Non-Receipt Of Pre-Referral Order From The Medical Authority Cannot Dismiss The Medical Reimbursement Claim: Tripura High Court - Synopsis
Karandeep Singh 3 Nov 2020

Non-Receipt Of Pre-Referral Order From The Medical Authority Cannot Dismiss The Medical Reimbursement Claim: Tripura High Court

In Kali Sankar Baidya vs The State of Tripura [W.P(C) No. 289/2020], Kali Sankar Baidya was a Head Clerk in a District Judiciary who was suffering from lesion on his nose which was getting enlarge by the passage of time. He consulted to ENT specialist and skin specialists for his treatment but it was not cured by them and on the advice of specialist he wished to move outside the state for his treatment. He filed an application before the Medical Board for getting permission for the same reason on November 30th, 2019 and waited for several days for their reply. Unfortunately, the board remains unanswered; consequently he started his travel on December 05th, 2019 and went to Vellore. On December 07th, 2020, doctors detects that he was suffering from Nasal Passage Cancer. He cured himself there in Hospital, Vellore for which total expenditure was generate of Rs. 3,72,031/-. He claims that as per the Government rules it is to be reimbursed. But the Government refused to do the same and rejected on the ground that he did not obtain prior referral order from the Medical Board and secondly, no extra ordinary urgency was there which makes him to travel outside the State for his treatment without presenting himself before the Medical Board. In consequence, he filed a petition before The High Court of Tripura, challenging the order of Government.

In appeal, The Court noted that the petitioner was struggling with aggressive infection which was not getting cured despite his treatment and on the opinions of the experts he moved outside the state for his treatment. He approached the authorities too for grant permission for the same but no response he received. As a result he went to Vellore where it was detected by the doctors that the petitioner was suffering from Nasal Passage Cancer. Under such circumstances it was not expected by the petitioner that Medical Board would calls him for personal appearance for granting of referral order which would delay his treatment. Under such circumstances it is unreasonable to expect the petitioner to wait for the referral order. Secondly, the ground that the petitioner was having no urgency to departing himself for treatment must be rejected also. As, he after waited for long enough for the treatment prescribed by the local doctors which was not having desired effect, the petitioner had to have a proper diagnosis treatment. It is not like that the petitioner departed immediately without informing the Medical Board. The petitioner did approach the Medical Board but could not give too long time for Medical Board to respond.

The court recounts on the judgment of Sri Samar Bhusan Chakraborty vs. The State of Tripura & others, 05 November, 2019, which have similar circumstances concluded that merely because prior referral order from the Medical Board was not obtained, such bills cannot be rejected. Subsequently, Justice Akil Kureshi disposed off the petition by directing the respondents to process with the medical reimbursement of bills of the petitioner and releases the same to the extent as per the Government policy.

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