Other States

HC intervention helps teen liver patient get Rs.14 lakh for transplant


A teenager from Aurangabad in Maharashtra, who suffers from a chronic liver disease, has been given a cover of Rs.14 lakh by the ESIC, following the intervention of the Delhi High Court on Wednesday, which pulled up the body for denying aid to the insured.

A Bench of Justice P.S. Teji was on Wednesday informed by advocate Ashok Agarwal that the ESIC had given a cheque of Rs.14 lakh to the boy’s family and that the same had been deposited with the Institute of Liver and Biliary Sciences (ILBS).


The Bench expressed its displeasure as it said the same was given only after its intervention. On June 6, the Court had directed ESIC to pay the medical cost.

The Court was hearing the petition of Prahlad Gaiykwad, whose 14-year-old son Sidhant Gaiykwad is in urgent need of a liver transplant and was referred to ILBS here. He could not get the transplant as the ESIC has refused to cover the cost of treatment as it was over Rs 10 lakh.

Prahlad is a machine operator in an auto company in Aurangabad and earns Rs.13,000 per month. His son Sidhant was getting treated at ESIC hospital in Aurangabad since 2012 and later was referred to ILBS. On May 16, ILBS gave him an estimate of Rs 17.60 lakh but the ESIC refused to sanction the same.


The petitioner then moved the Delhi High Court seeking cost of treatment and also challenging the clauses (5.1 and 5.3) of the ESIC guidelines as being arbitrary, irrational, unreasonable and illegal.

While clause 5.1 limits the cost of medical treatment at Rs 10 lakh, clause 5.3 says it will be not be given to the dependents of the insurer if they are born before the date of insurance.

In this case, Prahlad had taken insurance in 2004.

The boy couldn't get the transplant as ESIC refused to cover cost of treatment since it was over Rs.10 lakh

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Printable version | Jan 18, 2020 3:24:02 PM | https://www.thehindu.com/news/national/other-states/HC-intervention-helps-teen-liver-patient-get-Rs.14-lakh-for-transplant/article14427166.ece

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