The treatment in a non-network hospital cannot exclude medical reimbursement from being rejected.
Title- C. Mani VS Principal Secretary to Government of Tamil Nadu and others.
Court- The High Court of Madras
Case No. – W.P. (MD) No. 25304 of 2018
Decided on- 5th December, 2023.
Coram- Before Mr. S.M. Subramaniam and Mr. V. Lakshminarayanan, JJ
Introduction- The order of rejection to settle the medical reimbursement claim of the writ petitioner issued by the Director of Health and Rural Services is under challenge in this writ petition.
Facts- The petitioner is a State pensioner and a member of Medical Health Scheme. The petitioner was Chief Administrative Officer in Principal District Court, Pudukkottai and retired from service on 30.09.2010. He was paying subscription under the scheme regularly. The petitioner spent sum of Rs. 1,24,576/- as medical expenses. He submitted application for medical reimbursement and it was rejected by the Director of Health and Rural Services on the ground that the petitioner undertook treatment in a non-network hospital and therefore, the petitioner is not eligible for medical reimbursement claim. Aggrieved by this the Petitioner filed this petition.
Issues- Whether medical reimbursement can be rejected on the ground of non-network hospital?
The Court said that the issues regarding the settlement of the medical claim are no more res-integra in respect of the treatment undertaken in a non- network hospital. Several Court orders have been passed to settle the medical reimbursement claim and not to reject the same merely on the ground that the hospital is not falling under the list of network hospitals.
Court Analysis and Decision- In the present case, the genuinity of the treatment taken by the petitioner has not been disputed. The court said that once the treatment is found to be genuine, there is no reason to reject the medical claim of the petitioner.
After considering the facts and circumstances, the court set aside the impugned order passed by the Director of Health and Rural Services (2nd Respondent) dated on 2nd April, 2018. The court directed the Divisional Manager of United India Insurance Company Limited (7th Respondent) to settle the eligible medical reimbursement claim of the petitioner under the scheme within the period of six weeks from the date of receipt of a copy the court order. The court allowed this writ petition.
Insight- What is medical reimbursement?
Medical reimbursement is an arrangement between an employer and employee where the employer reimburses a portion of the employee’s medical expenses. It is a fixed amount provided by the employer to the employee to meet medical expenses.
WRITTEN BY:Nireesha rao
🏥💼 Important ruling! The High Court of Madras emphasizes that medical reimbursement cannot be denied solely based on treatment in a non-network hospital. Another victory for genuine medical claims! #LegalInsights #HealthcareRights 📝⚖️
Very interesting details you have mentioned, appreciate it for posting. “I never said most of the things I said.” by Lawrence Peter Berra.
I was more than happy to search out this web-site.I wished to thanks on your time for this glorious learn!! I undoubtedly enjoying every little bit of it and I have you bookmarked to check out new stuff you weblog post.
Hiya! Quick question that’s totally off topic. Do you know how to make your site mobile friendly? My weblog looks weird when viewing from my iphone. I’m trying to find a template or plugin that might be able to resolve this problem. If you have any suggestions, please share. Thank you!
Very interesting subject, appreciate it for posting. “It is much easier to try one’s hand at many things than to concentrate one’s powers on one thing.” by Quintilian.
Good ?V I should certainly pronounce, impressed with your site. I had no trouble navigating through all the tabs and related information ended up being truly simple to do to access. I recently found what I hoped for before you know it at all. Quite unusual. Is likely to appreciate it for those who add forums or anything, site theme . a tones way for your customer to communicate. Excellent task..
I really like your writing style, wonderful info, thanks for posting :D. “I will show you fear in a handful of dust.” by T. S. Eliot.
I do agree with all of the ideas you’ve presented in your post. They’re really convincing and will certainly work. Still, the posts are very short for novices. Could you please extend them a bit from next time? Thanks for the post.
I’ve been browsing online more than 3 hours today, yet I never found any interesting article like yours. It’s pretty worth enough for me. In my opinion, if all website owners and bloggers made good content as you did, the internet will be a lot more useful than ever before.
In the awesome design of things you’ll receive an A with regard to effort. Where you confused everybody was first on the particulars. As as the maxim goes, the devil is in the details… And it could not be more correct here. Having said that, allow me inform you what did do the job. The text is certainly pretty powerful and that is possibly the reason why I am taking the effort to comment. I do not really make it a regular habit of doing that. Second, even though I can easily see the leaps in reason you make, I am not necessarily confident of exactly how you seem to connect your ideas which make your conclusion. For right now I shall subscribe to your position however hope in the near future you actually link the dots much better.
Very good written post. It will be useful to anyone who usess it, as well as myself. Keep up the good work – looking forward to more posts.
Some genuinely great information, Gladiolus I found this.
Very interesting info !Perfect just what I was searching for!
It?¦s really a great and helpful piece of information. I?¦m satisfied that you just shared this helpful information with us. Please stay us informed like this. Thanks for sharing.
Thank you for the sensible critique. Me and my neighbor were just preparing to do some research on this. We got a grab a book from our area library but I think I learned more clear from this post. I’m very glad to see such wonderful information being shared freely out there.
very good post, i definitely love this web site, carry on it
An attention-grabbing discussion is price comment. I believe that you need to write more on this subject, it might not be a taboo subject however generally people are not enough to speak on such topics. To the next. Cheers
As I website owner I conceive the subject material here is rattling fantastic, thanks for your efforts.
