In a significant judgment protecting the rights of retired public servants, the Bombay High Court has directed the Central Government to reimburse ₹22,08,440 to Anirudh Prataprai Nansi, a retired Assistant Commissioner from Central Excise and Customs. Nansi had undergone a critical heart transplant surgery at Sir H.N. Reliance Hospital in Mumbai after government-empanelled hospitals failed to provide the required medical facilities.
A division bench comprising Justices G.S. Kulkarni and Advait M. Sethna held that denying full reimbursement of essential medical treatment amounts to a violation of fundamental rights under Article 21 of the Constitution.
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"In a situation to save his life, the petitioner was certainly entitled to take a decision to have a heart transplant at a private hospital, in the absence of such facilities being readily or timely made available in all the empanelled hospitals," the Court stated.
Nansi had been suffering from cardiomyopathy since 2009. On October 3, 2019, his Left Ventricle Ejection Fraction deteriorated to just 12–15%, leading his doctors, including renowned heart transplant surgeon Dr. Anvay Mulay, to recommend immediate heart transplantation.
Despite his attempts to access government facilities, no empanelled hospital in Mumbai was equipped to perform such surgery at the time. Faced with a life-threatening situation, he underwent the procedure at the private Reliance hospital in December 2020. Though he submitted a claim of ₹22,08,440, the CGHS authorities sanctioned only ₹69,000, citing that the surgery was performed at a non-empanelled hospital and thus reimbursement was limited to CGHS-prescribed rates.
The High Court found this argument unjustified.
"Not granting full reimbursement, in these circumstances in our opinion, is not only violative of the fundamental rights but strikes at the very root, purpose and essence of these basic human rights as guaranteed by the Constitution," the bench asserted.
While the government argued that the surgery was a planned, non-emergency procedure and that prior consent was given at CGHS rates, the Court disagreed, stating that a heart transplant is inherently urgent and should be treated as a special medical circumstance.
The judges further pointed out that the CGHS rates in Mumbai for heart transplant were unrealistically low (₹69,000), especially when compared to higher rates for other surgeries or in other cities. They also criticised the High Power Committee (HPC) for taking a mechanical and insensitive approach.
The High Power Committee ought to have been humanely sensitive in dealing with the petitioner’s case and ought not to have adopted a mechanical and narrow-minded approach, the Court observed.
It also reminded the authorities that reimbursement rules are not absolute and can be relaxed in deserving cases, especially when right to life is at stake.
"Such powers are conferred only to be utilized and more particularly when there is a need to exercise such powers not only to protect the fundamental rights but right to life and right to livelihood," the judges highlighted.
The Court allowed the petition and ordered that the full reimbursement be made within four weeks.
Case Title: Anirudh Prataprai Nansi vs Union of India (Writ Petition No. 7546 of 2022)
Order Type: Judgment
Coram: Justice G.S. Kulkarni and Justice Advait M. Sethna
Pronounced on: 6 June 2025
Counsel for Petitioner: Senior Advocate Prakash Shah with Anil Balani and team
Counsel for Respondents: Advocates Y.R. Sharma, Vinit Jain, Ashok Varma
