Right To Health Is Not A Bureaucratic Concession: Punjab & Haryana High Court Orders Full Reimbursement In Life-Threatening Emergency

“In Certified Life-Threatening Emergency, Empanelment Status Cannot Be The Sole Ground To Curtail Reimbursement”, In a constitutionally significant ruling dated 31 January 2026, the Punjab and Haryana High Court held that medical reimbursement in a genuine life-threatening emergency cannot be mechanically restricted to PGI/AIIMS notified rates merely because treatment was taken in a non-empanelled private hospital.

Justice Sandeep Moudgil, exercising jurisdiction under Articles 226 and 227 of the Constitution, quashed the calculation sheet dated 17.05.2018 to the extent it limited reimbursement to ₹1,38,422/- against an actual expenditure of ₹3,54,647/-. The Court directed the State to pay the balance ₹2,16,225/- with interest @ 9% per annum from the date of discharge.

The judgment emphatically reaffirmed that the “right to health and medical care is an integral facet of Article 21” and that executive policies cannot eclipse constitutional guarantees.

Retired Chief Engineer In Coma, ICU Treatment At Fortis

The petitioner, a retired Chief Engineer from the Irrigation & Water Resources Department, Haryana, suffered a serious medical emergency in January 2018. Initially admitted at Hisar, his condition deteriorated and he slipped into coma. On medical advice, he was shifted to Fortis Memorial Research Institute, Gurugram, where he remained in Emergency ICU from 16.01.2018 to 25.01.2018 and was diagnosed with viral meningoencephalitis.

The total medical expenditure amounted to ₹3,54,647/-. The emergency nature of the treatment was duly certified by the Civil Surgeon.

However, applying Government Memo dated 06.05.2005 and instructions dated 24.06.2013, the State restricted reimbursement to ₹1,38,422/- calculated at PGI/AIIMS rates, citing that Fortis was a non-empanelled hospital. The balance claim was declined without a speaking order. The petitioner obtained the calculation sheet only through the RTI Act.

Can Executive Policy Override Article 21?

The High Court framed the central question:

“Whether, in a case of admitted medical emergency involving coma and ICU admission, the State can restrict reimbursement to notified rates under executive instructions?”

Answering in the negative, the Court held that the issue transcended service law and entered the domain of constitutional rights.

“The Constitution of our country does not contemplate a hierarchy where executive memoranda supersede fundamental rights.”

Right To Health As Part Of Article 21

Tracing constitutional jurisprudence from Maneka Gandhi v. Union of India to Consumer Education & Research Centre v. Union of India and Paschim Banga Khet Mazdoor Samity v. State of West Bengal, the Court reiterated that the right to health is embedded within Article 21.

Quoting Consumer Education & Research Centre, the Court emphasized that “right to health and medical care is a fundamental right under Article 21” and extends even post-retirement.

Relying on Shiva Kant Jha v. Union of India (2018), the Court underscored that reimbursement cannot be denied merely because the hospital is not empanelled. The “real test must be the factum of treatment,” and once emergency and treatment are established, technicalities cannot defeat reimbursement.

Mechanical Restriction To PGI Rates Deprecated

Justice Moudgil strongly disapproved the mechanical application of rate ceilings in emergencies:

“Such an approach, when applied inflexibly, transforms a constitutional entitlement into a bureaucratic concession.”

The Court observed that in moments of coma or acute neurological crisis, neither the patient nor family members can verify empanelment lists or rate charts. To later restrict reimbursement to institutional ceilings amounts to penalising the citizen “for choosing survival over procedure.”

It was held that while executive policy binds administration, it cannot eclipse constitutional guarantees. Where two interpretations are possible, the one advancing preservation of life must prevail.

Welfare State And Retired Employees

The Court stressed that a retired government servant who devoted his life to public service cannot be left to bear substantial financial burden arising from life-saving treatment.

“Social security in old age is not an act of grace — it is a constitutional expectation flowing from the idea of a welfare State.”

The Bench observed that mechanical policy application reduces constitutional entitlement to a mere concession and undermines trust in governance.

Natural Justice And Non-Speaking Curtailment

The High Court also found fault with the administrative process. The balance claim was reduced without a speaking order and the calculation sheet was provided only under RTI. The Court termed the approach “mechanical and insensitive,” especially in the context of emergency medical claims.

“Self Preservation Is Intrinsic To Right To Life”

In a philosophically rich passage, the Court observed that self-preservation is inherent in Article 21. Referring to the doctrine of private defence and even verses from the Garuda Purana, the Court emphasized that protection of one’s body is foundational to human existence.

“In the present case, the petitioner was in coma. He was not exercising choice but was fighting for survival.”

Expecting bureaucratic compliance in such circumstances, the Court remarked, would be to “demand administrative formalism from the brink of mortality.”

Vision Of “Viksit Bharat 2047” And Health Security

In a forward-looking observation, the Court linked constitutional health security with the national vision of a developed India by 2047.

“A developed nation is not defined merely by economic metrics but by the social security, public health assurance, and opportunity of dignified ageing offered by it to its citizens.”

The Court held that fiscal discipline cannot override preservation of life and that development divorced from social justice cannot sustain democracy.

Directions Issued

Allowing the writ petition, the Court:

Quashed the calculation sheet dated 17.05.2018 to the extent it restricted reimbursement to ₹1,38,422/-.

Directed the respondents to reimburse the remaining ₹2,16,225/- within four weeks.

Ordered interest @ 9% per annum from 25.01.2018 (date of discharge) till actual payment.

Additionally, the Court advised the State Government to revisit its medical reimbursement policy to incorporate flexibility for full or substantial reimbursement in certified life-threatening emergencies, even in non-empanelled hospitals.

The judgment stands as a powerful reaffirmation that Article 21 is not a hollow promise. Medical reimbursement in genuine emergencies cannot be reduced to a matter of administrative convenience or fiscal arithmetic.

In clear terms, the Court declared that preservation of human life is paramount and that constitutional morality must guide policy implementation.

Date of Decision: 31 January 2026