Holding

Rule 7 does not apply where the required treatment is available in Rajasthan; reimbursement is limited under Rule 6, and the earlier Shankarial judgment is overruled.

Summary

Mahesh Kumar Sharma, a Rajasthan District Court employee, underwent heart bypass surgery in Delhi and claimed full reimbursement of medical expenses from the State. The State, applying the Rajasthan Civil Services (Medical Attendance) Rules, 1970, reimbursed only Rs. 50,000 as permitted. The High Court, relying on Rule 7, ordered full reimbursement, which the State appealed. The Supreme Court held that Rule 7 applies only when a treatment is unavailable in Rajasthan, which was not the case for heart surgery; therefore, Rule 6 governs and limits reimbursement. The Court set aside the High Court's order, upheld the limited reimbursement, and overruled the earlier Shankarial precedent, while refusing to recover amounts already paid.

Issues considered

Whether Rule 7 of the Rajasthan Civil Services (Medical Attendance) Rules, 1970 applies to a government servant who undergoes treatment outside the state when the treatment is available within the state.
Whether the State can recover the amount already reimbursed under the earlier interpretation of the rules.
Whether the precedent set in Shankarial v. State of Rajasthan should be overruled.

Legislation cited

Rajasthan Civil Services (Medical Attendance) Rules, 1970s. Rule 6, s. Rule 7

Subjects

medical reimbursementgovernment employee benefitsinterpretation of service rulesoverruling precedentRajasthan Civil Services RulesRule 6Rule 7

Judgment

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_..,.

·'[2011) 3 S.C.R 489

STATE OF· RAJASTHAN · 't · ·· • "·
...
A
V.
MAHESH KUMAR SHARMA
(Civil Appeal No. 2278 of 2011)
· MARCH 2, 2011
B
[J.M. PANCHAL. AND
.
H.L. GOKHALE, . . JJ.]
' '
. "· -.'
, ,
"
Rajasthan Civil Services (Medical Attendance) Rules,
1970: rr. 6 and 7 ·- Employee of Rajasthan District Court got
operated for heart siJrgery_in.Esoorts Heart Institute, New Delhi C
. - Claim for re-imbursemerit Of medical expenses - Held: He
is entitled to medical expenses to a limited extent permissible
in the rules - High Court erred in granting full re-imbursement
by relying upon r. 7 since it cannot be said that treatment for
heart surgery was not available in State of Rajasthan. D
The respondent was an employee in the District
Court at Balotra, Rajaf:>than. He had gone to Uttaranchal
on leave where he suffered a heart ailment. On his way
back to Balotra, he got admitted in the Escort Heart
Institute in New Delhi and was operated for by-pass E
surgery. He claimed reimbursement of the full medical
expenses from the State of Rajasthan. The State
Government accepted his request to a limited extent and
granted him reimbursement upto an amount of Rs.
50,0001· which was permissible as per the Rajasthan Civil F
Services (Medical Attendance) Rules, 1970. Aggrieved, ,. ,

the respondent filed a writ petition which was allowed by
. the High Court and full re-lmbursement was granted.
In the instant appeal, it was contended for the G
appellant that 'the High Court had erred In relying upon
Rule 7 as against Rule 6 thereof; Rule 6 applies to a
situation where an employee goes outside the Sta.te and
falls sick; and Rule 7 deals with a situation where a
489 H
--
490 SUPREME COURT REPORTS [2011) 3 S.C.R.

A Government servant Is not in a position to obtain the
necessary medical treatment for the disease In the State
of Rajasthan which Is a different situation and In which
case he Is permitted the treatment in the hospitals
mentioned In Appendlx-11 of the Rules.
B
Allowing the appeal, the Court

HELD: Rule 7 of the Rajasthan Civil Services
(Medical Attendance) Rules, 1970 deals with treatment of
a disease for which treatment Is not available In the State
C of Rajasthan.·Certalnly It cannot be contended and It Is
not so contended by the respondent that treatment for
heart surgery is not available in the State of Rajasthan.
Rule 7(1) lttelf points out that such Institute can be
approached for surgery but only for which treatment le
0 not available In Rajasthan. The High Court erred In relying
upon Rule 7(1) and in granting full reimbursement of the
expenses which were incurred by the employee
concerned while taking treatment In the Escorts Heart
Institute, Delhi. The Government has formulated
E necessary rules permitting the reimbursement of medical
expenses In certain situations and upto a certain limit.
The Government has been reimbursing the necessary
expenditure as permitted by the rules uniformly. It will,
therefore, not be proper for a Government employee or
F for his relatives to claim reimbursement of medical
expenees otherwise than what was provided In the RulM.
However, the respondent has already been paid the
amount which wae directed under the Judgment of Single
G Judge of the High Court and that the respondent has
subsequently retired from the service. The
relmburetment was done In view of the then prevalent
Interpretation of the relevant rules in *Shanlcarllal'• c•••·
In the facts and circumstances of the case, th• appellant
H
--
. .

