ANDA RAM Vs. STATE OF RAJASTHAN

JUDGEMENT

(1.) The present writ petition has been filed by the petitioner with the prayer for reimbursement of the medical claims qua the treatment of the petitioner's wife pertaining to severe spinal problems.

(2.) Briefly stated facts of the case are that petitioner's wife suffered severe problems in the spine and was taken to Goyal Hospital, Jodhpur in precarious condition in an emergent situation. After examination of the patient, the petitioner was advised by the treating Doctor to take his wife to Ahmedabad as the Hospital did not possess adequate facilities for treatment. The wife remained hospitalized from 30/10/2014 to 4/11/2014 and for treatment of the petitioner's wife, a sum of Rs.1,09,031.00 was incurred. The petitioner applied for reimbursement of the medical bills covered under the Medi-claim Policy before the respondent-authorities, who returned the same on the ground that the hospital, where the petitioner's wife availed treatment does not find place in the list of empanelled hospitals approved by the State Government.

(3.) The petitioner being aggrieved by the denial of medical claim, approached this Court by way of S.B.C.W. No. 11348/2015 (Anda Ram v. State of Rajasthan and Ors.). The Coordinate Bench of this Court vide order dtd. 5/10/2015, observed that the petitioner has remedy to approach the Insurance Ombudsman Office located nearest to the petitioner. The petition was dismissed as withdrawn with liberty to approach the appropriate authority.