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IN THE HIGH COURT OF ANDHRA PRADESH AT AMARAVATI
RAVI NATH TILHARI, CHALLA GUNARANJAN
Union of India – Appellant
Versus
Syed Gayaz Chisty – Respondent
ORDER :
1. Petitioners assail order, dated 23.02.2024, passed by the Central Administrative Tribunal, Hyderabad Bench (for short “the Tribunal”), in O.A.No.020/0884/2021, by which, they were directed to reimburse balance medical claim to a tune of Rs.1,69,300/- to the respondent herein, incurred for his medical treatment.
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 Commercial Clerk/NLR, South Central Railway, Vijayawada Division, on attaining age of superannuation on 30.09.2011. On 06.02.2020, he fell down and sustained injury. Therefore, he was admitted to Apollo Specialty Hospital at Nellore. His condition was evaluated and diagnosed as “D-10-D11 0YL WITH LISTHESIS L2-L5 SPONYLOLISHESIS LUMBAR CANAL STENOSIS ANKULOSED SPAINE IN KYPHO SCOLIOSIS.” Later, he had undergone surgical procedure on 11.02.2020 and was discharged from the hospital on 15.02.2020. Claimant has incurred an amount of Rs.1,90,000/- towards the medical treatment, which he claimed for reimbursement by appli
Claimants are required to establish emergency treatment necessity to qualify for full medical reimbursement beyond prescribed rates as per established policies.
Emergency medical treatments require reimbursement even if provided by non-empanelled facilities, prioritizing the necessity of treatment over technical compliance with prescribed rates.
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....
In emergency medical situations, full reimbursement of medical expenses is mandated regardless of any imposed ceiling limits, emphasizing the right to timely medical treatment.
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