Karnataka HC grants relief to court officer and directs authority to consider your request for reimbursement of emergency medical expenses

The Karnataka High Court has reiterated that government employees are entitled to reimbursement for medical expenses incurred in non-listed private hospitals, provided they were referred there by a recognized government hospital.

A single judge bench of Justice Hemant Chandangoudar accepted the petition filed by Nagabhushana B, assistant court officer, who challenged the order rejecting his claim for refund of the amount.

The petitioner sought treatment for CTD with ILD and pulmonary hypertension at Mazumdar Shaw Medical Center. Initially, he was admitted to the Sri Jayadeva Institute of Cardiovascular Science and Research.

The authority rejected his complaint based on a Government Order dated 05.11.2014. The order pertains to reimbursement of medical claims for government employees who received treatment in recognized hospitals. However, in exceptional circumstances, government employees are entitled to reimbursement for medical expenses incurred in non-covered private hospitals, especially when a recognized government hospital refers the patient to a non-covered private hospital for any reason.

While perusing the records, the court said, “In this case, the petitioner initially sought treatment at Sri. Jayadeva Institute of Cardiovascular Science and Research, which is a government hospital, and was later referred to a multi-specialty pulmonologist. Thereafter, the petitioner received treatment at Mazumdar Shaw Medical Center (a unit of Narayana Hrudayalaya), which is a private, non-structured hospital in accordance with the Government Order.

Therefore, it held that “The petitioner is entitled to reimbursement of medical expenses under Clause 5 of Paragraph 3 of the Government Order dated 11.05.2014, which allows public servants to request reimbursement of medical expenses at CGHS rates, even if the treatment has been provided at a private hospital price, provided that a recognized government hospital refers the patient to a specialist.”

It therefore directed the authority to consider the petitioner’s request for reimbursement of medical expenses at CGHS rates, subject to the petitioner’s provision of a complete set of documents, and to pass an appropriate order in accordance with law.

Appearance: Advocate Shridhar Prabhu for the Applicant.

Advocate TP Vivekananda FOR R1.

AGA Navya Shekhar FOR R2.

Advocate SH Prashanth FOR R3.

Citation No: 2024 LiveLaw (Kar) 435

Case Title: Nagabhushana B AND Registrar General and Others

Case No.: WRITTEN PETITION NO. 17956 OF 2024

Click here to read/download order