The claims for medical reimbursements provided to government employees as per their specific service rules cannot be “unlimited,” especially when the employee has received the treatment in a hospital other than those empanelled by the Government, the Supreme Court ruled on Tuesday.“In view of the settled principles of law, there cannot be any doubt that the rules regarding reimbursement of medical claim of an employee, when he obtains treatment from a hospital of his choice, can be made limited,” a Bench comprising Justices S B Sinha and V S Sirpurkar observed.The court, while analysing the interpretation of the Medical Benefit Rules prevalent in the states of Karnataka and Rajasthan, observed that such a rule had been framed under proviso to Article 309 of the Constitution that constitutes conditions of service.Writing for the Bench, Justice Sinha explained that as per rules, an employee would be granted the facility of medical aid free of cost from the recognised government hospitals and on the other, he, using his option, may get himself treated from other recognised hospitals/ institutions, subject of course to the conditions that “the reimbursement by the state therefore would be limited.”Quoting an earlier judgment of the apex court in 1998, it stated that no state or any country can have unlimited resources to spend on any of its project. It only approves its projects to the extent it is feasible.“The same holds good for providing medical facilities to its citizen, including its employees. Provision of facilities cannot be unlimited. It has to be to the extent the finances permit,” Justice Sinha recalled citing the 1998 case of State of Punjab and Others Vs. Ram Lubhaya Bagga and Others.The court was seized of appeals filed by the two state governments, where they had challenged their respective high court decisions asking them to pay the actual amount of medical bills of their employees. In the Karnataka case, the employee — working in the Department of Commercial Taxes — underwent coronary artery bypass surgery incurring a total of Rs 1,50,600, where the Government reimbursed Rs 39,207. And in the Rajasthan case, the employee was a judicial officer who breathed his last on November 7, 2003. In his case fought by his mother, out of total expenses of over Rs 6.5 lakh, the state paid Rs 75,000.However, the Bench, in a humane gesture, directed both the states “to pay the balance amounts.” But this order shall not be treated as a precedent, it clarified.
