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OPD Reimbursement Claim under WBHS
14-Mar-2025 (In Civil Law)
Since 2017 I had been undergone neurological treatment at Apollo Chennai on my own expenses. In Feb 2024 I had gone there for routine check up. On arrival suddenly I felt chest pain and sweating and immediately seek cardiologist's advice and detected severe heart blockage and as per doctor's advice to save my life immediate angioplasty was done.but in this emergent situation I had no time to obtain prior permission from WBHS authority. After discharged from hospital I made prayer for condonation and claim for reimbursement.But they denied citing no prior approval for treatment though I had already mentioned it was unwanted situation and no time to save my life. In this situation may I appeal before court for consideration.
In such situations where immediate medical intervention is required to save a life and obtaining prior permission is impossible, courts may consider waiving the requirement for prior approval. the core of argument would rest upon the ' emergency clause' or similar provision within the relevant regulations or case law that allow for ex-post facto approval or reimbursement in life-threatening situations. It is crucial to gather all the supporting documentation. the court will ultimately consider the specific facts and circumstances of the case whether to grant appeal for reimbursement.
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Adv. Eshita
Habra | 25+ Answers
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