Key Facts
In a significant development, the Himachal Pradesh High Court has directed the state government to clear pending payments under the Himcare health insurance scheme within two days. The order came after Special Secretary (Health) Dr. Ashwani Sharma personally appeared before the court on Tuesday and assured that the due amount would be released to the petitioner within the stipulated time.
Details of the Case
The petitioner, Surendra Kumar, a beneficiary of the Himcare scheme, had to undergo heart treatment at PGI Chandigarh where coronary stents were inserted. The total cost of treatment amounted to ₹2,70,604. As a Himcare cardholder, he was entitled to free treatment, but due to non-payment by the state government to the hospital, he was forced to pay the entire amount from his own pocket during a medical emergency.
After repeated pleas, he sent a legal notice to the CEO of HP Health Insurance Scheme Society on December 12, 2025. The department responded on February 2, 2026, admitting that the claim of ₹2.70 lakh was fully valid. However, the payment was not made, prompting him to approach the High Court.
Court Proceedings
Justice Jyotsna Rewal Dua, hearing the case, recorded the government's written assurance and the statement of Special Secretary Dr. Ashwani Sharma. The court observed that when the government is committed under the scheme and the department itself has accepted the claim, the payment cannot be withheld merely on the ground of non-availability of funds. The matter has been adjourned to Thursday for further hearing.
Impact and What Readers Should Know
- The Himcare scheme aims to provide cashless treatment up to ₹5 lakh per family per year in empanelled hospitals.
- Delays in payment to hospitals have caused hardship to patients, forcing them to pay out of pocket.
- The High Court's intervention is expected to expedite pending claims and ensure timely disbursal.
FAQ
What is the Himcare scheme?
Himcare is a health insurance scheme by the Himachal Pradesh government providing free treatment up to ₹5 lakh per family per year.
Why did the High Court intervene?
The court intervened after a beneficiary, Surendra Kumar, had to pay ₹2.70 lakh out of pocket for heart treatment at PGI Chandigarh due to non-payment by the scheme.
What was the court's order?
The court directed the state government to clear the pending payment within two days, accepting the assurance of Special Secretary Health Dr. Ashwani Sharma.