HC pulls up Haryana for 50% medical reimbursement

Saurabh Malik

Tribune News Service

Chandigarh, January 28

The Punjab and Haryana High Court has virtually rapped the state of Haryana for denying full medical reimbursement to an employee.

The Bench asserted that granting only 50 per cent reimbursement on “imaginary reasoning” was totally contrary, in violation of the state’s own instructions and could not be sustained.

Justice Nirmaljit Kaur asserted the refusal was nothing but discriminatory and on account of some personal opinion which could not replace expert counsel given by a government hospital doctor.

Her counsel submitted the petitioner lost hearing capacity and was declared 100 per cent disabled by a medical board at Rohtak General Hospital before she was admitted to the All-India Institute of Medical Sciences (AIIMS), New Delhi. She was operated upon for “cochlear implant” and remained an indoor patient from August 14, 2013, to August 22, 2013.

The respondents vide order dated January 29, 2015, sanctioned Rs 2, 48,172 even though the petitioner submitted all documents along with the medical bills. The reason cited was that the amount was sanctioned in terms of advice received vide a health department letter.

Referring to a written statement, Justice Nirmaljit Kaur observed that the Health Department accorded its consent by giving relaxation in rules to pay 50 per cent amount as special case with a condition that it would not be treated as precedent.

Justice Nirmaljit Kaur asserted: “No reason at all is forthcoming as to why the full reimbursement was denied. The argument expressed in the written statement that 50 per cent, too, is being granted as special case has no basis. The petitioner was suffering deafness of both ears. The treatment was found to be essential and indispensable in nature. There is nothing on record to show that any cheaper substitute was available.”

Justice Nirmaljit Kaur added the treatment was taken from a government hospital, AIIMS, which was specifically mentioned in the policy. A patient being treated by a doctor had no choice but to follow the advice. “Any denial of full reimbursement is against the very policy and rules applicable to the petitioner”.

Allowing the petition, Justice Nirmaljit Kaur directed the respondents to pay the balance amount of Rs 2,45,000 to the petitioner along with 6 per cent annual interest. “This court has just stopped itself from directing the recovery of the 6 per cent interest from the officer concerned who may be responsible for illegally denying the full reimbursement,” Justice Nirmaljit Kaur concluded.