Full Judgment Text
* IN THE HIGH COURT OF DELHI AT NEW DELHI
th
% Reserved on: 12 May, 2026
th
Pronounced on: 29 May, 2026
+ W.P.(C)922/2007, CM APPL. 1602/2007
SH. JEET SINGH
S/o Sh. Mansa Ram,
R/o House No. 1965, Top Floor,
Type-II, Gulabi Bagh, Delhi. .....Petitioner
Through: Appearance not given.
versus
1. GOVT. OF NCT OF DELHI
Through Principal Chief Secretary,
Players Building, New Delhi .
2. DISTRICT & SESSIONS JUDGE
Tis Hazari Court Complex, Delhi.
3. ACCOUNTS OFFICER
Tis Hazari Court Complex, Delhi.
4. SIR GANGARAM HOSPITAL
Sir Gangaram Hospital Marg,
Old Rajinder Nagar, New Delhi. .....Respondents
Through: Mrs. Avnish Ahlawat, SC-GNCTD
Services with Mr. Nitesh Kumar
Singh, Ms. Aliza Alam, Mr. Mohnish
Sehrawat, Advocates.
Mr. Vishal Thakur & Ms. Amita
Singh, Advocates for R-4.
CORAM:
HON'BLE MS. JUSTICE NEENA BANSAL KRISHNA
J U D G M E N T
1. The present writ petition has been filed under Article 226 of the
Constitution of India seeking issuance of a writ of mandamus and/or
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certiorari for quashing of the Demand Notice bearing No.
81757/MED/ACCTS/2006 dated 11.09.2006 (hereinafter referred to as 'the
impugned demand notice') issued by Respondent No. 2, whereby the
Petitioner has been directed to deposit Rs. 71,868/- (Rupees Seventy-One
Thousand Eight Hundred and Sixty-Eight only), being the alleged
differential between the actual medical expenditure incurred and the
reimbursement ceiling, under the Office Memorandums dated 25.10.2002
and 06.10.2003.
2. The petitioner further seeks a direction to reimburse the balance
amount of the actual expenditure of Rs. 1,89,324/- and to refund all amounts
already recovered from his salary.
3. The facts in brief are that the petitioner, Sh. Jeet Singh, is employed
as an Ahlmad in the office of Respondent No. 2, District and Sessions
Judge, Tis Hazari Court Complex, Delhi. He and his dependent family
members, are entitled to medical benefits under the Central Services
(Medical Attendance) Rules, 1944 (hereinafter referred to as 'the CS(MA)
Rules') and the Policy of the Government of NCT of Delhi, extending
equivalent benefits to its employees.
4. In the early days of April, 2006, the petitioner's wife, Smt. Indra
Singh (hereinafter referred to as 'the petitioner's spouse') , developed acute
jaundice, the severity of which worsened rapidly. Her condition deteriorated
to a degree where she began to suffer from altered sensorium , indicative of
impaired brain function, and was ultimately diagnosed as a case of
Fulminant Hepatic Failure, a life-threatening condition of acute and sudden
onset of liver failure.
5. Faced with the terrifying prospect of losing his wife, the petitioner
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rushed her on 10.04.2006 to Sir Ganga Ram Hospital, Rajinder Nagar, New
Delhi (hereinafter referred to as 'Respondent No. 4' or 'the hospital') , the
nearest accessible hospital at the time.
6. The Petitioner’s wife was received in a critical, comatose condition
and was immediately admitted to the Intensive Care Unit ('ICU'), where she
was intubated and placed under an anti-coma regime, supplemented with
intravenous antibiotics and other supportive measures.
7. A Certificate dated 14.04.2006 was issued by Respondent No. 4
confirming the critical condition of the petitioner's spouse and indicating an
approximate expenditure of Rs. 2,50,000/-.
8. Respondent No. 2, upon consideration of the petitioner's
representation, sanctioned an advance of Rs. 2,25,000/- under Section 2 of
the CS(MA) Rules and a cheque bearing No. 428062 dated 18.04.2006 was
issued directly in favour of Respondent No. 4, deposited with the hospital on
19.04.2006.
9. The petitioner's spouse gradually improved, hence was shifted out of
the ICU to the general ward, and was finally discharged on 24.04.2006,
having remained hospitalized for approximately two weeks. The total
expenditure charged by Respondent No. 4, was Rs. 1,89,324/-.
10. Since the advance sanctioned was Rs. 2,25,000/-, the hospital
refunded the unutilized balance of Rs. 35,676/- , vide cheque No. 791072
dated 25.04.2006.
11. The petitioner deposited the said cheque with Respondent No. 2 on
06.05.2006, along with all relevant medical documents and the treatment
certificate issued by the Medical Officer In-Charge .
