Sunday, April 1, 2018

Can’t deny mediclaim on technicality: HC
SPECIAL CORRESPONDENT

CHENNAI, APRIL 01, 2018 00:00 IST

Relief for those who chose unempanelled hospitals

A Division Bench of the Madras High Court has concurred with a view taken by a single judge that medical insurance cannot be denied to government servants and pensioners who took treatment in hospitals of their choice without approaching empanelled institutions.

Refusing to entertain a batch of writ appeals preferred by a nationalised insurance company, Justices C.T. Selvam and N. Sathish Kumar observed that an insured person’s claim for reimbursement for having taken treatment from a hospital of his/her choice could be restricted but could not be denied altogether.

The judges refused to even condone the delay of 95 days in preferring the present batch of appeals. Holding that the appellant had not cited plausible reasons for the delay, the Bench said, it had become a routine practice for government institutions to prefer appeals against every other court order.

“The present-day scenario of filing appeals, challenging every court order, clearly exhibits that the heads of the departments are shirking their responsibilities. In fact, now a tendency has developed among department heads to file appeals even in cases without merits only to avoid any query in the future,” it added.

Though only applications to condone the delay had been listed for hearing before the Bench, the judges gave a finding that even the appeals could not be entertained. “Though it is not fair on our part to touch upon the merits, still we are of the view that the order passed by the learned single judge cannot be faulted at all,” they said.

‘State duty-bound’

In his September 4, 2017 judgment, Justice S.M. Subramaniam said: “The State in this regard should be a model employer and the insurance companies, as a State, have a duty to deliver the medical insurance schemes promptly. They cannot escape their liabilities on mere technicalities.”

Referring to insurance claims being settled promptly in many countries, the judge said: “Such a practice is not prevailing in our country. But the Constitutional goal is to achieve such a result and we should thrive towards achieving the same.” The judge criticised the State for forcing even pensioners to file writ petitions seeking reimbursement of medical expenses and the insurance companies for taking repeated adjournments in such cases. He held that the officials were duty-bound to settle genuine claims on time.

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