Denying Medical Reimbursement For Chronic Illness On Ground That Treatment Was Taken In OPD Is 'Unreasonable Classification': Punjab & Haryana HC

The Punjab & Haryana High Court has made it clear that denying medical re-imbursement to an employee of the State Government for the treatment of wife's chronic illness on the ground that the same was done in Outpatient Department (OPD) is based on "unreasonable classification."

Chief Justice Sheel Nagu and Justice Sudhir Singh said, "the wife of respondent No. 1-writ petitioner was suffering from CKD (Chronic Kidney Disease), the treatment given by the concerned Doctors in the OPD, was totally dependent upon the expertise of the said Doctors and therefore, the denial of the claim of the medical reimbursement of the wife of respondent No. 1-writ petitioner on the ground that it was taken in OPD, is not based on a reasonable classification."

The Court further said that the disease being chronic in nature, the treatment even it taken in OPD, cannot be termed to be not falling in category of "emergency treatment", particularly when the disease relating to renal requires a continuous treatment.

These observations were made while hearing a LPA filed by Haryana Government challenging the order of the single judge who directed the State to calculate the amount of medical reimbursement for the treatment of the wife of respondent by keeping in view the expenditure chart and disburse the amount.

Facts In Brief

The wife of a Government Employee had got treatment for her Chronic Kidney Disease (CKD) from 2014 to 2016. She had been treated twice in emergency situation. The claim for the medical re-imbursement was rejected on the ground that that the treatment does not fall on the ground that cannot be categorised as an emergency as far as the outdoor treatment was concerned.

After hearing the submissions, the Court noted that the single judge held that when the treatment taken was essential to life saving and the disease was listed chronic, rejection of the medical reimbursement claim of the wife of the employee was not tenable.

The Court also referred to the policy on medical reimbursement of the Haryana Government Employees/Pensioners/Dependents, and found that a Government employee will not be allowed reimbursement of medical treatment in respect of himself or his dependents, if such treatment is taken in an emergencey in an "unapproved hospital."

Speaking for the bench Justice Sudhir Singh observed that, "Chronic means a condition that does not get completely better and lasts over a long time. A patient with CKD is also at an increased risk of other ailments like heart attack or stroke."

The bench added that, It is not disputed by the appellants that the wife of the employee had taken treatment from the approved hospitals and denying merely the re-imbursement on the ground it was taken in OPD is unreasonable classification.

In the light of the above, the Court dismissed the LPA and upheld the order of the single judge.

Mr. Deepak Balyan, Addl.A.G., Haryana.

Mr. Dinesh Arora, Advocate for respondent No. 1.

Title: State of Haryana v. Manoj Jain & Ors.

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