Region: Asia
Year: 2004
Court: High Court - Delhi
Health Topics: Chronic and noncommunicable diseases, Health care and health services, Health systems and financing, Hospitals
Human Rights: Right to health, Right to life
Tags: Access to treatment, Emergency care, Heart disease, Private hospitals, Public hospitals, Reimbursement, Secondary care, Tertiary care
Milap Singh, the Petitioner, underwent an emergency heart bypass surgery at Escorts Heart Institute and Research Centre (EHIRC). He was a retired government employee and also a member of the Central Government Health Scheme (CGHS), a government medical care scheme. On submitting his medical bills, full reimbursement was denied to the Petitioner. The Union of India, the Respondent, on the ground that reimbursement could only be up to the amount specified in package deal mentioned in the office memorandum of 11.06.1997.
The Petitioner filed the petition before the Delhi High Court under Article 226 of the Constitution (original writ jurisdiction of High Courts) praying to the Court to direct the Respondent to reimburse the full amount.
As to whether the Respondent should reimburse the amount in full, the Court held that the Respondent should reimburse the full amount. It held that the right to health was integral to the right to life and therefore the Respondent was under a constitutional obligation to reimburse the full amount. The Court further held that full reimbursement of expenses incurred during treatment in a specialty hospital approved by CGHS cannot be denied. It, therefore, directed the Respondent to pay the remaining amount to the Petitioner within a month of the judgment.
“If the respondents have any grievance about the quantification of the amounts charged, it is for the respondents to take up the matter in issue with the…Hospital. But that cannot deprive the petitioner of full reimbursement of the amount as charged by the recognized…Hospital.” Para. 14.