Patient In Grave Emergency Can’t Be Forced To Verify Whether Hospital Is Empaneled: Kerala High Court Dismisses FCI's Appeal
The Kerala High Court was considering an appeal filed by the Food Corporation of India (FCI) challenging the judgment holding the respondent entitled to “Special Life Time Ceiling” under the Post–Retirement Medical Scheme.
While reiterating that a patient in grave emergency cannot be forced to run from hospital to hospital, verifying whether it is an empanelled or non-empanelled hospital, the Kerala High Court has dismissed the appeal of the Food Corporation Of India challenging the grant made under the FCI Post–Retirement Medical Scheme.
The High Court was considering an appeal filed by the Food Corporation of India (FCI) challenging the judgment of the Single Judge holding the respondent entitled to “Special Life Time Ceiling”, FCI Post–Retirement Medical Scheme.
The Bench comprising Justice Devan Ramachandran and Justice Basant Balaji held, “As rightly argued by Sri.P.M.Mohammed Shiraz – learned counsel for the respondent, in Shiva Kant Jha (supra), the Honourable Supreme Court has made it unmistakable that, when it comes to saving of lives, or undertaking lifesaving treatment or procedures, the choice of the doctor and the treating protocols are acme. The reasoning therein is that a patient in grave emergency cannot be forced to run from hospital to hospital, verifying whether it is an empanelled or non-empanelled hospital.”
Standing Counsel Jose Kuriakose represented the Appellant while Advocate P.M. Mohammed Shiraz represented the Respondent.
Factual Background
The respondent retired from the services of the FCI as Assistant – Grade I and was then enrolled as a member of the Post-Retirement Medical Scheme (PRMS). According to him, he was paying regular subscriptions to the PRMS. He was diagnosed as suffering from malignant “Papillary Urothelial Carcinoma”, thus requiring urgent medical attention and intervention. He submitted that he had to undergo surgery at the Aster Medicity Hospital (Aster) – admitting that it was not a hospital empanelled under the Central Government Health Scheme (CGHS), on which the PRMS was based – and the total cost of the surgery incurred was Rs 3,64,126. He alleged that, when he applied for the reimbursement of the said amount under the PRMS, it was rejected, citing the reason that the surgery was done in a “Non-CGHS empanelled hospital.”
The respondent challenged the afore communication of the FCI, through the writ petition which was allowed. Aggrieved thereby, the FCI filed an appeal.
Reasoning
The Bench noted that there was no contest between the parties that the condition faced by the respondent was grave and even life-threatening. He initially consulted at the ‘Amrita’, whose doctors advised him to undergo surgery; but he said that he was asked to wait for some time, since there were other patients in the queue. He informed the FCI about this, but this was not found credible by them, leading to the order being challenged.
On a perusal of the facts, the Bench held that merely because the respondent informed the FCI in a particular manner, but then took treatment in ‘Aster’, as he had subsequently requested, one cannot hold that his condition was not a life-threatening one, which required only an elective surgery.
The Bench further clarified that it is the nature of the disease and the urgency of the treatment which is vital, and not the inconsistency in communications that he may have committed. “As explained by Sri.Mohammed Shiraz, the respondent may have been scared, and hence wanted second opinion before undergoing the surgery. This is normal human behaviour and response, in a situation where fear and apprehension clouds reasoning and mathematically perfect logical analysis”, it added.
The Bench dismissed the appeal, thereby confirming the views, holdings and directions of the Single Judge.
Cause Title: Food Corporation of India V. Govindan P. (Neutral Citation: 2026:KER:73842)