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Allowing reimbursement for bariatric surgery due to its emergency nature and referral by the MCD panel hospital – Delhi HC

Case Title: NORTH DELHI MUNICIPAL CORPORATION versus SUDHA SHARMA

Case No: W.P.(C) 10565/2017

Decided on: 20th May , 2024

Quorum: HON’BLE MS. JUSTICE REKHA PALLI and HON’BLE MR. JUSTICE SAURABH BANERJEE

Facts of the case

Sh. Krishan Kant Bhardwaj, the husband of Sudha Sharma, a staff nurse with the North Delhi Municipal Corporation, had bariatric surgery at the Shri Balaji Action Medical Institute. On January 14, 2016, Sudha Sharma went to the North Delhi Municipal Corporation’s Outpatient Department (OPD) clinic to get her husband treated. He was sent to HRH Hospital/MCD Panel Hospital for additional care following exams. He was then recommended to have bariatric surgery at Balaji Hospital, which is a hospital with an MCD panel, and on January 18, 2016, he had the procedure. It was decided that the surgery was required, and he had to pay Rs. 2,55,521 for both the procedure and the necessary medications. The company denied the reimbursement claim as the surgery had not been previously approved. After then, Sudha Sharma submitted an original application to be reimbursed, which was allowed by the Central Administrative Tribunal.

Issues

1. Was Prior Permission Necessary for the Bariatric Surgery Reimbursement Claim?

2. Did the Tribunal Justify Allowing the Claim Despite Lack of Prior Approval?

3. Was the Petitioner Justified in Rejecting the Claim Based on Procedural Grounds?

Legal Provisions

 Ministry of Health and Family Welfare Office Memorandum dated 06.11.2013, which describes the requirements and maximum amounts that must be met in order to receive authorization or reimbursement for bariatric surgery treatments under the CGHS/CS (MA) Rules, 1944 [T4]. Guidelines mandating prior authorization for bariatric surgery since it is regarded as an elective or planned procedure, as well as the process for securing authorization from the appropriate body on the basis of a government specialist’s advice prior to the surgery’s execution [T5].

Appellant Contentions

The appellant in this case, the North Delhi Municipal Corporation, argued that the reimbursement claim was properly denied in accordance with the Ministry of Health and Family Welfare’s OM dated April 6, 2013. They contended that previous consent ought to have been sought before the surgery was performed since bariatric surgery is a voluntary, scheduled procedure rather than an emergency. The appellant contended that the claim was properly denied since no prior authorization was obtained for the surgery. They attempted to overturn the Tribunal’s contested ruling, which instructed processing the reimbursement claim.

Respondent Contentions

Respondent Sudha Sharma contended that her husband’s medical condition, as determined by the Government Medical Officer, required bariatric surgery. They emphasized that the procedure was carried out at the MCD panel hospital, to which he had been directed, and that the Experts Committee had not discovered any instances of non-compliance with protocols or needless medical care. The claim was legitimate, according to Sudha Sharma, and the policy’s intention to repay employees for medical expenses was violated by the refusal of payment. Consequently, they asked the court to handle their claim for payment of the costs associated with the bariatric procedure.

Court Analysis and Judgement

In the case of North Delhi Municipal Corporation v. Sudha Sharma, the court considered the arguments made by each party with reference to the bariatric surgery reimbursement claim. The respondent’s husband had bariatric surgery at the MCD panel hospital to which he was directed, the court observed, despite the fact that norms demand prior clearance for such procedures. The court noted that the doctors at the panel hospital had determined that the surgery was essential and that there had been no denial of the claim’s veracity. The respondent’s claim for reimbursement was granted by the court, taking into account the hospital’s recommendation to perform surgery in order to treat the medical condition as soon as possible. In spite of the absence of prior authorization, the court recognized the urgency of the circumstances and the fact that the surgery was carried out for less money than was authorized. As a result, the court maintained the tribunal’s ruling approving the respondent’s request for payment of the costs associated with the bariatric procedure. The North Delhi Municipal Corporation filed a writ case, but the court dismissed it, finding no flaw in the contested ruling. In addition, the court allowed the petitioner time to pay the remaining claim amount after verification and ordered the release of the deposited funds in the respondent’s favor. Finally, the court decided in Sudha Sharma’s favor, ordering the North Delhi Municipal Corporation to handle her husband’s reimbursement claim for the costs of bariatric surgery.

