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In Case of Medical Emergency, Government Employees’ Medical and Travel Compensation Should Not Be Rejected: Tripura High Court

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Case: Sri Malay Pal vs The State of Tripura

Facts of the Case

In the given timeline of dates, the Petitioner was admitted to GBP Hospital, Agartala on 14-01-2018 due to his illness. The doctors at the hospital suggested the Petitioner seek advice from a higher medical hospital. It was found that the Petitioner was diagnosed with encephalitis and septicemia when he was admitted to ILS Hospital on 15-1-2018. He got discharged but again fell ill and was admitted to ILS Hospital. He was treated as an indoor patient. He fell ill again and was further admitted to the same hospital from 09-03-2018 to 20-03-2018. He fell ill once more due to some disease and was admitted to Apollo Hospital, Chennai on 11-04-2018. He underwent surgery on 22-04-2018 which was suggested by the doctors. He was discharged but for the interval post checkups, he had to be in Chennai. He returned to Agartala on 03-05-2018 but fell ill another time in few days and was admitted to Tripura Medical College & Hospital. The doctors suggested that the patient should be shifted to Apollo Hospital, Chennai for further treatment as the current situation is life-threatening. He remained there as an indoor patient for 28 days and then was discharged on 11-06-2018. For the post-checkups, he stayed there. His doctors there advised him to visit Apollo Hospital, Chennai for 12-18 months at regular intervals. He returned to Agartala on 20-07-2018 and joined his job again the following day. He visited Apollo Hospital on 03-12-2018 and 22-07-2019 for two post-check-ups respectively.

Arguments by Petitioner

The Learned Counsel stated that due to the Petitioner’s illness he got admitted to GBP Hospital, Agartala which is a government hospital on 14-01-2018. There,  he was suggested to take further medication from a higher medical centre. On the very next day, he was admitted to ILS Hospital. This fact proves that the Petitioner was in rush for his medical emergency and so on he didn’t have time to proceed to Standing Medical Board for the formal declaration. Secondly, the GBP Hospital reported that the said hospital did not have sufficient facilities for the treatment. Furthermore, he was admitted twice to Apollo Hospital, Chennai. He still didn’t have any time for formal declaration as he was hospitalized monthly. After his return, he was again admitted to Tripura Medical College & Hospital. 

Arguments by Respondent

It was stated that the treatment is done at ILS Hospital, Agartala, and Apollo Hospital, Chennai both are not admissible as the Petitioner did not approach the Standing Medical Board, Agartala. Further, the Standing Medical Board will issue a certificate for the patient who is undergoing treatment outside the state. It will valid for 30 days from the date of issue. The Counsel stated the cost of medical treatment for Group-C/Group-D Government employees and its conditions. 1) A Group-C/Group-D Government Employee going through a treatment other than Cancer, will be referred to the cost of treatment in that Hospital excluding the cost of a journey. 2) A Group-C/Group-D Government employee or any member of his/her family suffers from cancer and is referred to medical treatment outside the State by the Standing Medical Board, the cost of treatment in Hospital inclusive of admissible journey expenses only up to referred Institution/Hospital (both ways) is admissible for reimbursement. 

Court Analysis

It was observed that medical bills and compensation of a Government employee should not be rejected due to the absence of prior referral order. As the patient is in an emergency, the patient or his/her family members didn’t have time to approach the Standing Medical Board when the treatment is outside the State. Further, it was noticed that when the Petitioner was visiting the hospital for post-check-up he had enough time to approach the Standing Medical Board. Any claim regarding the post-check-up visits would not be reimbursed.

Court’s Decision

The said amount may be carried out within six months from today. If there is any delay beyond the given period, the amount shall carry simple interest @ 6.5% per annum from such date till actual payment. 

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