Howdy very nice blog!! Guy .. Excellent .. Amazing .. I will bookmark your site and take the feeds additionallyKI am glad to search out a lot of helpful info right here in the post, we need develop more strategies in this regard, thank you for sharing. . . . . .
The crux of your writing whilst appearing agreeable at first, did not sit well with me after some time. Somewhere within the paragraphs you actually were able to make me a believer unfortunately only for a short while. I still have a problem with your jumps in logic and you might do well to fill in all those gaps. In the event you can accomplish that, I could certainly be amazed.
Thank you for sharing with us, I believe this website genuinely stands out : D.
obviously like your web-site but you need to check the spelling on several of your posts. Several of them are rife with spelling problems and I find it very troublesome to tell the truth nevertheless I’ll certainly come back again.
I would like to show my passion for your kindness in support of men and women who really want guidance on this one field. Your personal dedication to getting the solution across was really productive and has regularly permitted guys and women like me to arrive at their pursuits. This interesting useful information means a lot a person like me and somewhat more to my mates. Many thanks; from everyone of us.
You got a very excellent website, Glad I observed it through yahoo.
Fantastic web site. Lots of useful information here. I am sending it to some friends ans also sharing in delicious. And naturally, thanks for your sweat!
What i do not realize is actually how you’re no longer actually a lot more well-favored than you might be now. You’re very intelligent. You understand therefore considerably with regards to this subject, made me in my opinion consider it from so many varied angles. Its like men and women are not interested until it’s one thing to do with Lady gaga! Your individual stuffs excellent. At all times maintain it up!
Greetings! I’ve been following your website for a while now and finally got the courage to go ahead and give you a shout out from Porter Texas! Just wanted to say keep up the excellent work!
What¦s Taking place i’m new to this, I stumbled upon this I have discovered It positively helpful and it has helped me out loads. I am hoping to contribute & aid other customers like its aided me. Great job.
My spouse and I stumbled over here from a different website and thought I should check things out. I like what I see so now i am following you. Look forward to checking out your web page repeatedly.
Hello! I just would like to give a huge thumbs up for the great info you have here on this post. I will be coming back to your blog for more soon.
Hello would you mind sharing which blog platform you’re working with? I’m planning to start my own blog soon but I’m having a difficult time making a decision between BlogEngine/Wordpress/B2evolution and Drupal. The reason I ask is because your design and style seems different then most blogs and I’m looking for something unique. P.S Sorry for being off-topic but I had to ask!
I got what you intend, thanks for putting up.Woh I am delighted to find this website through google.
A powerful share, I simply given this onto a colleague who was doing just a little evaluation on this. And he the truth is bought me breakfast because I found it for him.. smile. So let me reword that: Thnx for the deal with! However yeah Thnkx for spending the time to discuss this, I feel strongly about it and love reading more on this topic. If possible, as you turn into expertise, would you mind updating your weblog with extra details? It is extremely helpful for me. Massive thumb up for this weblog submit!
I haven’t checked in here for some time as I thought it was getting boring, but the last few posts are great quality so I guess I will add you back to my daily bloglist. You deserve it my friend 🙂
Magnificent website. A lot of helpful information here. I?¦m sending it to a few friends ans also sharing in delicious. And of course, thank you on your sweat!
Excellent web site. Plenty of useful info here. I’m sending it to some pals ans additionally sharing in delicious. And naturally, thank you for your effort!
Hey! Someone in my Facebook group shared this site with us so I came to take a look. I’m definitely enjoying the information. I’m bookmarking and will be tweeting this to my followers! Terrific blog and superb style and design.
Its like you read my mind! You appear to know a lot about this, like you wrote the book in it or something. I think that you can do with some pics to drive the message home a bit, but other than that, this is excellent blog. A great read. I’ll definitely be back.
My partner and I absolutely love your blog and find a lot of your post’s to be just what I’m looking for. can you offer guest writers to write content for you? I wouldn’t mind writing a post or elaborating on a lot of the subjects you write regarding here. Again, awesome site!
Outstanding post, you have pointed out some superb points, I as well think this s a very great website.
The core of your writing while appearing reasonable at first, did not really sit well with me after some time. Somewhere throughout the paragraphs you actually managed to make me a believer but just for a very short while. I however have a problem with your jumps in assumptions and one might do nicely to help fill in all those breaks. In the event you can accomplish that, I could surely be fascinated.
A formidable share, I simply given this onto a colleague who was doing a bit of evaluation on this. And he in reality purchased me breakfast because I discovered it for him.. smile. So let me reword that: Thnx for the treat! However yeah Thnkx for spending the time to discuss this, I feel strongly about it and love reading more on this topic. If possible, as you turn out to be experience, would you mind updating your blog with extra particulars? It’s extremely useful for me. Big thumb up for this weblog post!
Hey I am so glad I found your site, I really found you by error, while I was looking on Yahoo for something else, Anyhow I am here now and would just like to say thanks a lot for a remarkable post and a all round entertaining blog (I also love the theme/design), I don’t have time to read through it all at the minute but I have bookmarked it and also added your RSS feeds, so when I have time I will be back to read much more, Please do keep up the excellent work.
Well I sincerely liked reading it. This information offered by you is very constructive for correct planning.
Pretty! This was a really wonderful post. Thank you for your provided information.