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Judgement Analysis Written by – K.Immey Grace

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

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“Justice Served: Delving into the High Court’s Dismissal of the Habeas Corpus Petition in a Family Dispute”- Delhi HC

Case Title: INDRAKALI VERMA Versus STATE OF NCT OF DELHI

Case No: W.P.(CRL) 1611/2024

Decided on: 20th May , 2024

Quorum: HON’BLE MR. JUSTICE SURESH KUMAR KAIT and HON’BLE MR. JUSTICE MANOJ JAIN

Facts of the case

Indrakali Verma, the petitioner in this case, sought a writ of habeas corpus to force the court to produce her son Vikas, daughter-in-law Rachna, and grandsons. According to the petitioner, they were being held illegally. But it turned out that the son, daughter-in-law, and grandsons were not being held illegally; rather, they were living apart from the petitioner on their own volition during the legal proceedings. Through video conference, the son verified this information. It was further observed that the petitioner is actively seeking criminal prosecution against the defendants, having previously filed a similar petition (W.P. (Crl) No. 2359/21) which was withdrawn. In the end, the court dismissed the petition since it was determined that no additional order was required because of the voluntary residence of the relatives are kept apart from the petitioner.

Issues

1. Was the petitioner’s son and his family members wrongfully held, as stated in the writ of habeas corpus petition?

2. Based on the conversation with the son during the video conference, does the petitioner’s claim of wrongful imprisonment have merit, in the opinion of the court?

3. Did the petitioner’s allegation of unjustified detention receive enough support from the court to warrant the petition’s dismissal?

4. In deciding not to issue additional orders in this matter, did the court take into account the petitioner’s prior actions such as withdrawing a comparable petition and pursuing criminal prosecution into account?

5. Did the petitioner’s family members confirm during the court proceedings that they were living apart from her voluntarily?

Legal Provisions

Writ of Habeas Corpus: The petitioner requested a writ of habeas corpus, a legal procedure that allows someone to request release from unjustified incarceration or detention [T2]. Criminal Procedure Code (Cr.P.C.) Section 156(3): Following the dismissal of an earlier petition [T1], the petitioner was granted permission to present evidence under Section 200 Cr.P.C. After receiving a complaint of an offense [T1], a magistrate may question the complainant and witnesses under Section 200 of the Criminal Procedure Code (Cr.P.C). The petitioner’s claims and the court’s ruling in the case were taken into account when evaluating these legislative provisions.

Appellant Contentions

Seeking a writ of habeas corpus to bring her son Vikas, daughter-in-law Rachna, and grandsons before the court, the appellant, Indrakali Verma, alleged in the case [T2] that they were being wrongfully held. Nevertheless, it became clear throughout the proceedings that the family members were not being held in violation of the law; rather, they were living apart from the petitioner willingly. Through video conference, the son verified this information. The petitioner made some initial arguments, but the court dismissed the case after concluding that the claim of unlawful imprisonment lacked merit [T1].

Respondent Contentions

With the help of attorneys Priyam Agarwal and Shivesh Kaushik as well as counsel Mr. Sanjay Lao, the respondent in this matter, the State of the NCT of Delhi, argued that the petitioner’s family members her son Vikas, daughter-in-law Rachna, and grandsons were not being held in violation of the law. The son’s remark made during their video conference with the court provided evidence in favor of this claim. According to the respondent, the family members were not being forcibly detained and were living apart from the petitioner. Consequently, the respondent contended that there was no need for additional orders in this matter [T1].

