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| Significant Judgement | | | In a significant judgment the Jammu & Kashmir and Ladakh High Court has held that the claim for medical reimbursement cannot be denied on the ground that a patient was treated in an unapproved hospital.
The High Court directed the officials to reimburse the petitioner who had spent money on the treatment of her husband due to the medical emergency that had arisen.
The High Court maintained that the genuine contenders cannot be denied reimbursement for medical expenses.
The High Court’s recent judgment will help many people who have been seeking reimbursement for medical expenses but were denied the same for them moving to a hospital which was not approved.
Pertinently, when a medical emergency arises it becomes difficult for the people to search for the hospitals that figure in the approved list. They try their best to help their kith or kin by admitting him/her in the hospital which is easily accessible. At that point of time it’s not the money that matters. It’s life that matters.
The High Court maintained that in medical emergencies humane view was required to be taken while considering the reimbursement claim.
During the past few years many people have opted for health insurance and the insurance companies provide cashless treatment to their clients. But on many occasions people are denied the claim on the pretext that they haven’t visited the approved hospital.
In Badar Hussain versus State of J&K’ in 2017 after the court order the government relaxed the rules and allowed the reimbursement of the claim of the petitioner for expenses incurred on the medical treatment of his son to the extent of rates applicable in PGI Chandigarh. In that case, the son of the petitioner was treated in a hospital, which was not in the approved list of hospitals.
The recent ruling of the High Court has made it clear that the reimbursement of medical expenses of genuine contenders cannot be denied on flimsy grounds. The genuine people need to be reimbursed without being subjected to unwanted wrangles. |
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