Karnataka HC grants relief to Court Officer, affirms Right to Emergency Expense Reimbursement at Non-Empanelled Private Hospital
Bengaluru: The Karnataka High Court has clarified that government employees are allowed to seek reimbursement of medical expenses at the Central Government Health Scheme (CGHS) rates, even if the treatment was provided at a non-empanelled private hospital, provided that a recognized government hospital referred the patient to a specialist.
The bench, comprising Judge Hemant Chandangoudar, was considering a petition by an Assistant Court Officer. He sought treatment for CTD with ILD and pulmonary hypertension at Mazumdar Shaw Medical Centre. Initially, he was admitted to the Sri Jayadeva Institute of Cardiovascular Sciences & Research, located at the K.C. General Hospital premises in Malleshwaram, Bengaluru.
The petitioner submitted a medical claim application for reimbursement in the amount of Rs.2,63,764/—along with the prescription, bills, and discharge summary dated 23.12.2022. He also submitted a representation explaining the emergency circumstances that necessitated treatment at an unrecognized hospital.
The petitioner initially sought treatment at the Sri Jayadeva Institute of Cardiovascular Sciences and Research, which is a government hospital and was subsequently referred to a multispecialty pulmonologist. Thereafter, the petitioner received treatment at Mazumdar Shaw Medical Centre (a unit of Narayana Hrudayalaya), which is a private and non-empanelled hospital according to the Government Order.
A Single Bench of Justice Hemant Chandangoudar observed, “The petitioner is entitled to reimbursement of medical expenses under Clause 5 of Paragraph 3 of the Government Order dated 05.11.2014, which allows government servants to seek reimbursement of medical expenses at CGHS rates, even if the treatment was provided at a private hospital, provided that a recognized government hospital referred the patient to a specialist.”
To view the order, click the below link:
