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A Heart Patient’s Fight Exposes How Rigid Rules Can Turn Life-Saving Care into a Paper War
In a powerful affirmation of the constitutional right to health, the has ruled that state medical reimbursement policies must bend toward compassion when a patient’s life is at stake. Justice Harpreet Singh Brar directed the to pay the full ₹7.42 lakh bill—plus 6% annual interest—for an advanced intravascular lithotripsy (IVL) procedure performed at Paras Hospital, Panchkula, on an 85-year-old retiree. The court scathingly rejected the State’s hyper-technical reading of its own policy that would have left the family bearing the cost of a treatment that was medically essential.
The Case That Began with Chest Pain and Ended in Courtroom Drama
Hukam Singh, an elderly pensioner, was admitted to Paras Hospital on with critical coronary artery disease marked by heavily calcified blockages. Standard balloon angioplasty would have been ineffective, so doctors used Rotablation combined with the specialised IVL technique, which employs acoustic shockwaves to fracture calcium deposits. He was discharged three days later. When the hospital submitted its bill, the State reimbursed only the notified package component and refused the remainder, classifying the IVL catheter and consumables under a meagre “medicines and consumables” ceiling of ₹1,750 per day.
After the petitioner’s death, his legal heirs pursued the . The court had earlier directed the to file an affidavit explaining how package rates are fixed and whether hospitals were artificially lowering them to attract patients before billing extras separately.
Petitioner’s Stand: Treatment Was Medically Necessary, Not Optional
The legal heirs argued that the policy’s very purpose is to protect employees and pensioners during medical emergencies. They pointed out that the Instructions explicitly include stents, implants, and high-cost consumables as reimbursable when used within a treatment package. Because conventional angioplasty would have failed, the IVL procedure was the only life-preserving option. Denying reimbursement on the ground that IVL is not listed as a separate package, they contended, defeats the welfare objective of the scheme and violates .
State’s Defence: “It’s Not in the Package List”
The State maintained that IVL is a non-package procedure. It claimed the cost of the specialised catheter should be capped at the routine daily consumables rate and that hospitals must absorb any excess. The government also argued that it had already released all admissible amounts under the notified angioplasty and rotablation packages.
Justice Brar found this position “fundamentally misconceived.” Medical literature, he noted, describes IVL as a specialised modality of angioplasty itself—specifically designed for calcified lesions where ordinary balloon angioplasty risks dissection or rupture.
When Policy Literalism Threatens a Life
The court delivered a stinging critique of bureaucratic rigidity. In a key passage that is already being cited by health-rights advocates, Justice Brar wrote:
“A policy meant to preserve life cannot be allowed to become a .”
He further observed:
“. This approach defeats the very purpose of a medical aid policy.”
The judgment also rejected the State’s classification of a ₹3.5 lakh shockwave catheter as a routine “consumable,” calling the interpretation “” and a gross mischaracterisation that mocks the .
Court Cracks Down on Hospitals That Game the System
Drawing on disclosures in the State’s affidavit, the court took note of a troubling practice where empanelled hospitals advertise low package rates to attract patients and then levy separate, exorbitant charges for essential devices and procedures. The judgment explicitly records that such “shall not be permitted.”
In line with wider reporting on the case, the court issued sweeping systemic directions: the Director General must personally audit or cause audits of all empanelled hospitals’ package rates, obtain written patient consent only after explaining costs in a language the patient understands, and take corrective action—including possible de-empanelment or licence cancellation—against violators. The State has also been asked to consider formally including the IVL technique in coronary package rates within three months.
The Final Order: Full Payment, Policy Reform, and Systemic Accountability
Allowing the , the issued four clear directions:
- Reimburse the entire bill with 6% interest from the date it became due.
- Consider including IVL within notified package rates for coronary interventions.
- Conduct a comprehensive audit of empanelled hospitals and ensure .
- File a compliance report within three months.
The ruling sends an unambiguous message: when life hangs in balance, welfare policies must serve the living rather than become instruments of denial. For Haryana’s pensioners and government employees, the judgment restores both financial relief and faith that the State’s promise of medical security will not be defeated by .