12. On 11.09.2006, to the shock and surprise of the petitioner, the
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impugned Demand Notice directing him to deposit Rs. 71,868/- was issued,
being the differential between the actual expenditure of Rs. 1,89,324/- and
the ceiling of Rs. 1,17,456/-, computed as per the approved rates under the
Office Memorandums of 2002. No Show Cause Notice was issued and no
speaking order was passed.
13. The petitioner, aggrieved by the impugned Demand Notice , submitted
a representation dated 18.11.2006, to Respondent No. 2 requesting its
withdrawal.
14. However, instead of deciding the same, Respondent No. 2 merely
supplied a calculation sheet on 07.12.2006, which reflected room rent for
only a single day despite a fourteen-day hospitalization, demonstrating a
complete absence of application of mind. No speaking order was passed.
Without affording any opportunity of hearing, the Respondents commenced
deducting approximately 70% of the petitioner's salary, releasing only Rs.
2,650/- per month to him.
15. Aggrieved by the impugned Demand Notice and the consequential
salary deductions, the Petitioner filed the present Writ Petition seeking
reimbursement of the actual medical expenditure of Rs. 1,89,324/- as per the
bills raised by Respondent No. 4, and refund of all amounts already
deducted from his salary on account of the said demand notice.
16. After filing of this Petition, vide interim Order dated 05.02.2007, this
Court stayed the Demand Notice, which stay was made absolute on
18.03.2011.
17. Per contra , the Respondents have stated in their Counter-Affidavit
that medical reimbursement is permissible only as per the Rules and
instructions issued by the Government of India and accepted by the
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Government of NCT of Delhi. As per the instructions dated 25.10.2002 and
06.10.2003, since the petitioner was drawing a basic pay of Rs. 3,650/- per
month, he was entitled to benefits under the general category only , with a
maximum room rent of Rs. 500/- per day, and his medical reimbursement
was accordingly calculated at Rs. 1,17,456/-, making the differential of Rs.
71,868/- rightly recoverable.
18. Furthermore, it is alleged that the petitioner had fraudulently obtained
an estimate of Rs. 2,50,000/-, which was excessive, since only 7-8 days of
hospitalization was required in such cases, and even after fifteen days of
hospitalization, the total bill was much less than the estimate and the
advance sanctioned.
19. In reply to the grounds urged by the petitioner, the Respondents have
categorically stated that since Sir Ganga Ram Hospital is not a recognised
hospital on the panel of the Government of NCT of Delhi for the treatment
in question, the reimbursement has to be made item-wise as per Annexure
VIII of the CS(MA) Rules. The calculation as per Annexure R-5 is correct,
and the petitioner cannot retain government money given to him as advance.
20. It is contended that granting reimbursement beyond the prescribed
ceiling would have large-scale implications for all similarly placed
beneficiaries. Reliance is placed upon State of Punjab v. Ram Lubhaya
Bagga , (1998) 4 SCC 117, wherein the Supreme Court held that no State has
unlimited resources and there is no violation in giving reimbursement only
in accordance with the policy of the Government.
21. It is further submitted that the representation dated 20.11.2006 filed
by the petitioner, is without any merit as the recovery is fully justified.
Despite repeated requests, when the petitioner failed to refund the balance
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amount, there was no alternative but to recover the same from his salary in
instalments. The petitioner could have approached the authorities for making
smaller instalments, but chose not to do so.
22. The petitioner in his Rejoinder Affidavit , submitted that the rates
notified by the Government of NCT of Delhi are of the year 2002 and have
not been revised since, and are therefore, inapplicable to the expenditure
incurred in 2006. The Respondents were duty-bound to revise the rates
every year as held by this Court, and their failure to do so, renders the
application of stale 2002 rates, wholly arbitrary.
23. Furthermore, the impugned Demand Notice is non-speaking, was
issued without a Show Cause Notice, and salary deductions were
commenced without any opportunity of hearing, in flagrant violation of
natural justice. If the hospital has charged amounts in excess of the package
rates, the obligation to address the excess lies with the State, which has the
power to regulate the empanelled hospitals. The consequences of the State's
failure to regulate, cannot be visited upon the employee.
24. The allegation in the Respondents' Counter Affidavit that the initial
hospital estimate was fraudulently obtained, is vehemently denied . A
medical estimate is always a provisional clinical assessment, based on the
doctor's experience and no exact figure is possible at the initial stage of a
critical illness. Such an allegation made without any basis in the record
against an honest employee, is defamatory and unbecoming of a senior
government officer.
25. Learned counsel on behalf of the Petitioner in his Written Statement ,
has asserted that it is settled law that the right to health, is an integral
component of the right to life under Article 21, and the Government has a
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constitutional obligation to bear full medical expenses, at a specialised
approved hospital. Monetary ceilings prescribed under Service Rules, cannot
be mechanically applied to deny reimbursement of genuine emergency
medical expenditure.