Court Analysis and Judgement

The court examined the arguments made by the petitioner and the respondent in the matter of Indrakali Verma v. State of the NCT of Delhi. Through video conference, the petitioner’s son confirmed to the court that he was not being held illegally and that he, along with his wife and small children, were living apart from the petitioner freely. Additionally, the son said that the petitioner was welcome to see him at his home [T1]. The court determined that the petitioner’s request for a writ of habeas corpus was without merit in light of the facts that were given and the dearth of evidence that backed up the petitioner’s allegation of wrongful imprisonment. The petitioner had previously withdrawn a similar suit, the court found, and was already prosecuting the responders in criminal court. As a result, the court determined that no more orders were necessary in this matter and granted the petition [T1]. The evidence that was produced during the proceedings ultimately served as the foundation for the court’s decision, indicating that the petitioner’s family members were living apart from her freely and were not being wrongfully held.

“PRIME LEGAL is a full-service law firm that has won a National Award and has more than 20 years of experience in an array of sectors and practice areas. Prime legal fall into a category of best law firm, best lawyer, best family lawyer, best divorce lawyer, best divorce law firm, best criminal lawyer, best criminal law firm, best consumer lawyer, best civil lawyer.”

Judgement Analysis Written by – K.Immey Grace

 

 

 

 

 

 

 

 

 

 

 

 

 

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“Justice Served: Delving into the High Court’s Dismissal of the Habeas Corpus Petition in a Family Dispute”- Delhi HC

Case Title: INDRAKALI VERMA Versus STATE OF NCT OF DELHI

Case No: W.P.(CRL) 1611/2024

Decided on: 20th May , 2024

Quorum: HON’BLE MR. JUSTICE SURESH KUMAR KAIT and HON’BLE MR. JUSTICE MANOJ JAIN

Facts of the case

Indrakali Verma, the petitioner in this case, sought a writ of habeas corpus to force the court to produce her son Vikas, daughter-in-law Rachna, and grandsons. According to the petitioner, they were being held illegally. But it turned out that the son, daughter-in-law, and grandsons were not being held illegally; rather, they were living apart from the petitioner on their own volition during the legal proceedings. Through video conference, the son verified this information. It was further observed that the petitioner is actively seeking criminal prosecution against the defendants, having previously filed a similar petition (W.P. (Crl) No. 2359/21) which was withdrawn. In the end, the court dismissed the petition since it was determined that no additional order was required because of the voluntary residence of the relatives are kept apart from the petitioner.

Issues

1. Was the petitioner’s son and his family members wrongfully held, as stated in the writ of habeas corpus petition?

2. Based on the conversation with the son during the video conference, does the petitioner’s claim of wrongful imprisonment have merit, in the opinion of the court?

3. Did the petitioner’s allegation of unjustified detention receive enough support from the court to warrant the petition’s dismissal?

4. In deciding not to issue additional orders in this matter, did the court take into account the petitioner’s prior actions such as withdrawing a comparable petition and pursuing criminal prosecution into account?

5. Did the petitioner’s family members confirm during the court proceedings that they were living apart from her voluntarily?

Legal Provisions

Writ of Habeas Corpus: The petitioner requested a writ of habeas corpus, a legal procedure that allows someone to request release from unjustified incarceration or detention [T2]. Criminal Procedure Code (Cr.P.C.) Section 156(3): Following the dismissal of an earlier petition [T1], the petitioner was granted permission to present evidence under Section 200 Cr.P.C. After receiving a complaint of an offense [T1], a magistrate may question the complainant and witnesses under Section 200 of the Criminal Procedure Code (Cr.P.C). The petitioner’s claims and the court’s ruling in the case were taken into account when evaluating these legislative provisions.

