Reimburse medical expenses in unapproved hospital too: HC to Tamil Nadu government
TNN | Updated: Nov 10, 2017, 06:25 IST
MADURAI: The state government was bound to reimburse medical expenses incurred by a beneficiary of the new health insurancescheme for pensioners even if he or she undertook treatment in a hospital not approved by the concerned insurance company, the Madurai bench of the Madras high court has ruled.
The division bench of justices M Venugopal and Abdul Quddhose delivered the judgment while disposing of an appeal filed by the state's director of pension against an order of the single judge of the bench on February 27 directing the government to reimburse the medical expenses incurred by B Sarada with 9 % interest.
Justice M Venugopal said that right to health was an integral part of the right to life and the government had a constitutional obligation to provide health welfare facilities. "It can't be brushed aside that the state government is to satisfy the constitutional obligation to bear / refund the expenses incurred by a government servant while in service or after retirement from service, of course, based on the policy of the government. In emergency cases, the treatment that is required will be immediate / forthwith and if one has to comply with the procedure, ultimately 'waiting' in this regard may prove disastrous and fatal," the judge said.
He said that the payment /reimbursement of medical expenses incurred by the government servant concerned or his family was not 'bounty'. It was an obligation of the state government to pay / disburse the amount in question "without harping on either technicalities or hyper technicalities." However, the court reduced the interest to 6 % per annum from 9 % saying that it was slightly on the higher side.
B Sarada of Madurai had spent Rs 1.07 lakh for the surgery of her retired teacher husband on July 22, 2015 at Raksha hospital in Madurai. When she claimed the medical expenses under the New Health Insurance Scheme for pensioners, the district treasury officer rejected it saying that the treatment was in an unapproved hospital. She filed a case before the high court bench against this, on which the single judge passed the order. The state's director of pension had appealed against it.
Special government pleader V R Shanmuganathan argued that the state government had entered into a contract with United India Insurance company for bearing the medical expenses of eligible employees / subscribers of the scheme. However, the insurance company was not arrayed as a necessary party in the writ, which the single judge did not take note of.