26. The Rate Schedule applied was of the year 2002, to the emergency
expenditure incurred in 2006, i.e. after a gap of four years. Hospital rates
and treatment costs have increased manifold, in the interim. The
Respondents were duty-bound to revise their approved Rate Schedule
annually and their failure to do so, renders the application of stale 2002 rates
to the 2006 expenditure, wholly arbitrary and directly contrary to the
directions of this Court.
27. Reliance is placed on Shiva Kant Jha v. Union of India, (2018) 16
SCC 187; Union of India v. Joginder Singh, 2023 SCC OnLine Del 2707;
J.C. Sindhwani v. Union of India, 2005 SCC OnLine Del 1079; V.K. Gupta
v. Union of India, 2002 (65) DRJ 497; M.G. Mahindra v. Union of India,
2001 (59) DRJ 564; Roshan Lal Kapoor v. Union of India, 2006 SCC
OnLine Del 1138; Mahendra Kumar Verma v. Govt. of NCT of Delhi, 2023
SCC OnLine Del 75; and Dinesh Kumar v. Govt. of NCT of Delhi, 2022
SCC OnLine Del 3937."
Submissions heard and record perused.
28. The short question which arises for consideration is, whether the
Respondent was justified in restricting medical reimbursement to the
scheduled rate list to Rs. 1,17,456/- , or whether it was liable to reimburse
the actual expenditure of Rs. 1,89,324/- incurred by the petitioner.
29. This question must be answered in light of the constitutional
guarantee of the right to life under Article 21, of which the right to health, is
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a recognised and inseparable facet.
30. The Supreme Court of India in State of Punjab v. Mohinder Singh
Chawla , (1997) 2 SCC 83, laid down in the clearest terms that the right to
health is integral to the right to life, and that the Government has a
constitutional obligation to provide health facilities to its employees. When a
government servant suffers an ailment requiring treatment at a specialised
approved hospital and is referred there, it is the duty of the State to bear the
expenditure incurred, and such expenditure is required to be reimbursed to
the employee.
31. The Supreme Court in Shiva Kant Jha v. Union of India , (2018) 16
SCC 187, authoritatively settled the law on medical reimbursement in the
context of government employees, where it was held that a government
employee during his lifetime or after retirement, is entitled to get the benefit
of medical facilities and no fetters can be placed on his rights. Furthermore,
it was observed that the ultimate decision as to how a patient should be
treated vests only with the doctor, who is well-versed and expert on the basis
of academic qualification and experience gained, and that very little scope is
left to the patient or his relative, to decide the manner of treatment. Most
significantly, the Supreme Court held that the real test must be the factum of
treatment, once it is established that the claimant had actually taken
treatment and the same is supported by records duly certified by the
doctors/hospitals concerned, then the claim cannot be denied on technical
grounds. It was also held that the law does not require that prior permission
has to be taken in a situation, where the survival of the person is the prime
consideration.
32. Now coming to the facts of the present case, as per the Medical
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Record, the Petitioner's wife was admitted in a comatose condition for
Fulminant Hepatic Failure , impaired brain function, and the real and
immediate risk of death. There was no time for the petitioner to seek prior
permissions, compare rates, or make enquiries about whether the charges of
Respondent No. 4 were within the approved package rates. His only priority
at that moment was the life of his wife.
33. As the Supreme Court held in Shiva Kant Jha (supra) , the Central
Government Health Scheme was propounded with the purpose of providing
health facilities to government employees so that they are not left without
medical care, in furtherance of the object of a welfare State.
34. In the present case, the factum of treatment and the genuineness of the
expenditure, is not disputed. The bills are supported by certified records,
from the treating doctors.
35. The Respondents in their counter affidavit, made an allegation that
the initial hospital estimate submitted by the Petitioner, was fraudulent.
However, this contention is liable to be rejected in its entirety. A medical
estimate was issued by a treating physician and not by the Petitioner.
36. Furthermore, it is necessarily a provisional assessment based on
clinical experience, the probable complexity of the treatment, the likely
investigations, and the duration of hospitalization that may be required. No
doctor can predict the exact cost of treatment of a patient who had suffered
Fulminant Hepatic Failure, a condition involving multi-system failure and
intensive medical support at the initial stage.
37. That the final bill of Rs. 1,89,324/- was lower than the estimate of Rs.
2,50,000/-, far from suggesting fraud, rather demonstrates the petitioner's
bona fides , since the unutilized balance was promptly returned to the
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Department. Such an allegation of fraud against an employee who fought to
save his wife's life, is without any basis as the Respondent is not questioning
the treatment or the expenditure, but only the extent of reimbursement.
