Denying emergency Medical Reimbursement violates Article 21, rules HC

In a significant intervention touching the core of the right to life and healthcare, the Punjab and Haryana High Court stepped in to address a serious administrative lapse where a government employee was denied most of his medical reimbursement claim for his wife’s life-saving emergency surgery, raising troubling questions about arbitrariness, delay, and bureaucratic apathy in public health reimbursements.

The controversy began when Suresh Kumar, a government employee, was forced to rush his wife to a private hospital in Delhi after she was admitted in a critical condition requiring immediate surgery. With no time to seek prior approval or approach an empanelled hospital, Kumar bore medical expenses exceeding Rs.4.63 lakh. Despite submitting all documents, including an emergency certificate later issued by the Civil Surgeon, the authorities sanctioned only Rs,43,005, without offering any reasons for denying the remaining amount. Years of follow-ups, representations, and even an earlier writ petition yielded no relief, prompting Kumar to return to the High Court alleging arbitrary denial, violation of natural justice, and mental harassment.

Examining the record, the High Court came down heavily on the State’s conduct, holding that the denial of reimbursement was not only unjustified but unconstitutional. The Court underscored that the genuineness of the treatment and bills was never in dispute and that the surgery was undeniably emergent. Citing settled Supreme Court precedent, the Bench reminded the authorities that “the right to medical reimbursement flows directly from the fundamental right to life guaranteed under Article 21 of the Constitution.” Quoting State of Punjab v. Mohinder Singh Chawla, the Court reiterated that the State has a constitutional obligation to bear the cost of necessary medical treatment, especially in emergencies.

It further relied on Shiva Kant Jha v. Union of India, stressing that reimbursement “cannot be denied on technical grounds” once bona fide treatment is established. Rejecting the State’s argument of limiting reimbursement to AIIMS/PGIMER rates, the Court termed the approach “wholly misconceived” and noted that in life-threatening situations, patients cannot be expected to wait for admission in overburdened government hospitals.

Consequently, the writ petition was allowed, and the State was directed to reimburse the denied amount of Rs.4,20,766 along with 6% interest within four weeks.

Case Title: Suresh Kumar Versus State Of Haryana And Others
Case No.: CWP-6049-2023 (O&M)
Coram:  Hon'ble Sandeep Moudgil
Advocate for the Petitioner: Adv. Satish Garg
Advocate for the Respondent: DAG. R.D. Sharma,
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