Skip to main content

Delhi HC rules in favour of retired Air Force officer 'overcharged' for Covid treatment

By Rosamma Thomas* 

In a decision of May 22, 2023, the Delhi High Court ruled in favour of petitioner Group Captain Suresh Khanna who was under treatment at CK Birla Hospital, Gurugram, between April 28 and May 5, 2021, for a period of eight days, for Covid-19 pneumonia. The petitioner had to pay Rs 3,55,286 as treatment costs, but the Ex-Servicemen Contributory Health Scheme (ECHS) only reimbursed him for Rs 1,83,748, on the basis of government-approved rates. 
The Union of India, the respondent in this case, made the argument that the hospital had charged beyond the government-approved rates. Justice Pratibha M Singh, in her ruling, noted precedents in law including Dinesh Kumar v Government of the National Territory of Delhi, where it was established that “reimbursement has to be given to the beneficiaries and that it was incumbent upon the concerned government or authority to obtain recovery from the hospital”. 
She also cited the instance of the case of Squadron Commander Randeep Kumar Rana where the Division Bench held that the employer was under obligation to pay the government employee, and could make appropriate recoveries in accordance with law from the hospital which had overcharged him. Citing the earlier judgment at length, the ruling of May 22, 2023 noted:
“How a citizen can ensure that a hospital does not charge over and above the package rate? The power to lay down guidelines is with the respondent. A citizen is a mere spectator to what State authority do and decide. 
"If the hospital has charged over and above the package rate, the respondent is under an obligation to pay to such charges as the Petitioner has incurred over the package rates at the first instance and if in law state can recover from the hospital concerned, they may do so but they cannot deny their liability to pay to the Government employee who is entitled for medical reimbursement.”
The court ruled that Group Captain Khanna be reimbursed the differential amount of Rs 1,71,528 by July 2023
The ruling cited Shiva Kant Jha v. Union of India, 2018 16 SCC 187, while stating that the Supreme Court “has emphasized that the real test for ascertaining the claim for reimbursement must be the factum of treatment”. The claim, the judgment ruled, cannot be refused on technical grounds. Citing the SC ruling, the judge stated: 
“It is a settled legal position that the government employee during his lifetime or after his retirement is entitled to get the benefit of the medical facilities and no fetters can be placed on his rights…The right to medical claim cannot be denied merely because the name of the hospital is not included in the Government Order. 
"The real test must be the factum of treatment. Before any medical claim is honoured, the authorities are bound to ensure as to whether the claimant had actually taken treatment and the factum of treatment is supported by records duly certified by doctors/hospitals concerned. Once it is established, the claim cannot be denied on technical grounds.”
The court ruled that Group Captain Khanna be reimbursed the differential amount of Rs 1,71,528 by July 2023. If payment is delayed, interest at 6% will be liable to be paid from the date when the application of reimbursement was made. If payment is made in the stipulated time, no interest is liable to be paid. The respondent is also free to take action against CK Birla Hospital, in respect of overcharge, if any, including seeking refund of the overcharged amount.
The ruling is significant for all veterans of the defence forces and government employees, and even for citizens in general since the government is pushing for wider insurance coverage – Insurance Regulatory Authority of India is currently planning an all-in-one insurance policy that will cover health, accident, theft, death, and provide households with monetary support in case of illness in the family. 
New players will be allowed to enter the insurance market to serve untapped needs of specialized segments of society. The insurance regulator’s history of complaint redressal, however, is far from impressive and massive insurance scams have been reported but poorly investigated.
---
*Free lance journalist

Comments

laxman said…
Based on this judgement the Govt should issue clear instruction on the subject so as to keep all govt dept orministries on the same grid . No defence pensioner must suffer in future.

TRENDING

Insider plot to kill Deendayal Upadhyay? What RSS pracharak Balraj Madhok said

By Shamsul Islam*  Balraj Madhok's died on May 2, 2016 ending an era of old guards of Hindutva politics. A senior RSS pracharak till his death was paid handsome tributes by the RSS leaders including PM Modi, himself a senior pracharak, for being a "stalwart leader of Jan Sangh. Balraj Madhok ji's ideological commitment was strong and clarity of thought immense. He was selflessly devoted to the nation and society. I had the good fortune of interacting with Balraj Madhok ji on many occasions". The RSS also issued a formal condolence message signed by the Supremo Mohan Bhagwat on behalf of all swayamsevaks, referring to his contribution of commitment to nation and society. He was a leading RSS pracharak on whom his organization relied for initiating prominent Hindutva projects. But today nobody in the RSS-BJP top hierarchy remembers/talks about Madhok as he was an insider chronicler of the immense degeneration which was spreading as an epidemic in the high echelons of th

Central pollution watchdog sees red in Union ministry labelling waste to energy green

By Chythenyen Devika Kulasekaran*  “Destructors”, “incinerators” and “waste-to-energy (WTE) incineration” all mean the same thing – indiscriminate burning of garbage! Having a history of about one and a half centuries, WTE incinerators have seen several reboots over the 19th, 20th and 21st centuries. 