STATE OF RAJASTHAN v. MAHESH "KUMAR 491
.. . . . . SHARMA.. . ' ;

goverrnrtent Y,111 not recover 'the amount .which hai been. A.
paid to the respondent, nor will the government recover
any amount which has been similarly paid to other
employees seeking such medical reimbursement under
*Shankarlal's judgment which was prevalent so far.
[Paras 7, 8 and 10] [493-E-G; 494-F-G; 495-B·D] B
Shankarial v. State of Rajasthan 2000 3 WLC (Raj.) 585
.:.. overruled. · ·

State of Punjab and Others v. Ram Lubhaya Baggs and C
Othera (1998) 4 SCC 117 - referred to. ,.
Case Law .Reference:
2000 3· WLC .(Raj.) 685 overruled Para 5
(1998) 4 sec 117 referred to Para 8 O
CIVIL APPELLATE JURISDICTION : Civil Appeal No.
2278 of 2011.
From the Judgment & Order dated 05.09.2007 of the High
Court of Judicature for Rajastha at Jodhpur in 0.8. Civil Special E
Appeal No. 749 of 2007.
Dr. Manish Singhvi, D.K. Devesh, Milind Kumar for the ·
Appellant.
F-
Anupam Mishra, Jenis V. Fancis, V.J. Francis for .the
Respondent.
The Judgment of the Court was deliv~red by
GOKHAl,..E, J, 1. I-eave granted.
~. This 1;1ppe.Etl ~Y $PE!Oial le~ve by the Sl~te of Rajasthan
is preferred. against ~h~ judgment dated 6t'1 September, 2007
of a Division Bench c:>f the High Court of Judicature for
Rajasthan at Jodhpur in O.B. Civil Special Appeal No. 749 of H
--
492 SUPREME COURT REPORTS [2011) 3 S.C.R.

A 2007 dismissing the appeal filed by the appellant against the
judgment and order passed by a learned Single Judge of that
Court dated 12th September, 2006 in Civil Writ Petition No.
2611 of 2006.

