1. The present petition has been filed with a prayer for reimbursement of some part of medical claim which was not reimbursed to the petitioner on the count that the Department was under an obligation to reimburse the amount only to the extent as permissible in terms of the Rajasthan Civil Services (Medical Attendance) Rules, 2013 (hereinafter referred to as, ‘the Rules of 2013’).

2. The case of the petitioner is that because of a cardiac problem, he was admitted to Mathura Das Mathur Hospital, Jodhpur, and was operated. Two DE Stents were implanted and total expenses incurred qua the complete medical treatment were Rs.2,19,501/-. A certificate to the effect that the treatment was of the most emergent nature was also submitted but qua the total medical claim of Rs.2,19,501/-, an amount of Rs.96,019/- was only reimbursed.

3. Learned counsel for the petitioner submitted that in terms of the ratio laid down in the case of Sumer Singh vs. State; S.B. Civil Writ Petition No.7675/2014 and State of Rajasthan & Ors. vs. Smt. Mohan Kanwar Bhansali; D.B. Special Appeal Writ No.246/2019, as the treatment was undertaken by the petitioner in a government hospital and the stents as implanted were also purchased from a shop run under the Medical Relief Care Society, the complete amount of the claim was liable to be reimbursed.

Per contra, learned counsel for the respondents submitted that Appendix IX of the Rules of 2013 specifically prescribe the maximum limit of reimbursement and the department has already reimbursed in terms of the said Rules.

4. Heard learned counsel for the parties and perused the material available on record.

Appendix-IX of the Rules of 2013 (as amended in the year 2014) provides as under:

S. No.	Item	No. of Stents	Extent of Reimbursement (Rs.)
1	DE Stent	1	Rs. 70,500/-
2	Bare Metal Stent	1	Rs. 44,000/-
3	DE Stent (1) & Bare Metal Stent (1)	2	Rs. 1,14,500/- (70,500/- + 44,000/-)
4	Bare Metal Stent (2)	2	Rs. 82,500/-
5	DE Stent (1) & Bare Metal Stent (2)	3	Rs. 1,53,000/- (70,500/- + 42,500/-)
6	Bare Metal Stent (3)	3	Rs. 1,10,000/-
7	Balloon Intra Aortic	1	Rs. 28,000/-

Note : 1. If more than one DE Stent is implanted than reimbursement for additional DE Stent shall be allowed upto the limit of Bare Metal Stent only.

2. The reimbursement for more than three stents shall not be allowed.”

In the case of Sumer Singh (supra), the Division Bench of this Court held as under:

“On the basis of the aforesaid discussion this Court of the opinion that the treatment taken in a Government Hospital has to be completely reimbursed to the petitioner as the language of the scheme is very clear that the person concerned shall be legitimately entitled to complete reimbursement in the Government Hospital. The fundamental right under the Article 21of the Constitution of India envisages that right to life includes right to medical and health facilities within the stipulated statutory provisions. The rising health care costs have always been detrimental to proper treatment to a large part of the population. The State has always remained alive to the situation and taken care of such citizens by providing Ample Schemes and provisions for proper medical health care. The Government Servant working or retired is well covered under the Scheme and State ought to give full reimbursement for treatment taken in Government Hospital. The writ petition is, therefore, allowed.”

In Smt. Mohan Kanwar Bhansali Vs. State of Rajasthan; S.B. Civil Writ Petition No.13482/2013 wherein an exact similar controversy was in issue, the coordinate Bench of this Court held as under:

“…… Reimbursement in full of the expenditure incurred on treatment and purchase of medicines, Stent as well on Angioplasty at recognized Government MDM Hospital, cannot be denied to her by a welfare State, more so when the Stents and other accessories were not available with the Govt. authorized pharmacist shop and Non Availability Certificate was issued for its purchase from private shops. The attitude of the authority concerned of a welfare State in denying full reimbursement of the expenses incurred cannot be appreciated in the given circumstances.”

5. In the case of Mohan Kanwar Bhansali (supra), Division Bench held that if a patient is treated in a government hospital, it is the duty of the government hospital to provide all the equipment and if a consumable item is not available then the beneficiary is left with no option other than to purchase the same from the open market. With the said conclusion, the Division Bench held that the complete amount qua the medical expenses would be reimbursable. Here is the case where the patient underwent the treatment in a government hospital and even purchased the required implants from a government shop. Therefore, when qua the equipment purchased from a private shop also it has been held by the Division Bench that the same would be completely reimbursable, it cannot be held that the expenses for the equipment purchased from a government shop would not be reimbursable.

6. In view of the ratio as laid down in Mohan Kanwar Bhansali’s case (supra) and in view of the admitted position that the treatment was undertaken in a government hospital, the present petition is allowed. The respondents are directed to reimburse the remaining amount of claim as raised by the petitioner within a period of three weeks from the date of presentation of the present order.