38. The question of the stale rate schedule, was considered in the case of
Mahendra Kumar Verma v. Govt. of NCT of Delhi , 2023 SCC OnLine Del
75, wherein this Court considered near-identical facts. A government
employee of the Tis Hazari Court establishment sought reimbursement for
treatment of his son at Sir Ganga Ram Hospital, under the CS(MA) Rules,
where a recovery demand had been raised on the ground that the actual
expenditure exceeded the package rate. This Court held that the CS(MA)
Rules are a beneficiary piece of legislation that must be construed liberally
to achieve the objective of providing good and sound health, to government
employees and their families. When an employee is directed to a recognised
hospital, the Respondents cannot deny reimbursement on the basis that the
hospital charged in excess of the package rate, and that if the hospital has
charged over and above the package rate, the Respondent is under an
obligation to pay such charges to the employee at the first instance,
recovering from the hospital thereafter if so advised in law.
39. The question of outdated rates, has been addressed squarely by this
Court in Roshan Lal Kapoor vs. Union of India , 2007(139) DLT 716. The
Court observed that when the policy was adopted in 1996, the rates fixed
had a nexus to the actual treatment costs charged by hospitals at the time,
but that in the intervening period, hospitals raised their rates and the various
components of treatment became costlier. It would be arbitrary on the part of
the Government not to revise the rates from time to time to keep the balance
between the rates charged by the hospitals and the reimbursement offered to
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the beneficiaries, and explicitly directed the Respondents to revise
reimbursement rates at least once a year .
40. In the present case, the Respondents have applied the Rate Schedule
of 2002 to a medical emergency that occurred in 2006, i.e. after a gap of
four years. There is nothing before this Court to suggest that the 2002 Rate
Schedule bore any rational nexus to the actual costs of intensive emergency
treatment, at a specialised hospital in 2006.
41. The application of this stale rate schedule and consequent recovery of
the balance amount from the salary of the Petitioner, is therefore, arbitrary
and is liable to be set aside. The denial of full reimbursement on the ground
of rate ceilings, is precisely the kind of inhuman and mechanical approach
deprecated by the Supreme Court in the case of Shiva Kant Jha (supra) .
42. The contention of the Respondents that granting full reimbursement,
would have large-scale implications for all similarly placed beneficiaries, is
not a ground that this Court can accept. Every case of a genuine life-
threatening emergency where treatment is obtained at a recognised hospital
and the factum of treatment is supported by certified records, would merit
the same consideration, under the constitutional mandate of Article 21. The
question is of the constitutional mandate and the right of an individual to
medical treatment and thus, to life, and there exists no reason to deny it. To
mechanically deny a claim on technical grounds of rate ceilings is to defeat
that very purpose.
43. Before parting, this Court considers it necessary to observe that the
manner in which, a legitimate medical reimbursement claim of the Petitioner
has been handled by the Respondents is deeply troubling. Sh. Jeet Singh is
an Ahlmad, a functionary in the district court establishment. He spent every
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resource available to him to save the life of his wife who lay comatose in the
ICU of a recognised hospital. Respondent No. 2, having itself sanctioned
funds to the hospital during that crisis, thereafter issued a peremptory
demand for recovery without a Show Cause Notice, applied a rate schedule
four years old, deducted 70% of the petitioner's salary without hearing him,
and levelled allegations of fraud against him in a sworn affidavit; all in
clear disregard of a consistent line of judgments of this Court and the
Supreme Court on the subject.
44. As the Supreme Court observed in Shiva Kant Jha (supra), such
authorities are required to be more responsive and cannot in a mechanical
manner deprive an employee of his legitimate reimbursement. This is hardly
a satisfactory state of affairs.
45. In view of the foregoing, the restriction of reimbursement to
Rs.1,17,456/-, under Office Memorandum of 2002, is legally unsustainable
and constitutionally impermissible .
Conclusion And Relief:
46. The impugned demand notice bearing No. 81757/MED/ACCTS/2006
dated 11.09.2006 is hereby, quashed. Respondent No. 2 is directed to
reimburse the actual medical expenditure of Rs. 1,89,324/- incurred for the
treatment of the Petitioner's wife, as against the restricted reimbursement of
Rs. 1,17,456/-, offered by the Respondent.
47. Respondent No. 2 is further directed to refund the amounts deducted
from the salary of the petitioner pursuant to the impugned Demand Notice,
along with simple interest at the rate of 6% per annum, from the date of each
deduction till the date of actual refund, within eight (8) weeks, from the date
of this judgment.
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48. The writ petition is allowed, in the above terms . Pending
applications, if any, are disposed of accordingly.
(NEENA BANSAL KRISHNA)
JUDGE
MAY 29, 2026/ va/RS
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