REPORTABLE

IN THE SUPREME COURT OF INDIA

CIVIL APPELLATE JURISDICTION

CIVIL APPEAL NO.    4384    OF 2009 (Arising Out of SLP (C) No.25258 of 2004)

The Secretary to the  Government of Haryana & Ors. … Appellants

Versus

Vidya Sagar … Respondent

J U D G M E N T

S.B. Sinha, J.

1. Leave granted.

2. The sole respondent was an employee of the State of Haryana.  He has  

since retired.  He was serving in the ‘Health Department’ of the State having  

joined services on 26.11.1961.  He retired on 7.9.1988 on health grounds.   

3. He suffered an heart attack on 15.8.2002.  He was treated in the Post  

Graduate  Institute  of  Medical  Sciences  and  Research,  Chandigarh.   He

underwent a bye-pass surgery at Fortis Heart Institute and Multi-Speciality  

Hospital, Mohali.  It is on the recognized panel of the hospitals of the State  

of  Haryana.   He  submitted  a  bill  for  a  sum  of  Rs.1,87,907.65  towards  

medical expenses borne by him for its reimbursement.

Relying on or on the basis of a circular issued by the State of Haryana  

dated  30.11.1993,  the  Department  sanctioned  payment  for  a  sum  of  

Rs.1,62,298/- only.

4. Aggrieved by the said order, the respondent filed a writ petition before  

the High Court of Punjab and Haryana.  The said writ petition was allowed,  

holding:

“We have heard learned Counsel for the parties.

Shri W.R. Dua, learned counsel for the petitioner  drew our attention to the Punjab Services (Medical  Attendance)  Rules  1940,  as  applicable  to  the  Haryana employees/pensioners and the instructions  issued by the  Haryana  Government vide circular  letter  No.  HD.HR.  No.2/82/98-IHB-III  dated  31.10.2002 to  show that  Fortis  Hospital,  Mohali  has been recognized by the Haryana Government  for  the  treatment  of  Haryana  Government  employees/Pensioners/Family Pensioners.  He then  referred to the instructions issued vide letter dated  11.8.1992  (Annexure  P.5/A)  to  show  that  heart  disease   has  been  treated  as  one  of  the  chronic  ailments and argued that the petitioner is entitled to  full  medical  reimbursement  in  terms  of  the  

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instructions issued by the Government vide letter  dated 25.8.2003.

Learned Assistant Advocate General could not put  forward  any  tangible  argument  to  controvert  the  submissions of Shri W.R. Dua.

Having  considered  the  entire  matter,  we  are  convinced  that  the  Petitioner  is  entitled  to  reimbursement of the entire expenses incurred by  him in his treatment at Fortis Hospital, Mohali and  the decision of the Respondents to pay only 75%  thereof is legally unsustainable.”

5. Mr. Manjit Singh, learned counsel appearing on behalf of the State,  

contended that the High Court committed a serious error in so far as it failed  

to give effect to the circulars issued by the State laying down the norms for  

reimbursement of the medical bill.  

6. Mrs.  Nanita  Sharma,  learned  counsel  appearing  on  behalf  of  the  

respondent,  on  the  other  hand,  urged  that  the  heart  disease  having  been  

considered  to  be  one  of  the  chronic  diseases,  the  circular  letter  dated  

28.5.2003 would prevail.

7. The  Commissioner  and  Secretary  of  the  state  of  Haryana,  Health  

Department, by a circular dated 30.11.1993 directed as under :

“I have been directed to invite your attention to the  Haryana Government letter No.2/296/86-H.R.II-III  dated  19.11.1985  (sic  1986)  and  to  say  that  the  

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decision  for  granting  recognition  to  Nivedic  Prosyek  Centre  Daulat  Singh  Zirakpur  (Punjab)  Batra  Hospital  New  Delhi  for  taking  special  treatment  to  serving  Haryana  Govt.  officers/officials/pensioners/family pensioners and  members of their family and dependants subject to  the  condition  that  the  conditions  that  the  officers/officials/pensioners  who  would  undergo  for treatment in those approved institutions will get  reimbursement at the rates of All India Institute of  Medical  Sciences (AIIMS) New Delhi/PGI.  The  75% of the excess expenditure in comparative to  AIIMS will  also  be  re-imbursed  and  the  rest  of  25% will be borne by the claimant himself.  If a  Patient avails extra comfort as single room instead  of  double  occupy  room  facilities,  as  such  the  whole expenditure will  be borne by the claimant  himself.

