1998 (2) TMI 585 - SC - Indian Laws

Summary

Issues Involved:
1. Entitlement towards medical expenses of Punjab government employees and pensioners.
2. Validity of the new policy dated 13th February, 1995.
3. Violation of Article 21 of the Constitution of India.
4. Reimbursement at AIIMS rates vs. actual expenses incurred at private hospitals.

Summary:

Entitlement towards medical expenses:
The primary issue was the entitlement of Punjab government employees and pensioners towards medical expenses as per the relevant rules and Government policy. The Court examined whether the reimbursement for medical expenses incurred in non-governmental hospitals is admissible under the new policy dated 13th February, 1995, which replaced the old policy of 1991.

Validity of the new policy dated 13th February, 1995:
The new policy stipulates that reimbursement for medical expenses incurred in private hospitals is only admissible if the treatment is not available in any government hospital, and requires a no objection certificate from the Civil Surgeon or Director of Health Services. The Court upheld the new policy, stating that it is more liberal as it allows employees to choose any private hospital in India but limits reimbursement to rates fixed by the Director, Health and Family Welfare, Punjab, or the actual expenditure, whichever is less.

Violation of Article 21 of the Constitution of India:
The respondents argued that the new policy violated Article 21, which guarantees the right to life, as it restricted reimbursement for life-saving treatments. The Court reiterated that the right to life includes the right to live with human dignity and that the State has an obligation to provide medical facilities. However, the Court also acknowledged the financial constraints of the State and held that the new policy is not arbitrary or unreasonable and does not violate Article 21.

Reimbursement at AIIMS rates vs. actual expenses incurred at private hospitals:
The Court considered whether the new policy's restriction of reimbursement to AIIMS rates is justified. It concluded that no State can have unlimited resources, and the policy of fixing rates for reimbursement is reasonable and not violative of constitutional rights. The Court emphasized that the State's obligation to provide medical facilities must be balanced with its financial capacity.

Judgment Details:
1. SLP (C) Nos. 13167/97 and 12418/97: The respondents are entitled to reimbursement only at AIIMS rates for surgeries conducted after the introduction of the new policy.
2. SLP (C) Nos. 12143/97 and 12144/97: The appeals were dismissed as the amount claimed had already been paid at Escorts rates.
3. SLP (C) No. 11968/97: The respondent is entitled to the difference between what was paid and the rate admissible at Escorts due to the specific circumstances of the case.

The Court upheld the new policy dated 13th February, 1995, and set aside the impugned High Court orders to the extent indicated. The appeals were disposed of accordingly, with no order as to costs.