained admitted in private hospitals which were not empanelled. The condition of the husband of the petitioner was serious and it was the case of emergency. It is not the case of the respondents that the claim of the husband of The claim for medical reimbursement ought not to be dismissed merely because the claimant empanelled. In such cases, the PUNEET CHAWLA 2025.08.28 11:15 I attest to the accuracy and integrity of this document CWP-29586 test of essentiality and emergency comes into play, w medical procedure was undergone by the claimant in an emergency, on the advice of a doctor based on medical record, the reimbursement for the same must be made. Not only is the preservation of human life instinctive, but it also forms a part of Article 21 of the Constitution of India, and therefore, it shall always retain the highest priority. 8. availability of timely medical care to those in need. As such, it cannot expect the citizens to refrain from availing timely care, merely for the reason of non-empanelment of the hospital. Such conduct on the part of the State does not satisfy the criteria of fairness and reasonableness and therefore, amounts to a violation of the fund Constitution of India. Reliance in this regard can be placed on the judgments rendered by a two Judge bench of the Hon’ble Supreme Court in Singh vs. State of Punjab and others(1996) 2 SCC 336, through Justice M.M. Punchhi, the following was opined: “8. The policy, providing recognition for treatment of open heart surgery in the Escorts, specifically came to be examined by a Division Bench of the Punjab and Haryana High C.W.P. No. 13493 of 1992 titled as through Secretary, Health and Family Welfare Punjab, Civil Secretariat, Chandigarh and others, 1994(1) SCT 552 (P&H). petitioner to medical reimbursement was accepted wh save his life he had got himself operated upon in the Escorts, and the plea of the State that he could be paid rates as prevalent in the AIIMS was rejected. Special Leave Petition No. 22024 of 1995 against the 4 29586-2017 test of essentiality and emergency comes into play, w medical procedure was undergone by the claimant in an emergency, on the advice of a doctor based on medical record, the reimbursement for the same must be made. Not only is the preservation of human life instinctive, but it orms a part of Article 21 of the Constitution of India, and therefore, it shall always retain the highest priority. Moreover, the State bears an obligation to ensure the availability of timely medical care to those in need. As such, it cannot expect he citizens to refrain from availing timely care, merely for the reason of empanelment of the hospital. Such conduct on the part of the State does not satisfy the criteria of fairness and reasonableness and therefore, amounts to a violation of the fundamental rights enshrined in Article 21 of the Constitution of India. Reliance in this regard can be placed on the judgments rendered by a two Judge bench of the Hon’ble Supreme Court in Singh vs. State of Punjab and others(1996) 2 SCC 336, through Justice M.M. Punchhi, the following was opined: “8. The policy, providing recognition for treatment of open heart surgery in the Escorts, specifically came to be examined by a Division Bench of the Punjab and Haryana High C.W.P. No. 13493 of 1992 titled as Sad through Secretary, Health and Family Welfare Punjab, Civil Secretariat, Chandigarh and others, 1994(1) SCT 552 (P&H). decided on 6.10.1993, wherein the claim of the then writ petitioner to medical reimbursement was accepted wh save his life he had got himself operated upon in the Escorts, and the plea of the State that he could be paid rates as prevalent in the AIIMS was rejected. Special Leave Petition No. 22024 of 1995 against the test of essentiality and emergency comes into play, which dictates that if the medical procedure was undergone by the claimant in an emergency, on the advice of a doctor based on medical record, the reimbursement for the same must be made. Not only is the preservation of human life instinctive, but it orms a part of Article 21 of the Constitution of India, and therefore, it Moreover, the State bears an obligation to ensure the availability of timely medical care to those in need. As such, it cannot expect he citizens to refrain from availing timely care, merely for the reason of empanelment of the hospital. Such conduct on the part of the State does not satisfy the criteria of fairness and reasonableness and therefore, amounts amental rights enshrined in Article 21 of the Constitution of India. Reliance in this regard can be placed on the judgments rendered