The Delhi High Court Tuesday sought response from the city and central governments and the Institute of Liver and Biliary Sciences (ILBS) on a petition filed by the father of a 10-year-old liver patient who urgently needs transplant.
Justice Vibhu Bakhru also issued notice to the Employee's State Insurance Corporation (ESIC), the health department, the central government and the ILBS, asking them to file their responses by Dec 19 on the father's plea seeking free treatment for his child.
Mohd. Kalim moved the high court, saying his son Mohd. Shahnawaz was identified as a case of chronic Cholestatic Liver Disease PFIC type 3, and urgently requires liver transplant.
Advocate Ashok Agarwal, appearing for Kalim, told the court that the father works as a helper in a restaurant and earns Rs.7,000 per month and has four children, among whom Shahnawaz is the eldest.
Both Shahnawaz and his immediate sibling Mohd. Arbaz were suffering from the same disorder. However, Shahnawaz was more critically ill, Agarwal said.
Kalim is registered as an insured person with the ESIC and was consulting the ESI Hospital in Jhilmil for his sons.
Shahnawaz was referred by the ESI Hospital to empanelled hospital ILBS for treatment, the plea said.
However, when the ILBS gave an estimate of Rs.14 lakh as the initial expenditure for transplant, the ESIC refused to sanction the same, citing its new guidelines of July 2014 which stated that in case of diseases of genetic origin, if the beneficiary (Shahnawaz) is born before the date of ESIC registration of the insured person (Kalim), he shall not be entitled for coverage.
The plea said that according to the ESI Hospital, Shahnawaz's disease was of genetic origin.
In its new guidelines, the ESIC has also limited its liability to Rs.10 lakh per beneficiary per year for medical treatment.
Challenging the legality of the guidelines, the plea said it was "arbitrary, irrational, illogical, unreasonable and illegal" and tend to defeat the very object and purpose behind the ESI Act, 1948.
"Irrespective of the obligation of the ESIC to bear the cost of treatment, ILBS being an autonomous body under the Delhi government has an independent constitutional obligation to provide free medical treatment to the poor patient in order to save his life," Agarwal said.
