Health and Me

Ishita Roy

Punjab & Haryana HC Ends 19-Year Legal Battle Over Denied Heart Surgery Reimbursement

The <span>Punjab and Haryana High Court</span>, after 19 years, has finally ended the case of medical reimbursement of heart surgery from a non-empanelled hospital. The surgery happened in 2002. This was a government school teacher, Bhupinder Singh, from Government Elementary School, Phus Mandi, Mansa, who had undergone coronary artery bypass surgery at Escorts Heart Institute and Research Centre in Delhi. The bill was of Rs. 2,20,677 and Rs 11,000 during his admission from November 18 to 30 that year. 

Justice Sudeepti Sharma dismissed the earlier regular second appear filed by the State of Punjab, upholding the 2006 order of district judge, Mansa, that allowed the reimbursement. 

The court observed that Singh was referred to the hospital through official government channels after an angiography showed serious cardiac issues. It also noted that Escorts Heart Institute was a recognized center for open-heart surgery under a 1991 Punjab government notification, along with Christian Medical College, Ludhiana, and Apollo Hospital, Madras.

Read: <a href="https://www.healthandme.com/health-wellness/supreme-court-steps-in-for-31-year-olds-passive-euthanasia-plea-who-has-been-in-vegetative-state-for-10-years-article-153216648" data-type="tilCustomLink">Supreme Court Steps In For 31-year-old's Passive Euthanasia Plea Who Has Been In Vegetative State For 10 Years</a>

<h2>The Cycle Of Reimbursement Finally Ends</h2>

The judgment referred to official records showing that the referral was made by the Punjab Health Systems Corporation because of the patient’s critical condition. It also relied on a 1995 government instruction stating that prior approval from a medical board is not required in life-threatening emergencies.

The court came down strongly on the delay in deciding the case, expressing anguish over the 19-year wait. The judge noted that reimbursement matters should be settled promptly, pointing out that the patient had been pursuing his claim since 2002, only for it to take nearly two decades to reach a decision.

Justice Sharma noted: “The government should be liberal in framing the policies for medical treatment and reimbursement since a person in pain is not expected to choose the hospital and would prefer the nearest one only.”

Read: <a href="https://www.healthandme.com/health-news/andhra-pradesh-may-ban-social-media-for-under-16s-to-protect-teenagers-article-153488528" data-type="tilCustomLink">Andhra Pradesh May Ban Social Media for Under-16s To Protect Teenagers</a>

<h2>One More Medical Expense Case Allowed</h2>

In another news, in the case of another government employee asking for reimbursement from a non-panelled hospital, the Punjab and Haryana high Court under the judgment directed the Haryana Government to reimburse the remaining medical expenses of a government employee incurred for the emergency treatment of his wife, in a non-empanelled private hospital. Justice Sandeep Moudgil said that the denial of reimbursement without reasons is arbitrary and violative of the right to life under Article 21 of the Constitution.

Read: <a href="https://www.healthandme.com/health-news/delhi-high-court-permits-jntl-to-sell-180-crore-orsl-stock-despite-fssai-dispute-article-153022713" data-type="tilCustomLink">Delhi High Court Permits JNTL to Sell ₹180-Crore ORSL Stock Despite FSSAI Dispute</a> 

The court also found a violation of Article 14. It stated that such rigid application or procedural during a pandemic is arbitrary and unequal treatment. The petition was filed by CRPF personnel Balhar Singh, who is seeking the reimbursement for his wife's medical treatment, which were rejected on technical grounds during the COVID-19 pandemic. Singh began his wife's treatment at an empanelled CGHS hospital in Chandigarh, with limited facility, however, he was compelled to seek further cardiac care at a private hospital with better facilities. 

"The medical records established that both the petitioner and his wife faced urgent cardiac emergencies, making the treatment unavoidable. The repeated rejection of the petitioner and his wife's medical reimbursement claims during the COVID-19 pandemic amounts to a clear violation of constitutional rights."

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The Punjab and Haryana High Court, after 19 years, has finally ended the case of medical reimbursement of heart surgery from a non-empanelled hospital. The surgery happened in 2002. This was a government school teacher, Bhupinder Singh, from Government Elementary School, Phus Mandi, Mansa, who had undergone coronary artery bypass surgery at Escorts Heart Institute and Research Centre in Delhi. The bill was of Rs. 2,20,677 and Rs 11,000 during his admission from November 18 to 30 that year. Justice Sudeepti Sharma dismissed the earlier regular second appear filed by the State of Punjab, upholding the 2006 order of district judge, Mansa, that allowed the reimbursement. The court observed that Singh was referred to the hospital through official government channels after an angiography showed serious cardiac issues. It also noted that Escorts Heart Institute was a recognized center for open-heart surgery under a 1991 Punjab government notification, along with Christian Medical College, Ludhiana, and Apollo Hospital, Madras.Read: Supreme Court Steps In For 31-year-old's Passive Euthanasia Plea Who Has Been In Vegetative State For 10 YearsThe Cycle Of Reimbursement Finally EndsThe judgment referred to official records showing that the referral was made by the Punjab Health Systems Corporation because of the patient’s critical condition. It also relied on a 1995 government instruction stating that prior approval from a medical board is not required in life-threatening emergencies.The court came down strongly on the delay in deciding the case, expressing anguish over the 19-year wait. The judge noted that reimbursement matters should be settled promptly, pointing out that the patient had been pursuing his claim since 2002, only for it to take nearly two decades to reach a decision.Justice Sharma noted: “The government should be liberal in framing the policies for medical treatment and reimbursement since a person in pain is not expected to choose the hospital and would prefer the nearest one only.”Read: Andhra Pradesh May Ban Social Media for Under-16s To Protect TeenagersOne More Medical Expense Case AllowedIn another news, in the case of another government employee asking for reimbursement from a non-panelled hospital, the Punjab and Haryana high Court under the judgment directed the Haryana Government to reimburse the remaining medical expenses of a government employee incurred for the emergency treatment of his wife, in a non-empanelled private hospital. Justice Sandeep Moudgil said that the denial of reimbursement without reasons is arbitrary and violative of the right to life under Article 21 of the Constitution.Read: Delhi High Court Permits JNTL to Sell ₹180-Crore ORSL Stock Despite FSSAI Dispute The court also found a violation of Article 14. It stated that such rigid application or procedural during a pandemic is arbitrary and unequal treatment. The petition was filed by CRPF personnel Balhar Singh, who is seeking the reimbursement for his wife's medical treatment, which were rejected on technical grounds during the COVID-19 pandemic. Singh began his wife's treatment at an empanelled CGHS hospital in Chandigarh, with limited facility, however, he was compelled to seek further cardiac care at a private hospital with better facilities. "The medical records established that both the petitioner and his wife faced urgent cardiac emergencies, making the treatment unavoidable. The repeated rejection of the petitioner and his wife's medical reimbursement claims during the COVID-19 pandemic amounts to a clear violation of constitutional rights."