E-Paper
Medical claims: High court expands definition of ‘emergency’ for differently abled
The court further directed to create a supernumerary post for him in view of the 100% permanent disability and further treat the leave without pay availed by him after August 2025 till creation of a supernumerary post.
The Punjab and Haryana high court has said that the conventional understanding of ‘emergency,’ which constitutes likelihood of imminent death or acute medical crisis, is inherently able-bodied centric in medical reimbursement cases.
“For individuals living with disabilities caused by progressive degenerative chronic diseases such as ALS (amyotrophic lateral sclerosis), the scope of ‘emergency’ ought to be wider, as their concerns also validly include rapid and irreversible loss of bodily functions resulting in an inability to perform everyday tasks,” the bench of justice HS Brar said, while directing the Haryana government to reimburse ₹3.95 lakh to a clerk, who underwent a treatment in Plexus Neuro and Stem Cell Research Centre, Bangalore in October 2024.
The court further directed to create a supernumerary post for him in view of the 100% permanent disability and further treat the leave without pay availed by him after August 2025 till creation of a supernumerary post.
The petition was from one Sunil Kumar, working as assistant with the government, who had sought reimbursement of his spending on the treatment and creation of an alternative post due to his disability as mandated by the constitutional right under Rights of Persons with Disabilities Act, 2016. His claim was rejected stating that after examining the record, it was found that the treatment from a non-empanelled was not undertaken in “emergency conditions”. He was diagnosed with an incurable condition called ALS, a type of motor neuron disease, that has caused him a loss of function of both upper and lower limbs. Due to the rapid progression of the disease, he was treated under emergency conditions at an non-empanelled hospital.
The court observed that the government bears an obligation to ensure the availability of timely medical care to those in need. “As such, it cannot expect the citizens to refrain from availing timely care, merely for the reason of non- empanelment of the hospital. Such conduct on the part of the state does not satisfy the criteria of fairness and reasonableness and therefore, amounts to a violation of the fundamental rights enshrined in Article 21 of the Constitution of India,” it added.
It asserted that when a medical reimbursement claim is raised with respect to treatment in a non-empanelled hospital, the test of essentiality and emergency comes into play, which dictates that if the medical procedure was undergone by the claimant in an emergency, on the advice of a doctor based on his medical record, in order to save his life, the reimbursement for the same must be made. “Not only is the preservation of human life instinctive, but it also forms a part of Article 21 of the Constitution of India, and therefore, it shall always retain the highest priority,” it said adding that an inclusive understanding of ‘emergency’ is, therefore, more consistent with the constitutional commitment to equality and dignity as well as the object of the Act of 2016 which mandates non-discrimination and reasonable accommodation.
