Citing Garuda Purana, P&H High Court Holds Reimbursement For Emergency Medical Treatment In Non-Empanelled Hospital Can't Be Curtailed
In a significant ruling reinforcing the constitutional right to health and dignity, the Punjab and Haryana High Court has held that the State cannot mechanically restrict medical reimbursement to notified PGI/AIIMS rates when life-saving treatment was taken in a non-empanelled private hospital during a certified emergency.Justice Sandeep Moudgil said "it is important to bear in mind that...
In a significant ruling reinforcing the constitutional right to health and dignity, the Punjab and Haryana High Court has held that the State cannot mechanically restrict medical reimbursement to notified PGI/AIIMS rates when life-saving treatment was taken in a non-empanelled private hospital during a certified emergency.
Justice Sandeep Moudgil said "it is important to bear in mind that self preservation of one's life is the necessary concomitant of the right to life enshrined in Article 21 of the Constitution of India, fundamental in nature, sacred, precious and inviolable. The principle that a person possesses both a duty and a right to preserve one's own life finds clear expression in the doctrine of private defence recognised in criminal jurisprudence."
The court said that the law, in acknowledging the legitimacy of self-defence, reflects a far older moral and philosophical understanding that self-preservation is intrinsic to human existence.
Quoting Garuda Puran the Court said, "Long before the evolution of modern legal systems, thinkers of this ancient land had articulated and affirmed this principle. In that context, reference may be made to verses 17, 18, 20 and 22 of Chapter XVI of the Garuda Purana, presented as a dialogue between the Divine and Garuda, the holy and pious bird, wherein the sanctity of life and the imperative of protecting oneself are emphatically underscored."
The quotes include, " िवना देहेन क ािप च पु षाथ न िवते। ताद् देहं धनं रेत् पुकमा िण साधयेत्॥" which means, "Without the body how can one obtain the objects of human life ? Therefore protecting the body which is the wealth, one should perform the deeds of merit."
It also noted "शरीररणोपायाः ि-य.े सव दा बुधैः । ने12. च पुन3ागमिप कु &ािदरोिगणः ॥" i.e. "The wise always undertake the protective measures for the body. Even the persons suffering from leprosy and other diseases do not wish to get rid of the body."
The petitioner, a retired Chief Engineer from the Irrigation & Water Resources Department, Haryana, suffered a grave medical emergency in January 2018 while at Hisar. His condition deteriorated rapidly and he slipped into coma. On medical advice, he was shifted to Fortis Memorial Research Institute, Gurugram, where he was admitted to the Emergency ICU and diagnosed with viral meningoencephalitis.
He remained hospitalised from 16.01.2018 to 25.01.2018, incurring a total expenditure of ₹3,54,647. The emergency was duly certified by the Civil Surgeon. However, the State reimbursed only ₹1,38,422, restricting the claim to PGI/AIIMS rates under its 2005 reimbursement policy applicable to treatment in non-empanelled hospitals.
Aggrieved, the petitioner approached the High Court seeking quashing of the calculation sheet and full reimbursement.
The Court considered the issue, Whether, in a case of admitted life-threatening emergency, the State can restrict medical reimbursement to notified rates under executive instructions solely because the hospital was not empanelled.
The Court noted that in the present case, the petitioner was in coma. He was not exercising choice but was fighting for survival. His wife, in an hour of acute distress, acted upon medical advice and shifted him to a facility equipped to handle a neurological emergency.
Applying the above principles to the case at hand, the Court observed: “To expect, in such a moment, a verification of empanelment lists or rate charts is to demand bureaucratic compliance from the brink of mortality.”
While acknowledging that reimbursement policies serve fiscal discipline, the Court held that executive instructions cannot override constitutional guarantees.
“Policies are instruments of governance; they are not fetters upon justice,” the Court observed, adding that when mechanical application of a policy undermines the right to life, constitutional courts must interpret it with reasonableness and equity.
The Court emphasised that a retired government servant cannot be left to shoulder a substantial financial burden for life-saving treatment merely because the hospital was not empanelled.
The Court quashed the calculation sheet dated 17.05.2018 to the extent it limited reimbursement to ₹1,38,422, it also directed the respondents to reimburse the remaining ₹2,16,225 within four weeks.
Justice Moudgil ordered payment of interest at 9% per annum from 25.01.2018 (date of discharge) until actual payment and the Court also urged the State Government to revisit its medical reimbursement policy to incorporate flexibility for certified life-threatening emergencies in non-empanelled hospitals, so as to reduce litigation and align administrative practice with constitutional morality.
Mr. D.R. Bansal, Advocate for the petitioner.
Mr. R.D. Sharma, DAG, Haryana
Title: RAMA KANT SHARMA v. STATE OF HARYANA AND ANOTHER