Medical Reimbursement Cannot Be Denied Mechanically in Emergency Treatment Cases; Medical Reimbursement Policy Must Be Applied Humanely: Punjab and Haryana High Court
Case Name: Prem Chand v. State of Haryana and others
Date of Judgment: 02 July 2026
Citation: CWP-3119-2025
Bench: Hon’ble Mr. Justice Kuldeep Tiwari
Held: The Punjab and Haryana High Court held that medical reimbursement claims cannot be curtailed through a mechanical application of policy instructions, especially where treatment was taken in an emergent medical situation. The authorities must examine whether the treatment was taken by choice or under compelling circumstances, and whether the claim is covered under the applicable medical reimbursement policy.
Summary: The petitioner, an Additional Ahlmad in Sessions Division, Sirsa, challenged the partial sanction of medical reimbursement bills relating to the treatment of his wife and premature newborn child. The petitioner’s wife was admitted in New Delhi due to an emergent pregnancy-related condition, and the newborn required NICU/specialised treatment.
The petitioner submitted medical bills of Rs. 6,49,589/-, Rs. 12,670/- and Rs. 73,467/-, but the respondents sanctioned only Rs. 53,289/-, Rs. 1,200/- and Rs. 21,112/-, respectively. The respondents relied on policy instructions and contended that reimbursement could be restricted to PGIMER rates, since treatment was taken in a private hospital outside the approved list.
The Court observed that while the State can frame policies regulating medical reimbursement, such policies must be applied purposively and not in a manner that defeats the right to medical reimbursement in genuine emergency cases. The Court relied upon judgments including Shiva Kant Jha v. Union of India, Subhash Sharma v. State of Haryana, Kamla Devi v. State of Haryana, Shakuntla v. State of Haryana, and Parminder Singh v. State of Punjab, to reiterate that the factum of treatment, emergency, and availability of facilities are relevant considerations.
Decision: The writ petition was allowed. The impugned sanction orders were set aside. The Court directed the respondent to reconsider the petitioner’s claim for medical reimbursement in light of the legal position discussed in the judgment.