Friday, February 13

Relief to Father in Medical Expense Dispute

The Kerala High Court has directed the State government to reimburse medical expenses incurred for the treatment of a minor girl suffering from Adolescent Idiopathic Scoliosis (Type 6), a rare spinal condition. The treatment was undertaken at a hospital in Coimbatore as the required facilities were unavailable in Kerala. The Court ordered that reimbursement be made within six weeks.

Petition Filed by Palakkad Resident

The order was passed by Justice Harisankar V. Menon while hearing a petition filed by the girl’s father, a resident of Palakkad district. He had challenged the State government’s decision to deny reimbursement for the expenses incurred at a non-empanelled hospital.

Court Cites Lack of Facilities in Kerala

As reported by The Times of India, the High Court observed that the request deserved sympathetic consideration since no hospital in Kerala, including government institutions, offered treatment for the specific condition. The Court relied on a certificate issued by the Palakkad District Medical Officer confirming the absence of necessary medical facilities in the State.

Prior Approval Sought by Petitioner

The petitioner had initially sought prior approval from the government for financial assistance after his daughter was diagnosed with the rare disorder. He informed authorities that adequate treatment options were not available within Kerala and highlighted the urgency of medical intervention.

Treatment Undertaken in Coimbatore

Without waiting for a formal response from the State, the father proceeded with treatment at a specialised hospital in Coimbatore. In 2017, he submitted another application informing the government that the treatment was ongoing outside the State due to medical necessity.

Government Rejection of Claims

In October 2020, the State government rejected the reimbursement claim on the ground that the treatment was taken at a non-empanelled private hospital, citing a circular restricting such payments. A subsequent application filed in 2022 was also dismissed on similar grounds.

Court Finds Denial Unjustified

After examining the records, the Court held that the father could not be faulted for seeking specialised care outside Kerala when it was unavailable locally. The bench observed that rigid adherence to procedural norms should not defeat genuine medical necessity.

Six-Week Deadline for Payment

Accordingly, the High Court directed the State government to process and release the reimbursement amount within six weeks. The ruling reinforces the principle that patients cannot be denied financial relief when essential treatment facilities are not available within the State.

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