‘Reimburse treatment cost even if hospital not on CGHS list’: HC

The Delhi High Court has ruled that it is more important to verify whether the employee has actually undergone treatment or not and not whether he/she got treated at an empanelled hospital


A division bench of the Delhi High Court observed that it is important to save human lives and that it is the duty of the State to ensure that a person is given medical attention on time and when needed. If the obtaining of such a treatment is not accepted, then it is tantamount to violation of Article 21of the Constitution.

Therefore, according to the HC, if a government employee gets treated at a certain hospital in an emergency situation, and the hospital happens to be absent from the Central Government Health Scheme (CGHS) panel, the mediclaim for reimbursement will have to accepted and covered.

In such situations, the HC believes that it is not important to see whether the hospital that gave treatment is part of the CGHS panel or not, but more important to see whether the claim is genuine. That is, whether the employee did actually obtain treatment and has submitted documents to prove the same.

The bench comprising Justices V Kameswar Rao and Anoop Kumar dismissed a plea by the Central government questioning an order from the Central Administrative Tribunal that directed it to reimburse a pensioner who worked as a senior carpenter with the government, for the amount he spent on emergency medical treatment at the Vidyasagar Institute of Mental Health, Neuro & Allied Sciences (VIMHANS), Delhi. Since VIMHANS was not on the CGHS panel and the pensioner had got himself treated voluntarily, his claim for reimbursement had been denied, causing the government servant in question to approach the court.

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