3. The facts giving rise to the present appeal are thus:-
B
The respondent was an employee working in the District
& Sessions Court at Balotra, Rajasthan. He had gone to
Uttaranchal on leave where he suffered a heart ailment. On his
way back to Balotra, he suddenly fell ill and got admitted in the
C Escort Heart Institute in New Delhi and was operated for by-
pass surgery. He claimed the reimbursement of the full medical
expenses from the State of Rajasthan. The State Government
accepted his request to a limited extent and granted him
reimbursement upto an amount of Rs. 50,000/- which was
D permissible as per the Rules.
4. The respondent felt aggrieved and hence filed a writ
petition which was allowed by the learned Single Judge and
the appeal therefrom was dismissed by the Division Bench and
E hence this appeal by special leave by the State of Rajasthan.
5. The Division Bench as well as the Single Judge have
relied upon a judgment of a Division Bench of the Rajasthan
High Court viz Shankarial Vs. State of Rajasthan reported in
2000 3 WLC (Raj.) 585. What had happened in that case was
F that the.wife of the appellant had similarly gone along with him
outside Rajasthan where she had suffered a heart problem.
She was taken to Escort Heart Institute in New Delhi where she
was operated. The reimbursement of the expenditure of her
surgery was declined by the Government. She filed a writ
G petition which was allowed by the Division Bench.
6. The learned counsel for the appellant points out that the
Division Bench of the High Court had erred in relying upon Rule
7 of the Rajasthan Civil Services (Medical Attendance) Rules,
H 1970 as against Rule 6 thereof. He points out that the Rule 6
-- STATE OF RAJASTHAN v. MAHESH KUMAR 493
SHARMA [H.L. GOKHALE, J.]
of those rules is the relevant rule which applies to a situation A
where an. employee goes outside the state and falls sick. Rule
7 deals·with a situation where a Government servant is not in
a position to obtain the necessary medical treatment for the
desease in the State of Rajasthan which is a different situation
and in which case he is permitted the treatment in the. hospitals B
which are mentioned in Appendix-1 t of the Rules. Rule 6(1),
according to him, is the relevant rule which reads as under:-
. "
. 6. Medical attendance and treatment outside
Rajasthan:-
c
'
(1) A Government servant including members of his family
posted to a station or sent on duty or spending leave or
otherwise at a station outside Rajasthan in India and who
falls ill shall be entitled to free medical attendance and
treatment as an. indoor and outdoor patient in a hospital D
maintained by the Central Government or other .State
Government on the scale and conditions which would be
admissible to him under these rules, had he been on duty
· or on leave in Rajasthan.
E
7. As stated above, Rule 7 deals with the treatment of a
desease for which treatment is not available in the State of
Rajasthan. Certainly it cannot be contended and it is not so
contended by the respondent that treatment for a heart surgery
is not available in the State of Rajasthan. The learned counsel
for the respondent contended that the Escort Heart Institute,
F
New Delhi has been included in the Appendix 11 by the office
memorandum dated 25th August, 1989 and has been
approved and recognized by State of Rajasthan. Rule 7(1) itself
points out that such institute can be approached for surgery but
only for which treatment is not available in Rajasthan. Rule 7(1) G
reads as under:
7. Treatment of a disease for which treatment is not
available in the State :- :.
H
494 SUPREME COURT REPORTS [2011) 3 S.C.R.
--
A (1) A Government servant and the members of his famlly
suffering from a disease for which treatment is not
8"allabla in any Government Hospital in the State shall be
entiUed to medical attendance and treatment to the extent
Indicated In sub rule (2) of this rule in a Hospital/Institution
B outside the State recognised by the Government, provided
that it is certified by the Principal of a Medical College/
Director of Medical & Health Services on the basis of
opinion of the Authorised Medical Attendant to the effect
that the treatment of a particular disease from which the
c patient is suffering is not available in any Government
hospital in the State and it is considered absolutely
essential for the recovery of the patient to have treatment
at a hospital outside the State.
This being the position, in our view, the learned Single
D Judge as well as the Division Bench and the earlier Division
Bench which decided Shankarial's case (supra) erred in relying
upon Rule 7(1) and granting full reimbursement of the expenses
which were incurred by the employee concerned while taking
treatment in the Escort Heart Institute, Delhi.
E
8. In this connection it will be profitable to refer to the
judgment of a Bench of three Judges of this Court in State of
Punjab and Others Vs. Ram Lubhaya Bagga and Others
reported in (1998) 4 SCC 117 where the Bench has laid down
F that the Government would be justified in limiting the medical
facilities to the extent it is permitted by its financial resources.
In the instant case, the Government has formulated necessary
rules permitting the reimbursement of medical expenses in
certain situations and upto a certain limit. The Government has
G been reimbursing the necessary expenditure as permitted by
the rules uniformly. It will, therefore, not be proper for a
Government employee or for his relatives to claim
reimbursement of medical expenses otherwise than what was
provided in the Rules.
H 9. In the circumstances, we allow this appeal and set aside
-- STATE OF RAJASTHAN v. MAHESH KUMAR
SHARMA [H.L. GOKHALE, J.] .. ' .
495

the Judgment rendered by the DiVision Bench as well as by the A
·,.Slngte Judge, :The writ,petitior1 filed by;the ·respondentwill'stand
; cUsmissed.ri: . · · · . · . :' : ": ·' · · ' ·· ·
c. •! ··. . . ·. : . .'. f. ·~:·~ ··.,.~· •
.. ' 1O. Although, this appeal· is being allowed, we. ere informed
·that the respondent has already been paid the amount which 8
was directed under the Judgment dated 12.9.2006 of the
Single Judge in January, 2008 and that the respondent has
subsequently retired from the service. It is clear that the
reimbursement was done in view of the then prevent
interpretation of the relevant rules in Shankarilal's case (supra). C
This being the position, in the facts and circumstances of the
case, the appellant government will not recover the amount
which has been paid to the respondent, nor will the government
recover any amount which has been similarly paid to other
employees seeking such medical reimbursement under
Shankarial's judgment which was prevalent so far. However, it D
is now made clear that the judgment in Shankarial's case does
not lay down the correct law, and stands over-ruled. The legal
position as explained herein above shall apply hereafter.
11. The appeal is allowed and disposed of accordingly. E
However, there spall be no order as to the costs.
D.G. Appeal allowed.