First-of-its-kind? 'Eco-friendly, low cost' sewage treatment system installed in Gujarat

Counterview Desk Following the installation of the Unconventional Decentralized Multi-Stage Reactor (UDMSR) for sewage treatment, a note on what is claimed to be the  first-of-its-kind technology said, the treated sewage from this system “can be directly utilized for agricultural purposes”, even as proving to be a “saviour in the times of water crisis.”

A Hindu alternative to Valentine's Day? 'Shiv-Parvati was first love marriage in Universe'

By Rajiv Shah*   The other day, I was searching on Google a quote on Maha Shivratri which I wanted to send to someone, a confirmed Shiv Bhakt, quite close to me -- with an underlying message to act positively instead of being negative. On top of the search, I chanced upon an article in, imagine!, a Nashik Corporation site which offered me something very unusual. 

Indo-Bangla border: Farmers facing 'illegal obstacles' in harvesting, transporting yields

  Counterview Desk  In a representation to the chairperson, National Human Rights Commission, human rights defender Kirity Roy, who is secretary, Banglar Manabadhikar Suraksha Mancha (MASUM), has said that Border Security Force (BSF) personnel are creating "illegal obstacles" for farmers seeking to harvest their ripened yields and transport them to the market in village Jhaukuthi of Cooch Behar district.

'Flawed' argument: Gandhi had minimal role, naval mutinies alone led to Independence

Counterview Desk Reacting to a Counterview  story , "Rewiring history? Bose, not Gandhi, was real Father of Nation: British PM Attlee 'cited'" (January 26, 2016), an avid reader has forwarded  reaction  in the form of a  link , which carries the article "Did Atlee say Gandhi had minimal role in Independence? #FactCheck", published in the site satyagrahis.in. The satyagraha.in article seeks to debunk the view, reported in the Counterview story, taken by retired army officer GD Bakshi in his book, “Bose: An Indian Samurai”, which claims that Gandhiji had a minimal role to play in India's freedom struggle, and that it was Netaji who played the crucial role. We reproduce the satyagraha.in article here. Text: Nowadays it is said by many MK Gandhi critics that Clement Atlee made a statement in which he said Gandhi has ‘minimal’ role in India's independence and gave credit to naval mutinies and with this statement, they concluded the whole freedom struggle.

Wasteland, a colonial legacy, being used to 'give away' vast tracts to Ratnagiri refinery

By Fouziya Tehzeeb* William D’Souza, a 55-year old farmer from Kuthethur, Mangalore, was busy mixing cattle feed when we arrived at his doorsteps. Around 25 km from the bustling city of Mangalore, Kuthethur is a lush green village with thick vegetation. On the way to William’s house the idyllic view gets blocked by the flares and smoke arising from the Mangalore Refinery and Petrochemicals Limited (MRPL).

CAA disregards India's inclusive plural ethos, 'betrays' ideals of freedom struggle: PUCL

Counterview Desk    "Outraged" at the move of the Central government to implement the Citizenship Amendment Act, 2019 (CAA 2019) weeks before the election, the top rights group, People's Union for Civil Liberties (PUCL), has demanded that the law be repealed. 

Buddhist shrines were 'massively destroyed' by Brahmanical rulers: Historian DN Jha

Nalanda mahavihara By Our Representative Prominent historian DN Jha, an expert in India's ancient and medieval past, in his new book , "Against the Grain: Notes on Identity, Intolerance and History", in a sharp critique of "Hindutva ideologues", who look at the ancient period of Indian history as "a golden age marked by social harmony, devoid of any religious violence", has said, "Demolition and desecration of rival religious establishments, and the appropriation of their idols, was not uncommon in India before the advent of Islam".

Invincible, Modi 'taller' than BJP, RSS: An opportunity for Congress beyond 2024?

By NS Venkataraman*  With the announcement of poll schedule for the 2024 parliamentary election, there is palpable excitement and expectation amongst the countrymen  about the shape of things to happen in India after the  results of the election would be announced. There is also speculation abroad about the future course of developments in India.