Appellant Contentions

Seeking a writ of habeas corpus to bring her son Vikas, daughter-in-law Rachna, and grandsons before the court, the appellant, Indrakali Verma, alleged in the case [T2] that they were being wrongfully held. Nevertheless, it became clear throughout the proceedings that the family members were not being held in violation of the law; rather, they were living apart from the petitioner willingly. Through video conference, the son verified this information. The petitioner made some initial arguments, but the court dismissed the case after concluding that the claim of unlawful imprisonment lacked merit [T1].

Respondent Contentions

With the help of attorneys Priyam Agarwal and Shivesh Kaushik as well as counsel Mr. Sanjay Lao, the respondent in this matter, the State of the NCT of Delhi, argued that the petitioner’s family members her son Vikas, daughter-in-law Rachna, and grandsons were not being held in violation of the law. The son’s remark made during their video conference with the court provided evidence in favor of this claim. According to the respondent, the family members were not being forcibly detained and were living apart from the petitioner. Consequently, the respondent contended that there was no need for additional orders in this matter [T1].

Court Analysis and Judgement

The court examined the arguments made by the petitioner and the respondent in the matter of Indrakali Verma v. State of the NCT of Delhi. Through video conference, the petitioner’s son confirmed to the court that he was not being held illegally and that he, along with his wife and small children, were living apart from the petitioner freely. Additionally, the son said that the petitioner was welcome to see him at his home [T1]. The court determined that the petitioner’s request for a writ of habeas corpus was without merit in light of the facts that were given and the dearth of evidence that backed up the petitioner’s allegation of wrongful imprisonment. The petitioner had previously withdrawn a similar suit, the court found, and was already prosecuting the responders in criminal court. As a result, the court determined that no more orders were necessary in this matter and granted the petition [T1]. The evidence that was produced during the proceedings ultimately served as the foundation for the court’s decision, indicating that the petitioner’s family members were living apart from her freely and were not being wrongfully held.

“PRIME LEGAL is a full-service law firm that has won a National Award and has more than 20 years of experience in an array of sectors and practice areas. Prime legal fall into a category of best law firm, best lawyer, best family lawyer, best divorce lawyer, best divorce law firm, best criminal lawyer, best criminal law firm, best consumer lawyer, best civil lawyer.”

Judgement Analysis Written by – K.Immey Grace

 

 

 

 

 

 

 

 

 

 

 

 

 

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“Timely Transplant: Upholding Efficiency and Clarity in Organ Donation Processes”

Case Title: Amar Singh Bhatia & Anr. Versus Sir Ganga Ram Hospital & Ors.,

Case No: W.P.(C) 3590/2020

Decided on: 20th May , 2024

Quorum: The Hon’ble JUSTICE PRATHIBA M. SINGH

Facts of the case

In the Delhi High Court case Amar Singh Bhatia & Anr. Versus Sir Ganga Ram Hospital & Ors., the issue at hand concerned the prompt processing of transplant application forms in accordance with the Transplantation of Human Organs and Tissues Act, 1994. The court stressed the necessity of set deadlines for the transplantation decision-making process in order to guarantee the Authorization Committees’ effective and organized operation [T5]. Amar Singh Bhatia & Anr., the petitioners, expressed concern about the lags and ambiguities in the decision-making and communication processes pertaining to organ donation applications. They emphasized how crucial it is to communicate with donors and beneficiaries in a clear and timely manner in order to streamline the decision-making process [T2]. The lawsuit also involved the respondents, who were represented by Sir Ganga Ram Hospital & Ors. The tribunal weighed the arguments put out by both sides before issuing a ruling on May 20, 2024, which mandates the establishment of precise deadlines for Authorization Committee operations in accordance with the Transplantation of Human Organs and Tissues Act, 1994. The court’s ruling was intended to guarantee that all parties involved hospitals and government agencies, among others—complied with the established deadlines [T3], [T4].

Issues

1. What events led to the filing of the Delhi High Court case Amar Singh Bhatia & Anr. Versus Sir Ganga Ram Hospital & Ors?

2. With reference to the Transplantation of Human Organs and Tissues Act, 1994, what were the primary legal problems that the court considered in this case?