by a two Judge bench of the Hon’ble Supreme Court in Surjit Singh vs. State of Punjab and others(1996) 2 SCC 336,whereby, speaking through Justice M.M. Punchhi, the following was opined: “8. The policy, providing recognition for treatment of open heart surgery in the Escorts, specifically came to be examined by a Division Bench of the Punjab and Haryana High Court at Chandigarh in Sadhu R. Pall v. State of Punjab through Secretary, Health and Family Welfare Punjab, Civil Secretariat, Chandigarh and others, 1994(1) SCT 552 decided on 6.10.1993, wherein the claim of the then writ petitioner to medical reimbursement was accepted when in order to save his life he had got himself operated upon in the Escorts, and the plea of the State that he could be paid rates as prevalent in the AIIMS was rejected. Special Leave Petition No. 22024 of 1995 against the hich dictates that if the medical procedure was undergone by the claimant in an emergency, on the advice of a doctor based on medical record, the reimbursement for the same must be made. Not only is the preservation of human life instinctive, but it orms a part of Article 21 of the Constitution of India, and therefore, it Moreover, the State bears an obligation to ensure the availability of timely medical care to those in need. As such, it cannot expect he citizens to refrain from availing timely care, merely for the reason of empanelment of the hospital. Such conduct on the part of the State does not satisfy the criteria of fairness and reasonableness and therefore, amounts amental rights enshrined in Article 21 of the Constitution of India. Reliance in this regard can be placed on the judgments Surjit peaking “8. The policy, providing recognition for treatment of open heart surgery in the Escorts, specifically came to be examined by a Division h in hu R. Pall v. State of Punjab through Secretary, Health and Family Welfare Punjab, Civil Secretariat, Chandigarh and others, 1994(1) SCT 552 decided on 6.10.1993, wherein the claim of the then writ en in order to save his life he had got himself operated upon in the Escorts, and the plea of the State that he could be paid rates as prevalent in the AIIMS was rejected. Special Leave Petition No. 22024 of 1995 against the PUNEET CHAWLA 2025.08.28 11:15 I attest to the accuracy and integrity of this document CWP-29586 said decision was dismissed by judgments of the High case are : xxx 10. It is otherwise important to bear in mind that self preservation of one's life is the necessary concomitant of the right to life enshrined in Article precious and inviolable. The importance and validity of the duty and right to self criminal law… 11. The appellant therefore had the right to take steps in self preservation. He did not have to stand in queue before the Medical Board, the manning and assembling of which, bare meetings difficult to happen. The appellant also did in queue in the Government hospital of AIIMS and could go elsewhere to an alternate hospital as per policy. When the State itself has brought the Escorts on the recognised list, it is futile for it to contend that the appellant could in n claim cannot on that basis be allowed, on suppositions. the contrary…” 5 29586-2017 said decision was dismissed by this judgments of the High Court following the decision in Sadhu R. Pall's case are : (1) C.W.P. No. 18562 of 1992 decided on 10.5.95 titled Kohli v. State of Punjab and others, 1995(4) SCT 280 (P&H) (2) C.W.P. No. 260 of 1995, decided on 30.5.1995 titled Ra Mohan Duggal v. State of Punjab and others (DB) (3) C.W.P. No. 5669 of 1994 decided on 4.9.94 titled Prem Singh Gill v. State of Punjab and others; (4) 1995(4) SCT 816 (P&H) : 1995 (III) Punjab Law Report 529 titled Tarlok Chander v. State of Punjab etc. (SB); (5) 1996(2) SCT 148 (P&H) : 1995 (III), Punjab Law Reporter 682 titled Mrs. Surya Pandit v. State of Punjab and others xxx 10. It is otherwise important to bear in mind that self preservation of one's life is the necessary concomitant of the right to life enshrined in Article 21 of the Constitution of India precious and inviolable. The importance and validity of the duty and right to self-preservation has a species in the right of self defence in criminal law… 11. The appellant therefore had the right to take steps in self preservation. He did not have to stand in queue before the Medical Board, the manning and assembling of which, bare meetings difficult to happen. The appellant also did in queue in the Government hospital of AIIMS and could go elsewhere to an alternate hospital as per policy. When the State itself has brought the Escorts on the