In Brief
A retired government pensioner in his late 70s sought reimbursement of Rs. 13.84 lakh for emergency cardiac and neurological treatment at private hospitals not empanelled under the Central Government Health Scheme (CGHS). The CGHS had rejected or curtailed his claims citing procedural rules. The Supreme Court held that employees and pensioners are entitled to medical reimbursement even at non-empanelled hospitals during genuine medical emergencies when no alternative exists. The Court directed payment of the outstanding balance and mandated that CGHS must establish a one-month turnaround time for all pensioner claims, supervised by a high-powered ministerial committee for faster grievance redressal.
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