Srinagar- The High Court of J&K and Ladakh on Wednesday directed the government to utilize a premium amount of Rs. 427.73 crores lying with it for reimbursement of medical claims as regards Ayushman BharatPradhan Mantri Jan Arogya Yojana-SEHAT in Jammu and Kashmir.
A division bench of Justice Sanjeev Kumar and Justice Sindhu Sharma however said that reimbursement of the premium amount shall be subject to outcome of the appeal filed by IFFCO Tokio General Insurance Co. Ltd against an order by court’s single bench earlier this year in which the company was asked to continue with the existing arrangement.
“In the meanwhile, there shall be stay of the proceedings in the contempt matter,” the Division bench said.
In its order last month, the court’s single bench said had government plea, underlining that the insurance contract between the parties (Government through State Health Agency and IFFCO TOKIO General Insurance Company Limited), was for a period of three years and the Company having already extended the insurance cover for the second year, in terms of clause 9 of the contract, “cannot turn around and wriggle out of the contract for the third year extension and plunge the people of UT into risk and uncertainty.”
In the appeal, the insurance company has challenged on various grounds and among other submitted the Single Judge was a duly constituted Commercial Division Court under the Provisions of Section 4 of the Commercial Courts Act and hence did have jurisdiction to entertain, adjudicate and consequently decide the issue.
As noted by the court’s single bench, the Government of Jammu and Kashmir launched Ayushman BharatPradhan Mantri Jan Arogya Yojana-SEHAT [“AB-PMJAY-SEHAT”] to provide free of cost Universal Health Coverage to all its residents, including the serving and retired employees and their families. The Scheme is intended to provide same benefits those were available under Ayushman BharatPradhan Mantri Jan Arogya Yojana [“AB-PMJAY”], a Government of India Scheme, that is providing annual health insurance cover of Rs.5.00 lacs per family on a floater and cashless basis through an established network of health care providers. Pertinently, the Scheme came to be introduced by the Government with the object to reduce catastrophic health expenditure and to improve access to quality health care of the domiciles of UT, the court had noted.
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