Medical Reimbursement Not 'Alms': Punjab & Haryana High Court Fixes 2-Month Deadline For Authorities, Orders Payment Of Interest For Delay
The Punjab and Haryana High Court has held that medical reimbursement is a legitimate right of government employees and not a matter of charity, directing States and public authorities to process such claims within a two months or face interest liability.
Justice Sudeepti Sharma dismissed the State's second appeal and upheld concurrent findings of the trial court and appellate court granting full medical reimbursement along with interest to the respondent.
"It is not so difficult to decide the entitlement/reimbursement of medical bills which are placed before the department along with the documentary proof of the same, that the department takes such a long period to grant the benefit of medical reimbursement, which its employee is entitled to, since it is part of one of the benefits or entitlements granted to him along with his job. Medical remibursement cannot be stated to be alms given to an employee who is otherwise entitled to the same,"the Court said.
It added that, once an employee is entitled to any benefit which is not granted to him within a reasonable period, it should be granted with interest. Otherwise, the department would not be releasing the benefit for years together and would keep on moving the file from one department to another to decide such a small claim of medical reimbursement, for which only the medical bills as well as other documents are to be verified.
The judge said it does not and cannot take maximum more than one month and can be decided in a week also.
Deadline Of Two Months
The Court clarified that in larger public interest that this Court laid down maximum time period within which medical bills should be paid. It is need of the hour that, to avoid delay in decision of medical reimbursement bills, a reasonable time period should be fixed by the Court.
"Beyond that period, interest at the rate of 9% per annum should be added so that the departments do the needful within the stipulated time period. State of Punjab, State of Haryana, and U.T., Chandigarh, Corporations and Boards which entitle their employees for medical reimbursement are directed to decide their claim within a maximum period of two months from the date of submission of the medical bills and beyond that period they would be liable to pay interest @9% per annum," it added.
Background
The case arose from prolonged denial and partial reimbursement of medical expenses incurred by the respondent for treatment of her husband following a serious accident in 2009. Despite submitting claims supported by bills and emergency certificates, the reimbursement was delayed, curtailed, and subjected to repeated objections.
The trial court decreed the suit in favour of the respondent, directing reimbursement of the remaining amounts along with 12% interest. The first appellate court upheld the decision, leading the State to file a second appeal.
The High Court found no infirmity in the concurrent findings, noting that the medical expenses and treatment were not disputed by the State.
It added that mergency circumstances justified treatment at private hospitals
The State failed to explain prolonged delays and arbitrary curtailment
The Court strongly criticised the bureaucratic handling of the claim, observing that the respondent—already under distress due to her husband's medical condition—was further harassed by movement of files between departments for over a year.
Right to Medical Reimbursement
Emphasising the welfare nature of such benefits, the Court held, “Medical reimbursement is a right of a government employee… It cannot be treated as alms.”
The Court further observed that forcing patients in emergency situations to adhere strictly to lists of approved hospitals is unrealistic and unjust, especially when life is at stake.
Interest on Delayed Payment
Distinguishing the Supreme Court's ruling in Om Prakash Gargi v. State of Punjab, the Court held that in the present case, the claim was duly verified and established through evidence, justifying grant of interest.
It ruled that where legitimate dues are withheld without justification, the employee is entitled to interest, failing which departments would have no incentive to process claims in a timely manner.
Dismissing the appeal, the Court underscored that delays of years defeat the very purpose of medical reimbursement schemes, particularly when employees spend substantial sums during medical emergencies.
Mr. Harish Nain, Assistant Advocate General, Haryana
Mr. Aditya Yadav, Advocate and Ms. Hemlata, Advocate for the respondent.
Title: STATE OF HARYANA AND ORS. v. SAVITA YADAV