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IN THE HIGH COURT OF JHARKHAND AT RANCHI
Sri Ananda Sen, J
Santosh Kumar Verma Son Of Lt. Bhuneswar Sahay – Appellant
Versus
Bharat Coking Coal Ltd., – Respondent
The court concluded that the exclusion of psychiatric treatment from reimbursement under the healthcare scheme violates the principles of equality and non-discrimination mandated by the Mental Healthcare Act, 2017 (!) (!) (!) (!) . Since the Act explicitly requires that persons with mental illness receive healthcare services of the same quality and extent as those with physical illnesses, any scheme that denies reimbursement for mental health treatment is unlawful and unconstitutional (!) - (!) (!) . The scheme's exclusion clause for psychiatric treatment is therefore invalid, and the respondents are directed to reimburse the petitioner for the expenses incurred for his wife's psychiatric treatment, ensuring compliance with the statutory requirement of equal treatment for mental health conditions (!) . This decision reinforces the principle that healthcare schemes must provide non-discriminatory access and benefits for mental health, aligning with the constitutional and statutory mandates for equality in healthcare services.
ORDER :
ANANDA SEN, J.
By filing this writ petition, petitioner prays to quash the Office Note dated 26.10.2019 (Annexure 4) and letter dated 23.01.2020 (Annexure 6), by which the Medical Bill for psychiatric treatment of petitioner’s wife has been rejected on the ground that the same is not admissible as per Clause 6.3(i) of CPRMSE Rules. It has also been prayed that the respondents be directed to reimburse the amount, which has been spent by the petitioner for psychiatric treatment of his wife, which has been illegally deducted from the bills raised by the petitioner.
2. Learned counsel appearing on behalf of the petitioner submitted that the wife of the petitioner was suffering from some disorder, which needed psychiatric treatment. He argued that as a retired executive of Bharat Coking Coal Limited, he is entitled for reimbursement of the amount spent on his wife for psychiatric treatment, but the respondents, taking shelter of Clause 6.3(i) of the Contributory Post Retirement Medicare Scheme for Executives of CIL & its Subsidiaries (hereinafter referred to as CPRMS), have denied reimbursement, which is absolutely illegal. He submitted that treatment of mental health and mental he
Exclusion of psychiatric treatment from reimbursement under CPRMS violates the Mental Healthcare Act, 2017, which mandates equal treatment for mental and physical illnesses.
The central legal point established in the judgment is the obligation of insurance companies to provide non-discriminatory insurance coverage for mental illnesses as mandated by the Mental Healthcare....
Insurance policies must not discriminate against mental illnesses under the Mental Healthcare Act, 2017; all insurers are required to cover mental health on the same basis as physical health.
In emergency medical situations, full reimbursement of medical expenses is mandated regardless of any imposed ceiling limits, emphasizing the right to timely medical treatment.
Full medical reimbursement mandatory for genuine emergency treatment in empanelled hospitals, regardless of CGHS rates.
Denial of reimbursement for emergency medical treatment under CGHS violates constitutional rights and undermines the scheme's welfare purpose.
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