High Court directs reimbursement of medical expenses
Claimed by the wife of a deceased government employee
The Madurai Bench of the Madras High Court on Thursday directed the Director of Pension to sanction the medical expenses incurred by a deceased government employee’s wife for his treatment.
The claim was rejected as the employee underwent a surgery at a hospital which was not in the list of hospitals approved by the government for reimbursement of medical expenses.
A Division Bench of Justices M. Venugopal and Abdul Quddhose, while upholding an earlier judgement of a single judge bench, however reduced the rate of interest from 9% to 6% and directed that the claim be paid within four weeks.
Hearing the appeal preferred by the State, the Division Bench observed that it was the obligation of the government to disburse the amount without harping on hyper technicalities.
It observed that Right to Health was an integral part of Right to Life and the government was under a constitutional obligation to provide healthcare facilities.
The District-level Empowered Committee in Madurai had rejected the medical claim as the treatment was done at an unapproved hospital and it was not cashless treatment. The employee’s wife had demanded medical reimbursement of Rs. 1.07 lakh after his death in 2016.
The Government Pleader had contended that a contract was entered with an insurance company for making payments for medical reimbursement and the subscription amount was paid to the company. The agreement approved 726 hospitals and 113 surgical procedures.
The counsel for the respondents argued that the State could not deny the reimbursement just because the hospital was not ‘approved’. It was the duty of the State to reimburse the amount.
