Allowed

Asg Hospital Pvt. Ltd. v. State of Chhattisgarh

Chhattisgarh HC9 Oct 2023WPC/846/2020

Case brief

AI extract

What is this about?

Petitioner-hospital sought direction to release Rs.1.43 crore claim under RSBY/MSBY schemes which remained pending. Court held that until respondent decides on the claim following GRC direction, writ lies and granted time-bound decision.

What did the court decide?

Writ petition allowed in part; respondent No.2 directed to take decision on petitioner's claim within four weeks of receiving the order.

Asg Hospital Pvt. Ltd. Vs State of… — Pension and Retirement Benefits | Chhattisgarh HC (2023)

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Page No.1

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NAFR

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HIGH COURT OF CHHATTISGARH, BILASPUR

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WPC No. 846 of 2020

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ASG Hospital Pvt. Ltd. Raipur Through Its Authorized Officer Mr. Shailesh Kumar Dutta, 2nd And 3rd Floor, Madan Complex, Shakti Nagar, Main Road, Shankar Nagar Raipur Chhattisgarh., District : Raipur, Chhattisgarh

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---- Petitioner

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Versus

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1 - State Of Chhattisgarh Through The Secretary, Department Of Health And Family Welfare, Mahanadi Bhawan, P.S. And P.O. - Rakhi, Atal Nagar, Raipur, District - Raipur Chhattisgarh., District : Raipur, Chhattisgarh

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2 - New India Assurance Co. Ltd. Through Its Chairman Cum Managing Director, Head Office, 87, Mg Road, Fort, Mumbai (Mh) 492001.,District:Mumbai,Maharashtra

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3 - Vidal Health Tpa Pvt. Ltd. Through Its Director, Towar-2, 1st Floor, Sjri Park, Plot No. 13, 14, 15, Epip Area, Whitefield, Bangalore., District :Bengaluru,Karnataka

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4 - Project Officer Rashtriya Swasthya Bima Yojana (Rsby) And Mukhyamantri Swastya Bima Yojana (Msby), State Nodal Agency, Behind Dks Bhawan, 2nd Floor, Old Nursing Hostel, Raipur Chhattisgarh., District : Raipur, Chhattisgarh

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---- Respondents

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------------------------------------------------------------------------------------------------------- For Petitioners : Mr. Anish Tiwari, Advocate. For State/Respondent No.1 : Mr. P. Acharya, PL. For Respondent No.2 : Mr. S.N. Nande and Mr. B.N. Nande, Advocates. For Respondent No.4 : Dr. Sudeep Agrawal, Advocate.

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Hon'ble Shri Justice Parth Prateem Sahu Order On Board

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09/10/2023

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Petitioner has filed this writ petition seeking following relief:-

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“10.1. That this Hon'ble Court may kindly be pleased to issue writ of mandamus and direct the respondent No.2 for releasing the petitioner's claim of Rs.1.43 crore for administering treatment to the 2412 beneficiaries of the smart card along

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Page No.2

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with interest, in the interest of justice.

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10.2 That this Hon'ble Court may kindly be pleased to grant such other relief(s) as this Hon'ble Court deems fit, in the interest of justice.”

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Learned counsel for the petitioner submits that the petitioner is a chain of super-specialty hospitals and one of its branches is situated in Raipur (CG) which inter alia provides specialized treatment of eye. Petitioner entered into a tripartite agreement with respondents No.2 & 3 for providing health care services / treatment under Rashtriya Swastha Bima Yojna & Mukhyamantri Swastha Bima Yojna. After providing services under the aforementioned schemes, the petitioner raised claim to the tune of Rs.1.43 Crore for treating total 2412 cases, which was not considered and payment against the same was not made. As per clause-16 of tripartite agreement, petitioner approached the Grievance Redressal Committee and said Committee issued notice to respondent No.2. The Grievance Redressal Committee in its meeting dated 6.11.2017 decided to pay claim of petitioner hospital. Respondent No.4 vide letter dated 17.1.2018 intimated that even after sending various e-mails, any revert has not been received from petitioner company side. Learned counsel for petitioner further submits that the GRC has sent back the matter to respondent No.2 for re-looking into the matter, however, even thereafter no decision is taken by the respondent No.2 with regard to the claim of payment of the petitioner.

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Mr. S.N. Nande, counsel for respondent No.2 submits that under the agreement, specific clause of 'law and arbitration' and in case

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Page No.3

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of any dispute or controversy with regard to the claim, the petitioner has to initiate the proceeding under the Arbitration and Conciliation Act, 1996 and therefore writ petition is not maintainable.

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Dr. Sudeep Agrawal, counsel for respondent No.4 submits that the Committee constituted by respondent No.4 after considering the claim had written letter to the respondent No.2 on 17.1.2018 and it is for respondent No.2 to re-look into the claim, as directed, in the light of clause-16 of the agreement.

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I have heard counsel for respective parties and perused the documents annexed with petition.

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It is not in dispute that the petitioner's grievance is with regard to non-payment of amount to the tune of Rs. 1.43 crore towards the treatment/service provided by him under the RSBY & MSBY also known as 'smart card scheme'. It is also not in dispute that the petitioner entered into the agreement with respondent No.2 and clause-7 of the agreement provides for law and arbitration with respect to the dispute and controversy. It provides for taking recourse of the arbitration as provided under the Arbitration and Conciliation Act, 1996. This Court cannot lost sight of the fact that under the same agreement there is clause-16 which provides that the healthcare provider can approach the Grievance Redressal Committee for the redressal. The petitioner invoking clause-16 of the agreement has approached the Grievance Redressal Committee, which is also not in dispute, and the Committee vide

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Page No.4

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letter dated 17.1.2018, written to respondent No.2, has observed that Chief Managing Director of the respondent No.2 to look into the claim of the petitioner. When the specific query is made to counsel for respondent No.2 as to any document is placed in record, showing that after the letter dated 17.1.2018 of Grievance Redressal Committee any decision is taken with regard to claim of petitioner, he fairly submitted that to this aspect he is having no instruction and no document is submitted along with the reply.

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Considering the aforementioned facts and circumstances of the case and submission made by counsel for respective parties, in particular, clause-16 of the agreement and further letter written by the Grievance Redressal Committee on 17.1.2018 to respondent No.2, in the opinion of this Court, until and unless the respondent No.2 re-looks into the matter and takes decision on the claim of the petitioner, the stage with regard to the disputed facts of the claim would not arise. The Respondent No. 2 has yet to take the decision on claim of petitioner in pursuance of direction or observation made by GRC under Clause-16 of the agreement.

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In the aforementioned facts of the case, writ petition is allowed in part, respondent No.2 is directed to take decision on the claim of the petitioner as observed by GRC in its letter dated 17.1.2018 within a period of four weeks from the date of receipt of order.

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Sd/-

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(Parth Prateem Sahu) Judge

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Nisha

Asg Hospital Pvt. Ltd. v. State of Chhattisgarh

Case brief

What is this about?

What did the court decide?

Asg Hospital Pvt. Ltd. v. State of Chhattisgarh

Case brief

What is this about?

What did the court decide?

What the court decided

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