Excluding Psychiatric Treatment From Medical Reimbursement Schemes Violates Mental Healthcare Act: Jharkhand High Court

The Jharkhand High Court has held one cannot be denied reimbursement for expenses incurred to get treatment for mental health, ruling that excluding psychiatric treatment from medical reimbursement schemes violates the Mental Healthcare Act, 2017. It was emphasized by the Court that the treatment of mental health is required to be treated on a par with physical healthcare and that no reimbursement policy can capriciously exclude psychiatric care.Justice Ananda Sen, presiding over the case, held, “there cannot be any discrimination in respect of reimbursement of expenses made by a person suffering from physical illness and mental illness. Clause 6.3(i) of the CPRMS, which denies reimbursement of any expenses incurred by the member for psychiatric treatment is directly in conflict with various provisions of the Mental Healthcare Act, 2017, especially Section 21(4) of the Act. This discrimination made in the CPRMS is not based on any intelligible differentia.”“... after promulgation of Mental Healthcare Act, 2017, provision of Clause 6.3(i) of the CPRMS as adopted by the Board, so far as it relates to non-reimbursement of expenses for psychiatric treatment, is in direct conflict with the Act. Thus, I hold and declare that after promulgation of Mental Healthcare Act, 2017 and especially taking into consideration Section 21(4) of the Act, exclusion of psychiatric treatment in CPRMS is rendered nugatory,” Justice Sen added.The ruling was made in a writ petition filed by a retired executive of Bharat Coking Coal Limited (BCCL), a subsidiary of Coal India Limited (CIL). The petitioner had sought to quash an Office Note dated 26.10.2019 and a letter dated 23.01.2020, which rejected his claim for reimbursement of expenses incurred on psychiatric treatment for his wife, citing Clause 6.3(i) of the Contributory Post Retirement Medicare Scheme (CPRMS). The petitioner also sought a direction for reimbursement of the amount that had been deducted from his medical bills.The petitioner argued that as a retired executive of BCCL, he was entitled to reimbursement for his wife's psychiatric treatment and that mental healthcare should not be treated differently from other medical conditions. He contended that Clause 6.3(i) of the CPRMS, which excludes psychiatric treatment from reimbursement, was arbitrary, discriminatory, and in violation of statutory rights under the Mental Healthcare Act, 2017. The respondents, on the other hand, argued that CPRMS was a non-statutory scheme and that reimbursement was governed strictly by its provisions, which expressly excluded psychiatric treatment.The court found that CPRMS, while not a statutory scheme, functioned as a medical insurance cover for retired executives of CIL and its subsidiaries. It held that after the enactment of the Mental Healthcare Act, 2017, all healthcare policies and reimbursement schemes were required to comply with its provisions. The court extensively referred to Section 21(1) and 21(4) of the Act, which mandate there cannot be any discrimination between a person suffering from mental illness and a person suffering from any other physical illness.“In one line it can be summarized that there cannot be any difference so far as treatment and giving other facilities, between a mentally ill person or a physically ill person. Both of them are kept on the same pedestal so far as treatment is concerned without any discrimination,” the Court stated.The court emphasized that CPRMS was a scheme floated and approved by its Board Meeting. The Court held that state-controlled entities could not adopt policies that contravened parliamentary legislation, stating, “Coal India Limited and its subsidiary companies are State within the meaning of Article 12 of the Constitution of India. Their action or any resolution, which they adopt cannot be contrary to the provisions of any Statute promulgated by the legislatures, herein the Parliament of India.”The Court stated, “Considering what has been observed above, a patient receiving psychiatric treatment has to get the same benefit similar to a person suffering from physical illness and as the CPRMS provides for giving several benefits to the persons suffering from physical illness, persons suffering from mental illness are also entitled to receive the same benefit without any discrimination. The benefits also and must include reimbursement of medical expenses also.”Accordingly, the Office Note and the letter by which the Medical Bill for psychiatric treatment of petitioner's wife had been rejected on the ground that the same was not admissible as per Clause 6.3(i) of CPRMS, were set aside and the Respondents were directed by the Court to reimburse the amount of admissible expenses to the petitioner within six weeks of the date of the Order and not take the defence of Clause 6.3.(i) of the CPRMS. Consequently, the writ petition was allowed.Case Title: Santosh Kumar Verma v. Bharat Coking Coal Ltd and OthersLL Citation: 2025 LiveLaw (Jha) ...

Excluding Psychiatric Treatment From Medical Reimbursement Schemes Violates Mental Healthcare Act: Jharkhand High Court

Bhavya Singh

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