3. How did the court see the requirement for set deadlines in the decision-making process regarding transplantation?

Legal Provisions

In handling the matters pertaining to organ transplantation petitions, the court took into account the requirements of the Transplantation of Human Organs and Tissues Act, 1994 (THOTA) [T3]. The court also made reference to the 2014 Rules while establishing deadlines for different stages of the organ donation application procedure, highlighting the necessity of the Authorization Committees operating in a methodical manner [T4].

Appellant Contentions

Amar Singh Bhatia & Anr., the petitioners, expressed concern regarding the lags and ambiguities in the decision-making and communication processes pertaining to organ donation applications [T2]. They underlined the necessity of set deadlines at different stages of the application procedure for organ donation in order to guarantee prompt processing of applications and prevent protracted waiting times for both donors and receivers [T5]. In order to speed up the decision-making process and lessen emotional and physical suffering for all parties concerned, the petitioners emphasized the significance of timely and clear communication between donors and recipients [T5].

Respondent Contentions 

The respondents, in this case, argued against the need for specific timelines for each step of the organ transplantation process. They intended to contend that the existing system was functioning adequately and that imposing rigid timelines could lead to rushed decisions or compromise the thoroughness of the process. Additionally, they tried to highlight the logistical challenges or administrative burdens in implementing such strict timelines. Further, they emphasized on the importance of discretion and careful consideration in evaluating organ transplantation applications, suggesting that fixed timelines could undermine these aspects.

Court Analysis and Judgement

The Authorization Committee expedited the organ donation application process by establishing specific deadlines for nearly every action it took [T3]. To guarantee proof of communication, notifications about missing paperwork or requirements in the process should be given to donors or recipients by WhatsApp or email [T3]. Under the Transplantation of Human Organs and Tissues Act, 1994 [T3], the court ordered the Ministry of Health and Family Welfare to communicate deadlines for all Authorization Committees by May 3, 2024. To guarantee appropriate cooperation by all parties involved, including hospitals and governmental agencies, enough publicity should be provided to the timetables and the court order [T3]. The ruling highlighted how crucial it is to make prompt decisions on organ donation in order to Prevent extended waiting times and psychological and physical distress for recipients, donors, and their families [T4]. The court’s emphasis on establishing precise deadlines, enhancing communication, and guaranteeing the prompt processing of applications for organ donation in order to respect the letter of the law and reduce doubts and delays in the procedure.

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Judgement Analysis Written by – K.Immey Grace

 

 

 

 

 

 

 

 

 

 

 

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Intriguing insights from a landmark court decision on interpreting limitation and acknowledgment.

Case Title: M/S VOIR INDIA ELECTRONICS PVT. LTD. THROUGH ITS DIRECTOR Versus M/S POLYBLENDS (INDIA) PVT. LTD. THROUGH ITS DIRECTOR

Case No: C.R.P. 69/2022 & CM APPL. 22206/2022

Decided on: 20th May , 2024

Quorum: HON’BLE MR. JUSTICE DHARMESH SHARMA

Facts of the case

A debit balance of Rs. 10,25,916/-that became payable by the petitioner/defendant to the respondent/plaintiff was at the center of the dispute between M/S Voir India Electronics Pvt. Ltd. (petitioner/defendant) and M/S Polyblends (India) Pvt. Ltd. (respondent/plaintiff). In their business interactions with the respondent, the petitioner bought materials like colored plastic dana and reinforced ABS on credit and paid the raised invoices. The amount was not paid despite a legal notice dated 16.01.2018 requesting payment, so on 03.04.2018 the respondent/plaintiff filed a suit for recovery against the petitioner/defendant [T6]. In its ruling, the Trial Court examined the idea of “cause of action” as well as the question of territorial jurisdiction in light of the Memorandum of Association.

Issues

1. Did M/S Voir India Electronics Pvt. Ltd. Successfully argue that the lawsuit brought by M/S Polyblends (India) Pvt. Ltd. Was precluded by limitation under Article 15 of the Limitation Act, 1963?

