Gauhati HC denies Rs 4 lakh reimbursement to OIL engineer for tinnitus treatment

Guwahati: The Gauhati High Court has dismissed a plea filed by a senior engineer of Oil India Limited who was seeking reimbursement of approximately Rs 4.09 lakh for a Tinnitus Masker device and expenses incurred for treatment abroad. The court emphasised that medical reimbursement schemes are fiscally structured frameworks with defined ceilings and categories, and courts cannot rewrite policy based on sympathy. 

Justice Arun Dev Chaudhury, in an order dated February 25, stated, “The sympathy of this court with the petitioner cannot substitute for statutory authorisation. This Court must resist the temptation to rewrite policy under the guise of interpretation and be influenced by sympathy.” 

According to a report by The Indian Express, the petitioner joined OIL in November 2020 and was diagnosed with sensorineural hearing loss (SNHL) in 2022. He later consulted at Apollo Hospital and All India Institute of Medical Sciences, and was advised to undergo Tinnitus Retraining Therapy (TRT) and use a Tinnitus Masking Device. In this particular case, while TRT and masking devices may be clinically recommended for tinnitus management, reimbursement depends on the employer’s codified scheme rather than medical desirability alone.

The petitioner sought financial assistance for the masking device and later requested approval for specialised treatment at a tinnitus clinic abroad. OIL declined these requests, stating that only a hearing aid up to the prescribed ceiling of Rs 50,000 under the OIL Employees’ Medical Attendance Rules, 2018, was available. The company also clarified that treatment abroad during personal travel was not covered. Later, the treating doctor at Indraprastha Apollo Hospital informed OIL that the referral for overseas treatment had been made at the patient’s insistence.

The petitioner travelled abroad on personal leave and subsequently approached the High Court seeking reimbursement and damages, alleging medical negligence. Given the petitioner’s unfamiliarity with judicial review, the court appointed an amicus curiae to assist.

The amicus argued that Rule 8.0 of the 2018 Rules, which uses the phrase “means… and includes,” should be interpreted broadly to cover foreign treatment and devices such as the Tinnitus Masker. It was further contended that since overseas treatment was not expressly listed under the exclusions clause in Rule 9.0, it should be treated as permissible.

Opposing the plea, counsel for OIL argued that the rules provide an exhaustive definition of “treatment,” and that the specific recognition of a hearing aid capped at Rs 50,000 demonstrated a conscious policy choice. The omission of the Tinnitus Masker from the list of authorised artificial appliances was described as deliberate. It was also submitted that foreign medical expenses are reimbursable only when incurred during official tours or training programmes abroad, which did not apply to the petitioner.

The court agreed with OIL’s interpretation, which held that the 2018 Rules constitute a codified benefits scheme forming part of service conditions, with finite entitlements. The judge emphasised that entitlement flows from textual authorisation, not solely from medical recommendation. Addressing the semantic argument around “means” and “includes,” the court found that jurisprudence does not support an elastic reading that expands the scope beyond enumerated items.

The bench further observed that when a specific device, such as a hearing aid, is expressly recognised and capped, it reflects deliberate policy intent. The omission of the Tinnitus Masker, therefore, was not accidental. Applying the principle of “expressio unius est exclusio alterius”, meaning the express mention of one thing implies the exclusion of others, the court concluded that devices of a similar class not listed are impliedly excluded unless expressly incorporated. 

A claim for reimbursement of treatment at a foreign specialised clinic or for equipment not permitted under the employer’s medical scheme cannot be elevated into an enforceable fundamental right under Article 21. The plea was consequently dismissed, reinforcing the principle that courts will not substitute administrative or financial policy decisions in the absence of illegality, the bench added.