‘Court can’t rewrite policy on sympathy’: Gauhati High Court denies OIL engineer’s Rs 4 lakh foreign treatment claim

Abroad treatment, rejecected reimbursment

• The petitioner, Udipta Mech, joined OIL in November 2020 and was subsequently diagnosed with Sensorineural Hearing Loss (SNHL) in 2022.
• Following consultation at Apollo Hospital, Delhi, and AIIMS, he was advised to undergo Tinnitus Retraining Therapy (TRT) and use a Tinnitus Masking Device.
• Mech sought financial assistance for the device, valued at approximately Rs 4.09 lakh, and later sought approval for specialised treatment in a Tinnitus clinic abroad.
• OIL rejected these requests, approving only a hearing aid up to a ceiling of Rs 50,000 and stating that treatment abroad for personal visits was not covered under the OIL Employees’ Medical Attendance Rules, 2018.
• Subsequently, on a clarification sought by OIL, the doctor who treated the petitioner at Indraprastha Apollo Hospital and advised him for treatment abroad, intimated OIL that the referral for treatment abroad was made at the patient/petitioner’s insistence.
• The petitioner subsequently traveled abroad for treatment on personal leave and approached the court for reimbursement and damages for alleged medical negligence.

Interpretation of rules for overseas treatment

• Due to the petitioner’s lack of familiarity with judicial review, the court appointed K P Pathak as amicus curiae.
• The amicus curiae argued that Rule 8.0 of the 2018 Rules, which uses the phrase “means… and includes,” should be interpreted expansively to cover foreign treatment and specialised devices like the Tinnitus Masker.
• He further contended that since foreign treatment was not specifically listed under “Exclusions” in Rule 9.0, it should be deemed permissible.

OIL’s stand

• Appearing for the OIL, advocate P K Tiwari argued that the rules provide an exhaustive definition of “treatment” and that the omission of the Tinnitus Masker from the list of authorised artificial appliances was deliberate, and accordingly, the employer has rightly rejected his claim.
• He further submitted that the medical expenses incurred in a foreign country are to be reimbursed through insurance and are only available to those employees while travelling abroad on an official tour/training programme, which is not applicable in the case of the petitioner.

‘Procurement of specific hearing aid device was deliberate’

• The Rules, 2018 is codified with finite entitlement, and such rules are not advisory guidelines.
• The same is a codified benefits scheme forming part of service conditions.
• Entitlement does not flow solely from medical desirability. It flows from textual authorisation.
• Courts have repeatedly cautioned that in matters of financial and policy allocation, judicial review must be confined to legality and not venture into policy substitution.
• The argument of the amicus curiae hinges on the semantics of “means” and “includes” as they are used separately, and it is argued that the word “includes” renders the definition elastic and capable of embracing modalities not enumerated in that textual content.

• However, jurisprudence does not support such a sweeping reading.
• When a specific device, a hearing aid, is expressly recognised and capped at Rs 50,000, the rule demonstrates a conscious intention to treat auditory assistance devices differently.
• The omission of Tinnitus Masker from the enumerated list is, therefore, in the opinion of this court, not accidental but it is deliberate.

‘Mention of one thing implies exclusion of others’

• The maxim “expressio unius est exclusio alterius”, in the opinion of this Court, applies in the given facts of the present case. In Latin, it means “the mention of one thing implies the exclusion of others.”
• This maxim plays a vital role in assisting Courts in determining intention by specifying particular items or conditions, particularly in contracts.
• This maxim plays a vital role in assisting Courts in determining intention by specifying particular items or conditions, particularly in contracts.
• Although such a maxim should be applied cautiously, in the case in hand, when certain items are expressly provided, others of the same genus are impliedly excluded unless expressly incorporated.
• A claim for treatment at a foreign specialised clinic or reimbursement of medical equipment, not permitted under the medical scheme of the employer, cannot be constitutionalised into an enforceable fundamental right under Article 21 of the Constitution, based on a prescription made in the Rules, 2018.