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IN THE HIGH COURT OF ANDHRA PRADESH AT AMARAVATI
RAVI NATH TILHARI, CHALLA GUNARANJAN
Union of India – Appellant
Versus
A. Chalapati Rao – Respondent
ORDER :
1. Petitioners assail order, dated 23.02.2024, passed by the Central Administrative Tribunal, Hyderabad (for short “the Tribunal”), in O.A.No.020/0883/2021, by which, they were directed to reimburse balance medical claim to a tune of Rs.3,80,717/- to the respondent herein, incurred on account of medical treatment of his daughter.
2. Petitioners herein are respondents and respondent is claimant before the Tribunal. For the sake of convenience, they are referred to as “respondents” and “claimant” as arrayed before the Tribunal.
3. Claimant retired from service from the post of Senior Section Engineer (P.Way)/BTTR, South Central Railway, Vijayawada Division, on attaining age of superannuation on 31.03.2018. His dependent daughter, aged 24 years, as was suffering from severe left leg pain and unable to walk, was taken to private hospital at Nellore on 10.01.2019, upon diagnosing the seriousness and immediate medical treatment, she was referred to Vijaya Super Specialty Hospital at Chennai. She was immediately admitted in I.C.U. at aforesaid hospital on 10.01.2019 itself in view of emergency. After thorough diagnosis and evaluation of patient, the treating doctor diagnosed her illn
Emergency medical treatments require reimbursement even if provided by non-empanelled facilities, prioritizing the necessity of treatment over technical compliance with prescribed rates.
Claimants are required to establish emergency treatment necessity to qualify for full medical reimbursement beyond prescribed rates as per established policies.
In emergency medical situations, full reimbursement of medical expenses is mandated regardless of any imposed ceiling limits, emphasizing the right to timely medical treatment.
The main legal point established in the judgment is the obligation of the state to ensure timely medical treatment and the need for a compassionate and sympathetic consideration of medical reimbursem....
The right to medical reimbursement for government employees cannot be denied due to hospital non-recognition or exceeding package limits if treatment necessity is established.
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