recognised list, it is futile for it to contend that the appellant could in no event have gone to the Escorts and his claim cannot on that basis be allowed, on suppositions. contrary…” this Court on 2.2.1994. The other following the decision in Sadhu R. Pall's (1) C.W.P. No. 18562 of 1992 decided on 10.5.95 titled K.L. Kohli v. State of Punjab and others, 1995(4) SCT 280 (P&H); C.W.P. No. 260 of 1995, decided on 30.5.1995 titled Ravi Mohan Duggal v. State of Punjab and others (DB) C.W.P. No. 5669 of 1994 decided on 4.9.94 titled Gill v. State of Punjab and others; 1995(4) SCT 816 (P&H) : 1995 (III) Punjab Law Report 529 titled Tarlok Chander v. State of Punjab etc. (SB); and 1996(2) SCT 148 (P&H) : 1995 (III), Punjab Law Reporter 682 titled Mrs. Surya Pandit v. State of Punjab and others (SB) xxx xxx 10. It is otherwise important to bear in mind that self preservation of one's life is the necessary concomitant of the right to life enshrined in India , fundamental in nature, sacred, precious and inviolable. The importance and validity of the duty and preservation has a species in the right of self defence in 11. The appellant therefore had the right to take steps in self preservation. He did not have to stand in queue before the Medical Board, the manning and assembling of which, bare-facedly, makes its meetings difficult to happen. The appellant also did not have to stand in queue in the Government hospital of AIIMS and could go elsewhere to an alternate hospital as per policy. When the State itself has brought the Escorts on the recognised list, it is futile for it to contend o event have gone to the Escorts and his claim cannot on that basis be allowed, on suppositions. We think to on 2.2.1994. The other following the decision in Sadhu R. Pall's K.L. vi C.W.P. No. 5669 of 1994 decided on 4.9.94 titled 1995(4) SCT 816 (P&H) : 1995 (III) Punjab Law Report 1996(2) SCT 148 (P&H) : 1995 (III), Punjab Law Reporter (SB) 10. It is otherwise important to bear in mind that self preservation of one's life is the necessary concomitant of the right to life enshrined in , fundamental in nature, sacred, precious and inviolable. The importance and validity of the duty and preservation has a species in the right of self defence in 11. The appellant therefore had the right to take steps in self preservation. He did not have to stand in queue before the Medical facedly, makes its not have to stand in queue in the Government hospital of AIIMS and could go elsewhere to an alternate hospital as per policy. When the State itself has brought the Escorts on the recognised list, it is futile for it to contend o event have gone to the Escorts and his We think to PUNEET CHAWLA 2025.08.28 11:15 I attest to the accuracy and integrity of this document CWP-29586 9. admitted in hospital due to severe injuries on vital organs and u died. The test of essentiality and emergency stands satisfied. 10. are directed to medical procedure undergone by husband o three months from the date of receiving a certified copy of this order. 11. disposed of. August 21, 2025 P.C 6 29586-2017 In the matter at hand, the husband of the petitioner remained admitted in hospital due to severe injuries on vital organs and u died. The test of essentiality and emergency stands satisfied. Accordingly, the present petition is allowed. The respondents are directed to make payment of remaining medical reimbursement for the medical procedure undergone by husband o three months from the date of receiving a certified copy of this order. Pending miscellaneous application(s), if any, shall also stands disposed of. August 21, 2025 Whether speaking/reasoned. : Whether Reportable. : In the matter at hand, the husband of the petitioner remained admitted in hospital due to severe injuries on vital organs and ultimately he died. The test of essentiality and emergency stands satisfied. Accordingly, the present petition is allowed. The respondents payment of remaining medical reimbursement for the medical procedure undergone by husband of petitioner within a period of three months from the date of receiving a certified copy of this order. Pending miscellaneous application(s), if any, shall also stands (HARPREET SINGH BRAR) JUDGE Yes/No Yes/No In the matter at hand, the husband of the petitioner remained ltimately he Accordingly, the present petition is allowed. The respondents payment of remaining medical reimbursement for the f petitioner within a period of Pending miscellaneous application(s), if any, shall also stands (HARPREET SINGH BRAR) PUNEET CHAWLA 2025.08.28 11:15 I attest to the accuracy and integrity of this document