Madhya Pradesh High Court
Manju Sharma vs The State Of Madhya Pradesh on 7 September, 2022
Author: Gurpal Singh Ahluwalia
Bench: Gurpal Singh Ahluwalia
1
IN THE HIGH COURT OF MADHYA PRADESH
AT GWALIOR
BEFORE
HON'BLE SHRI JUSTICE GURPAL SINGH AHLUWALIA
ON THE 7th OF SEPTEMBER, 2022
WRIT PETITION NO.13148 OF 2022
Between:-
MANJU SHARMA, W/O NIRMAL
SHARMA AGE : 52 OCCUPATION:
SERVICE, R/O MARKANDESWAR
BAZAAR MORENA (MADHYA
PRADESH)
........PETITIONER
(BY SHRI PRASHANT SHARMA - ADVOCATE)
AND
1. STATE OF MADHYA PRADESH
THROUGH PRINCIPAL
SECRETARY DEPARTMENT OF
LABOR VALLABH BHAWAN
BHOPAL M.P.
2. DIRECTOR, EMPLOYEE STATE
INSURANCE CORPORATION ESI
CORPORATION, PANCHDEEP
BHAWAN, NANDA NAGAR,
INDORE.
3. SUPERINTENDENT EMPLOYEE
STATE INSURANCE HOSPITAL
TANSEN ROAD, GWALIOR M.P.
2
........RESPONDENTS
(SHRI JITESH SHARMA - GOVERNMENT ADVOCATE
FOR RESPONDENT NO.1/STATE AND SHRI YOGESH
SINGHAL - ADVOCATE FOR RESPONDENT NO.2)
----------------------------------------------------------------------------------------
This petition coming on for hearing this day, the Court passed the
following:
ORDER
This petition under Article 226 of the Constitution of India has been filed seeking following reliefs:
i. Direction issued in relation to re-
imbursement after implantation be quashed. ii. Respondent be directed to get the implant under the ESI scheme itself under cashless facility. It is the case of the petitioner that the son of the petitioner is 100% deaf and dumb. In the year 2010, hearing aid device was implanted at Pushpanjali Hospital, Agra. After the operation in the year 2010, since sprint was not working therefore, replacement has been advised with new sound processor - KANSO-2 (CP 1150) in order to communicate effectively and to fulfill educational requirement. The said facility is not available at Jayarogya Hospital, Gwalior, therefore, the son of the petitioner was referred to Shri Aurobindo Institute of Medical Science Indore. The cost of implant is Rs.6,73,050/-. After reference from the employee state insurance hospital, the respondent is keeping the matter pending and is not providing cash-less facility which is their liability. It is further submitted that by the impugned order, a recommendation has 3 been made for reimbursement of the amount instead of providing cash- less scheme.
The respondent No.2 has filed its return and has taken the following stand:
7. That, in reply to contents of para 5.7, it is respectfully submitted that answering respondent shall bear 100% cost of upgradation and/or replacement of Cochlear implant upto the celling limit of Rs.5,35,000/- in the cases where due to wear and tear, upgradation/replacement is required on the opinion of two ENT surgeon of Govt.
Hospital, subject to fulfilment of all other conditions laid down in CGHS Guidelines.
By referring to paragraph 7 of the return filed by respondent No.2 in which the respondent No.2 has accepted its liability to bear 100% cost of upgradation liability subject to upper limit of Rs.5,35,000/-, submitted that the respondents be directed to provide the cash-less facility upto Rs.5,35,000/- and the remaining outstanding amount shall be borne by the petitioner.
In view of the statement made by the counsel for the petitioner, the counsel for respondent No.2 also expressed his no objection to the said proposition as submitted by the counsel for the petitioner.
Accordingly, this petition is finally disposed of with the following observations:
(i) Subject to recommendation of two ENT Specialists, the respondent No.2 shall provide 4 cash-less facility to the extent of Rs.5,35,000/- for implanting new sound processor - KANSO-2 (CP 1150) or any other processor as decided by the Doctors and the remaining expenses shall be borne by the petitioner.
With aforesaid observations, the petition is finally disposed of.
(G.S. AHLUWALIA) JUDGE (alok) ALOK KUMAR 2022.09.12 19:40:35 +05'30'