2. This  has  the  concurrence  of  the  finance  department vide their memo No.56/80A/86-6 Fin.  Deptt. TT/229-1532-2297 dated 13.10.93.

3. This  order  will  come  into  force  from  the  date of issue.”

8. However, it appears that on or about 28.5.2003, the same authority,  

referring to an earlier memo dated 11.8.1992, directed as under :

“I have been directed to draw your attention on the  above subject to the memo No.2/160/89-1 H.B. III  dated  11.8.1992  whereby  reimbursement  on  the  out  door  treatment  of  chronic  diseases  upto  maximum  of  Rs.6,000/-  to  the  Haryana  Govt.  employees/officers/pensioners/family  members  of  pensioners  used  to  be  allowed.   The  matter  regarding  removing  the  maximum  limit  for  reimbursement  of  expenses  incurred  on  the  

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treatment  of  chronic  diseases  has  been  under  consideration of the Government keeping in view  the  interest  of  employees  and  pronouncements  delivered by the Courts in this respect.  Now the  Government  has  decided  that  in  view  of  instructions dated 11.8.1992 reimbursement of all  the expenses incurred on the treatment of chronic  diseases outdoor as well indoor shall be allowed.

All  the  other  conditions  issued  on  11.8.92  shall  remain in force.

These instructions will take effect from the issue of  this letter.

The  concurrence  of  the  Finance  Department  has  been  obtained  vide  their  endst.  No.70/20/2000-6  H.A. III/1450 dated 28.5.2003.”

9. The High Court, as noticed hereinbefore, was of the opinion that heart  

disease having been treated to be one of the chronic ailments in terms of the  

circular letter dated 11.8.1992, the respondent was entitled to reimbursement  

of the medical bill in its entirety.   

We  see  no  reason  to  differ  with  the  views  of  the  High  Court.  

Although  the  circular  dated  28.5.2003  does  not  expressly  supersede  the  

circular letter dated 30.11.1993, but the latter having been issued subsequent  

to the former and in relation to a particular category of disease, namely, the  

chronic diseases, shall prevail over the earlier general circular letter.  The  

said circular letter dated 28.5.2003 brings within its umbrage not only the  

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expenses  incurred  for  the  treatment  of  chronic  disease  outdoor  but  also  

indoor.   In  that  view  of  the  matter,  the  impugned  judgment  must  be  

sustained.

10. Mr. Singh had relied upon a decision of this Court in State of Punjab  

& Ors. v.  Ram Lubhaya Bagga & Ors. [(1998) 4 SCC 117] to urge that  

obligation on the part of the State to foot the medical bill of its employee can  

be restricted by framing appropriate  rules and/or by issuance of requisite  

circular.   No  exception  to  the  dicta  laid  down  therein  can  be  taken.  

However, the said decision is itself an authority for the proposition that the  

State can change its policy decision from time to time.  Once the State in its  

magnanimity adopted a decision that the medical  bills in their entirety in  

connection with the heart diseases shall be reimbursed, the authorities of the  

State being bound thereby were obligated to comply therewith.   

11. The  question  has  also  been  considered  by  this  Court  in  State  of  

Karnataka & Anr. v.  R. Vivekananda Swamy [(2008) 5 SCC 328] in the  

following terms :

“24. In  view  of  the  aforementioned  settled  principles of law there cannot be any doubt that the  Rules  regarding reimbursement  of  medical  claim  of an employee when he obtains treatment from a  hospital of his choice can be made limited.  Such  Rules furthermore having been framed the proviso  

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to  Article  309  of  the  Constitution  of  India  constitute conditions of service in terms whereof  on the one hand the employee would be granted  the  facility  of  medical  aid  free  of  cost  from the  recognized government hospital and on the other  he,  at  his  option,  may  get  himself  treated  from  other  recognized  hospitals/institutions  subject  of  course to the condition that the reimbursement by  the State therefor would be limited.”   

12. For the reasons aforementioned, there is no merit in the appeal.  It is  

dismissed  accordingly  with  costs.   Counsel’s  fee  assessed  at  Rs.10,000/-  

(Rupees ten thousand only).

……………………….J.  [S.B. Sinha]

`

……………………..…J.     [Deepak Verma]

New Delhi; July 16, 2009

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