Punjab State Electricity Board & ANR Vs. Shri Jasbir Singh [1999] INSC
30 (12 February 1999)
M.Srinivasan,
S.N.Phukan, DER Leave granted.
The
respondent's son had problem of growth in his height which was, in medical
terms, attributed to disease of pituitary glands. Injection Norditropin was
prescribed for treatment. The claim of the respondent for reimbursement of the
medical expenses incurred on purchase of the said injection to the tune of Rs.
3,13,200/- was rejected by the appellant Board. The respondent, thereupon,
filed a writ petition seeking a direction for reimbursement of the said amount
with interest in the High Court. The writ petition was resisted primarily on
the ground that the policy of the Board was not to reimburse expenses on
"imported medicines".
The
High Court noticed that the drug in question was not available in India and that the same was an imported
drug. The High Court, however, allowed the writ petition observing that the
respondent's son had a serious problem and that since the imported drug had
been duly prescribed by the doctor at the Post Graduate Institute of Medical
Sciences, Chandigarh the respondent was entitled to be
reimbursed for the expenses incurred in purchasing the imported drug. The Bench
observed:
"In
fact, instances are not lacking were people have gone abroad for treatment and
the expenses have been paid by the State. Surely, if a particular medicine is
not available in India and has to be imported, nobody can
help.
A poor
patient has to import the medicine and take it. This is precisely what appears
to have happened in the present case. Still further no reason whatsoever has
been advanced in the written statement to indicate as to why a person is not
entitled to reimbursement of expenses incurred by him on account of the import
of medicine. It can be imagined that if a drug is available in India and yet a
person chooses to import a particular medicine and spends money which is
avoidable, the competent authority may take the view that no re-imbursement
should be allowed or that it should be confined to the expense which the
patient would have incurred on getting the drug within the country. However, it
is not even suggested in the present case that the drug is available in India. In such a situation, it appears
fair to assume that this life saving drug had to be imported. That being so,
there would be no reasonable basis for declining to reimburse the
expenses." Aggrieved by the direction issued by the High Court to re-imburse
the amount together with interest, the Board is in appeal by special leave.
We
have heard learned counsel for the parties and examined the record.
It is
an admitted case of the parties that the policy of the Government of India,
which has also been adopted by the Govt. of Punjab and the Board, is that where
the drugs manufactured in India have proved ineffective and the prescription of
some imported life saving drug is imperative for "saving the life of the
patient", such a drug can be prescribed and the patient can procure the
same either by placing an order with the foreign firm or otherwise and when
that is done and the certificate is issued by the Chief Medical Officer of the
District/Medical Superintendent of the hospital to the effect that he is
satisfied that the drug in question is considered absolutely essential to
"save the life of the patient", reimbursement of costs of the drug,
excluding the packaging charges, customs duty from charges etc. is permissible.
The High Court, however, appears to have assumed that the drug in question was
a "life saving drug". The certificate issued by the Post Graduate
Institute of Medical Sciences, Chandigarh which is available on the record at
page 32, shows that the disease was not life threatening and Norditropin
injection is "not a life saving drug". The submission of learned
counsel for the respondent that since the son of the respondent was suffering
from a chronic disease, he was entitled to reimbursement of the medical
expenses including the expenses incurred on the imported medicine on the basis
of the instructions dated 1.1.1991 does not appear to be correct. A careful
perusal of the instructions dated 1.1.91 shows that it only lists certain
chronic diseases, the treatment for which can be done either as an out-door
patient i.e. without being admitted in the hospital or by admission in the
hospital. Vide para 2 of those instructions, no reimbursement limit has been
fixed as an out-door patient for the employees and pensioners of the State
Governments. These general instructions, however, have to be read along with
the specific instructions contained in the Government of India instructions
dated 21.7.1972 and the instructions issued by the Board in 1997 declaring as a
policy of the Board that reimbursement of imported drug shall be permitted only
where the imported drug is a "life saving drug". It becomes obvious
from joint reading of various instructions (supra) that reimbursement of the
drugs, whether imported by the patient himself or purchased from a chemist who
has imported those drugs, is permissible only where the imported drug is
considered as absolutely essential to "save the life of the patient".
It is not in dispute that the drug in question was essential for "saving
the life of the patient". That the disease of the patient was a
"chronic disease" does not mean that it was "life
threatening" in view of the unambiguous certificate issued by the PGI, as
referred to above. The Board was, therefore, perfectly justified on the basis
of instructions referred to above and its policy decision, to decline to
reimburse the medical expenses incurred on the purchase of the imported drug Norditropin,
being not a "life saving drug". Since, the High Court wrongly assumed
the drug to be a "life saving drug" it clearly fell in error in
issuing the direction for reimbursement of the amount. The judgment of the High
Court under the circumstances cannot be sustained.
This
appeal, therefore, succeeds and is allowed. The judgment of the High Court is
set aside. The writ petition, filed before the High Court shall stand
dismissed. No costs.
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