Region: Asia
Year: 2001
Court: High Court - Delhi
Health Topics: Chronic and noncommunicable diseases, Health care and health services, Health systems and financing, Hospitals
Human Rights: Right to health, Right to life
Tags: Access to treatment, Heart disease, Military, Private hospitals, Reimbursement, Secondary care, Tertiary care
Lt. Col. B.S. Dhanda, the Petitioner, was an army official who was advised to undergo angiography and other specialized treatment at Escorts Hospital. The medial expenses incurred during this period were cleared by the Army Hospital. On submitting the bills for reimbursement, only a part of the claim was reimbursed.
The Petitioner unsuccessfully filed a statutory complaint against the Union of India and others, the Respondents, for the failure to reimburse his medical expenses in full. The Petitioner thereafter filed a petition in the Delhi High Court under Article 226 of the Constitution (original writ jurisdiction of High Courts), praying the Court to direct the Respondent to reimburse the full amount. The Respondent claimed that the Petitioner was aware that there were other hospitals he could have gone to and that there was a limit up to which reimbursement could be claimed.
As to whether the Respondent could put a limit on the amount reimbursed, the Court held that the State could indeed limit the amount of medical expenses that could be reimbursed. Placing reliance on State of Punjab & Ors. v. Ram Lubhaya Bagga, ((1998) 1 SCR 1120), the Court noted that a larger bench of the Supreme Court had previously held that placing limits on reimbursement was neither a violation of Article 21 (right to life) nor of Article 47 (duty of state to improve public health).
The Court further held that the failure to fix a scale for reimbursements meant private hospitals could charge exorbitant rates and the State would be obliged to reimburse the same. However, the Court decided to refrain from interfering in the fixation of such a scale because it was a policy decision to be made by other branches of government.
“[P]rinciples of fixation of rate and scale under the policy is justified and cannot be held to be violative of Article 21 of Article 47 of the Constitution of India. It was also held that the Court would not generally interfere with any opinion formed by the Government, if it is based on relevant facts and circumstances or based on expert advice.” Para. 10.