Medical treatment

Right to health – Medical care reimbursement provisions should be interpreted liberally: Chhattisgarh High Court

The Chhattisgarh High Court has ruled that self-preservation is a facet of the right to health, a fundamental right under Article 21 of the Constitution of India. Ordering the authority to consider the claimant’s claim for medical reimbursement ex post, Judge Sanjay Kumar Agarwal held that the provisions relating to the reimbursement of medical care should be interpreted liberally.

The Court held that the “right to health” includes the “right to affordable treatment” and that “provisions relating to the reimbursement of medical care should be interpreted liberally”.

Fund

The applicant nurse underwent spinal cord surgery after which she claimed reimbursement of medical expenses amounting to Rs. 99,743/-. However, the claim was rejected because she did not intimidate the surgery and therefore is not entitled to a refund. The return of the request was justified on the grounds that post hoc sanction cannot be granted on the basis of Chhattisgarh Civil Service (Medical Assistance) Rules, 2013.

Defender Akash Kumar Kundu, representing the applicant, argued that since the surgery was urgent, after which she had to remain hospitalized for seven days, the rule of informing the competent authority could not be complied with. He challenged the return of the medical bill as arbitrary as a rule that was not mandatory to follow. He also argued that the right to self-preservation is part of the right to life under Article 21 of the Constitution of India.

Deputy General Counsel argued that the applicant’s family members must have informed the authorities within 48 hours of the start of treatment. Failing this, the reimbursement rule concerned cannot be invoked.

Findings of the Court

Referring to the relevant rules for the reimbursement of medical treatment, the Court ruled that in an emergency, notification to the service concerned is required within 48 hours of the start of treatment. Admitting that such a communication was not made, the Court observed that in the event of non-communication, whether the rules relating to the posteriori sanction can be covered or not.

The Court referred to the decision of the Supreme Court in Consumer Education & Research Center and Ors v. Union of India & Ors. In this case, it was held that the right to health and medicine is to protect one’s health and vigor while on duty or after retirement is a fundamental right of a worker under the Article 21 of the Constitution of India.

After referring to a series of other judgments of the Supreme Courts, the Court noted that the petitioner had the right to take measures to preserve her own life, a facet of the right to health. He further noted,

“..the failure to indicate the start of treatment within 48 hours would not prevent him from recovering the amount of medical reimbursement from the respondents, because Rule 11 of the 2013 Regulations takes care of this situation and under the rule 11(1), an a posteriori sanction may be imposed by the competent authority.”

The Court ordered the authority to consider the petitioner’s case for the granting of a post hoc sanction under the relevant rules within 45 days from the date of receipt of the order.

Case Title: Khuku Biswas v. State of Chattisgarh

Quote: 2022 LiveLaw (Chh) 3

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