Meer Singh Yadav v. Govt. of NCT of Delhi and Anr

ORDER %

23.02.2015

¶1This petitionhas been filed by one Mr. Meer Singh Yadav to claim reimbursement of medical expenses incurred on behalf of his wife, Smt. Saroj Yadav.

1.1 However,during the pendencyof the writ petition,the husband, i.e. Mr. Meer SinghYadav, expired,and thus, the requisitesteps were taken to bring on record Smt. Saroj Yadav. Orderto that effectwas passedby this court on 1.4.2013.

¶2Briefly, insofar as the merits of the case are concerned,Smt. Saroj Yadav was admittedto Deepak MemorialHospital and Medical Research Centre (in shortDeepakMemorialHospital),which is operatedby Kailash Health Care Limited, on 28.4.2011, and was discharged, on 29.4.2011. It appears that since her conditiondeteriorated,she was referredby Deepak MemorialHospitalto a ''higher centrefor further managemenf. , Page1 of5 Signed By:RAM DATT Certify that the digital and physical file have been compared and the digital data is as per the physical file and no page is missing. fo

¶3It is not in dispute that the medical expenses incurred qua the treatmentofSmt. Saroj Yadav,whileshe was admittedto DeepakMemorial Hospital,werereimbursedby the respondent.

¶4Continuing with the narrative,on 29.4.2011,Smt. Saroj Yadav was admittedto KailashHospitaland HeartInstitute(in shortKailashHospital), which is also a unit of KailashHealth Care Limited. She was discharged from the said hospital on 18.5.2011.

¶5Therefore,the reimbursementofmedicalexpenses,which Smt. Saroj Yadav seeks, is vis-a-visa expenses incurred on her treatment, which includesroom charges,consultationchargesand other expenses,while she was admitted to Kailash Hospital.

5.1 The dischargesummarygeneratedby the said hospitalindicatesthat on admittance,whichhappened on 29.4.2011,she was immediately,shifted to the ICU for further management under the care of the consultant physician. It appearsthat the doctors,at that stage, suspectedthat she had developed"fungal infection",and, therefore,was put on broad spectrum anti-biotics.

¶6The bills in respectofwhich Smt. Saroj Yadav seeks reimbursement are appended at pages 19 to 24 (Annexure-P6-colly) and page 26 (Annexure-P8)ofthe paperbook. The detailsofthe totalamountwhichthe petitionerclaimsare advertedto in Annexure-P9,whichis appendedat page 32 of the paper book.

¶7Learnedcounselfor the petitionersays that, broadly,the respondent's objection is that the expenses incurred towards treatmentof Smt. Saroj Yadav,whileshe was in KailashHospital,cannotbe reimbursed,as the said hospital,is notan empanelledhospital. 2of5 i

7.1 This apart, an additional objection is taken, according to the learned counsel for the petitioner, is to the effect, that, there was no emergent situation, which required, admittance of Smt. Saroj Yadav to a non-empanelled hospital.

¶8Learned counsel for the petitioner says that though the respondents have relied upon Office Memorandum(page 56 of the paper book) dated

25.10.2007(in short 2007 O.M.), what requiresto be seen along with the said O.M. is a clarification issued by the respondents vide Office Memorandum dated 2.2.2010.

8.1 Learnedcounselfor the petitioner,inparticular,reliesuponparagraph 3(ii)clause(a) ofthe OfficeMemorandumdated2.2.2010.

¶9Ms Arora, in her submissions, has affirmed that the objections articulatedin paragraph7 above, are in fact the same objectionsof the respondents.

9.1 To be noted, there are no other objectionarticulatedbefore me, by Ms. Arora.

¶10I may only indicatethat insofar as the respondentshave taken the objectionsthat no emergentconditionarose which, requiredthe admittance of Smt. Saroj Yadav to a non-empanelledhospital,the said objectiondoes notappearto be tenable. The dischargesummaryissuedbothby the Deepak MemorialHospitaland KailashHospital,beliesthis objection. Immediacy and criticalityof Smt.SarojYadav'sconditionis writ large on the discharge summary.

¶11The only other question which then arises for considerationis; whether Smt.Saroj Yadav's relatives could have admitted her, in an empanelledhospital,which was closer in proximityto Deepak Memorial Page3 of5 f Hospitalas comparedto the KailashHospital.

11.1 Ms. Arora, as amatterof fact, based on clause 10(i) of 2007 O.M., contendedthat, consideringthe urgency in the matter, a referencecould have been, straightwaymade by the AuthorizedMedicalAttendant(AMA) attachedto DeepakMemorialHospital,in view of the statedcriticalityof Smt. Saroj Yadav's health status.

¶12In this context,itis necessaryto evaluatedocumentsfiled. Aperusal of the discharge summary of the two hospitals would show that both hospitals are managed by Kailash Health Care Limited.

12.1 As indicated above, the discharge summary issued by Deepak Memorial Hospital, inter alia, alludes to the following "referred to higher centre for further management."

12.2 The discharge summary of Kailash Hospital is also indicative of the fact that, it is a unit of Kailash Health Care Limited; a fact which I have alreadynoted hereinabove. Therefore,in sum and substance,what appears to have beenconveyedto Smt. Saroj Yadav's relatives,is that, sinceDeepak Memorial Hospital did not have the necessary facilities, they could access the requisitemedicalfacilities,which Smt. Saroj Yadav was in urgentneed of, at Kailash Hospital.

¶13Clause 10(i) of 2007 O.M. is indicative of the fact that, a reference can be made by the AMA at the attached dispensary or the hospital concerned, if such, a transfer is required in an emergent condition. As a matterof fact, the said clauseadvertsto the fact that the retiredbeneficiary need not approach the concerned department.

¶14Factually, reference in this case was made by Deepak Memorial Hospital,to KailashHospital. The dischargesummaryofDeepakMemorial Page4of5 \ Hospital, bears this fact out. This, in my view, entails substantive compliancewithRule 10(i)ofthe 2007 O.M. It mustbe bornein mindthat in an emergent situation,the onus is squarely on the referringhospital. Amongstotherfactors,in arrivingat adecision,the referringhospital,will possibly, have to look at the suitabilityof the other hospital i.e., the transfereehospital. In this behalf, the accessabilityto relevant medical facilitiesboth in terms ofinfrastructureand expertiseofthe treatingdoctor may have to be borne in mind by the doctor / A.M.A. of the referring hospital. Therefore,the physicaldistancebetweenthe referringhospitaland the hospitalsto which the patientis to be transferred,cannotbe the only determinative factor.

¶15In these circumstances,I am ofthe opinionthat the objectionstaken by the respondentsare not tenable in law or on facts. Accordingly,the respondentsare directedto verifythe bills submittedby Smt. Saroj Yadav, and pay, what is due to her as per the extant rules, which operate in the matter.

¶16Counselfor the petitioner,at this stage, say that he does not wish to pressthe prayermade for interestin thepetition. The saidstatementis taken on record.

¶17Needfulwillbe donewithinfourweeksfromtoday.

¶18Thepetitionis disposedof. FEBRUARY 23,2015 s.pal WP(C)-2248/20I2 rtv RAJIV SHAKDHER, J Page 5 of5

$-12 * IN THE HIGH COURT OF DELHI AT NEW DELHI + W.P.(C) 2248/2012 MEER SINGH YADAV Petitioner Through; Mr. NareshThanai,Mr. J.P. Singh and Mr. Kunal Kumar, Advs. versus GOVT. OF NCT OF DELHI AND ANR Respondents Through: Ms. Sonia Arora, Adv. CORAM: HON'BLE MR. JUSTICE RAHV SHAKDHER