2. Did M/S Voir India Electronics Pvt. Ltd.’s dishonored checks to M/S Polyblends (India) Pvt. Ltd. Constitute an admission of debt and liability, thereby extending the statute of limitations?

3. Was there any proof to back up the claim that M/S Voir India Electronics Pvt. Ltd. Gave M/S Polyblends (India) Pvt. Ltd. Postdated checks that were misused?

4. Based on the addresses of the plaintiff and defendant listed on the invoices and the plaint’s face value, did the Trial Court have the authority to consider the lawsuit?

Legal Provisions

Section 18 of the Limitation Act, 1963 addresses the impact of written acknowledgment on the statute of limitations. According to this clause, a written acceptance of culpability signed by the party asserting a claim against property or a right may cause a new statute of limitations to begin running at the time of acknowledgment [T3]. Section 8 of the Limitation Act, 1859, which is equivalent to Article 1 of the Schedule to the Limitation Act, 1963, is the legal provision that does away with the concept of implied acknowledgment in cases of accounts between non-merchants and merchants. This section addresses lawsuits pertaining to current balances of accounts between traders and merchants, outlining the statute of limitations and the time frame from which the period begins to run.

Appellant contentions

Argument that the suit is blocked by limitation: According to Article 15 of the Limitation Act, 1963, the appellant argued that the respondent’s suit was barred by limitation since it was filed after the statute of limitations had passed. According to the appellant, the statute of limitations began on a particular day and ended before the lawsuit was filed [T3]. Misuse of postdated checks: The appellant brought up the concern that several postdated checks that were given to the respondent had been mishandled. They said that their stance on this issue was supported by the Division Bench ruling in Taneja Skins Company Private Limited v. Bharat Skins Corporation [T5]. These claims served as the foundation and were essential to the appellant’s case against the respondent.

Respondent Contentions

Recognition of debt and liability through dishonored checks: According to the respondent, the appellant’s dishonored checks constituted an acknowledgement of debt and liability, extending the statute of limitations in accordance with Section 18 of the Limitation Act, 1963. To bolster their argument, they cited the ruling in Hindustan Apparel Industries v. Fair Deal Corporation [T3]. Adherence to the statute of limitations: The respondent said that since they got their last payment on a particular date and sent out their legal notice within the allotted time, their lawsuit was filed fully within the statute of limitations. They contended that the lawsuit complied with the statute of limitations because it was filed within three years of the date of the legal notice [T2].

Court Analysis and Judgement

The respondent, M/S Polyblends (India) Pvt. Ltd., and the appellant, M/S Voir India Electronics Pvt. Ltd., both made reasons and contentions that the court considered during the case. On May 20, 2024, the court rendered its decision after taking into account the facts, the laws, and the precedents that both parties had referenced. Limitation Period: The court considered the appellant’s claim regarding the acknowledgment of debt through dishonored checks, as well as the respondent’s contentions regarding the applicable limitation period. To evaluate the effect of the acknowledgment on the limitation period [T3], [T4], the court cited Section 18 of the Limitation Act, 1963 and the ruling in Hindustan Apparel Industries v. Fair Deal Corporation. The court also took into consideration the respondent’s argument regarding compliance with limitation. Since they got the last payment on a particular day and sent out the legal notice in the allotted time, the lawsuit was filed within the allotted statute of limitations. A key component of the court’s approach was this adherence to the statute of limitations [T2]. The court rendered its decision after considering the arguments, case law, and legal precedents that were put up by each party.

“PRIME LEGAL is a full-service law firm that has won a National Award and has more than 20 years of experience in an array of sectors and practice areas. Prime legal fall into a category of best law firm, best lawyer, best family lawyer, best divorce lawyer, best divorce law firm, best criminal lawyer, best criminal law firm, best consumer lawyer, best civil lawyer.”

Judgement Analysis Written by – K.Immey Grace

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

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