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Reimbursement of medical bill

(Querist) 15 March 2018 This query is : Resolved 
My nabour got removed uterus from Private Hospital which charged Rs. 55000/- as an Emergency case. Her husband is a Rajsthan State Govt Servant. Her Husband has an private assurance policy also in addition to this policy, he has right to get the amount reimbursed from State Govt/.
Now according to assurance policy only Rs. 20000/- can be reimbursed as it is not older than two years. Management of Hospital told that though our Hospital is not on the list of approved Hospital of State Govt, yet in Emergency cases amount can be reimbursed.
It was suggested to her that First all original bills of Rs. 55000/- should be given to Govt Dept, if it reimbursed fully,O.k.
AT the same time information and photocopy of original bills of Rs. 55000/- should be given to private assurance company with request that if amount is not reimbursed by State Govt i.e. if rejected as it is of private Hospital, please reimburse only Rs. 20000/-
Please advise whether it is legally O.k. and same can be done.
Sudhir Kumar, Advocate (Expert) 15 March 2018
please read reimbursement rules of the state govt.
kavksatyanarayana (Expert) 15 March 2018
I am of opinion that no reimbursement will be sanctioned if the treatment was given at a non-recognized hospital. better to consult in his own department.
Dr J C Vashista (Expert) 17 March 2018
Consult your HR/Department.


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