State Of Punjab & Ors vs Ram Lubhaya Bagga Etc. Etc on 26 February, 1998
It has been decided that employees and pensioners should be given freedom to get
treatment in any, private institute/hospital (of their own choice), in the country
provided that he/she gives an undertaking out of his/her free will and in an
unambiguous terms that he/she will accept reimbursement of expenses incurred by
him/her on his/her treatment to the level of expenditure as per rates fixed by the
Director, Health and Family Welfare, Punjab for a similar treatment package or
actual expenditure whichever is less. The rate for a particular treatment would be
included in the advice issued by the District/State medical Board. A Committee of
technical experts shall be constituted by the Director Health and Family Welfare
Punjab to finalise the rates of various treatment packages and the same rate list shall
be made available in the offices of the Civil Surgeons of the State.
However, this permission would be granted by the Director, health and Family
Welfare, Punjab on the advice of State medical Board in case of treatment in Private
Hospitals outside the State and the District Medical Board in case of treatment in
private hospitals within the State.
It is further submitted that in an emergent case prior permission could be waived
from the Medical Board but Ex-post facto approval from the Medical Board for
reimbursement of medical expenses is absolutely essential in accordance with the
instructions dated 5.10.1995.
TREATMENT ABROAD
-----------------The treatment of a disease in a country abroad would be permitted in extremely rare
cases where satisfactory treatment and follow up should be recommended by the
State Medical Board. Prior approval of the State Medical Board shall be a
pre-requisite in such cases. All efforts should be made by the concerned
employee/pensioner to take prior approval of the State Medical Board."
Learned counsel for the respondents strongly relies on the case of Surjit Singh (supra). The
contention is that in that case the claim for getting reimbursement expenses incurred in Escorts was
upheld and hence it would be impermissible now for the State Government to deny reimbursement
of expenses incurred at Escorts on the basis of the alleged new policy. The decision under the new
policy to reimburse expenses only on the basis of the rates at the AIIMS, it is contended illegal.
Everyone in order to protect his life has to go wherever best possible treatment is available. If
respondent went to Escorts which was once a designated hospital. The refusal now to reimburse
expenses incurred at Escort has no justifiable ground to stand.
Having heard learned counsel for the parties at length, we find the Surjit Singh's case admittedly
was based on the old policy. There the medical reimbursement claim, was admissible at the rate
admissible in Escort's, as Escorts's was one of the designated hospitals. In that case denial of such
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