Medical reimbursement cannot be denied only due to change in hospital’s name: Karnataka High Court

The professor’s counsel argued that the hospital was indeed on the list of eligible for reimbursement, but in 2021, it changed its name from Kasturba Medical College Hospital, Manipal, to Kasturba Hospital, Manipal. He submitted that this change had not been reflected in the government’s list of hospitals. The opposing government counsel argued that only the hospitals appearing on the list could be considered.

In the September 10 order, Justice Suraj Govindaraj of the Dharwad bench noted, “It is evident that if treatment is availed from an unrecognised hospital, reimbursement is not permissible. However, in the present case… the authorities have failed to update the name, resulting in rejection of reimbursement claims. The hospital remains the same legal entity, and the name change was duly recorded under the Karnataka Private Medical Establishments Act.”

The court stated that to reject the claim for reimbursement merely on account of the name not having been updated for the same hospital would be “arbitrary and legally unsustainable”, as the authorities ought to have updated the list.

“The respondent authorities were obligated to verify the request and update the recognised list after following the due procedure. Their failure to do so cannot prejudice the petitioner,” said the court, as it quashed the previous orders by the state in this matter and directed to reconsider the issue within six weeks.