My son is hearing impaired. Owing to overdose of Antibiotic Injection Gentamicin at the age of 1 year, his hearing capacity declined gradually over the years. We came to know about his hearing problem only at his age of 04 years which then was very little. Since is not born deaf, his speech is normal. Now he is 18 years old. He was using digital hearing aid from 2007 onwards and now he is doing Engineering (1st Year). He complained that he is unable to hear lectures and whether they are being delivered in Hindi or English. It was then, we realized the magnitude of his problem and Doctors at Sir Ganga Ram Hospital and Saket City Hospital have advised for Cochlear Implant Surgery. I am a Central Government Employee and is a beneficiary of CGHS. But as per latest CGHS rule, the reimbursement is limited to Rs.5,35,000/- provided the child should be in the age group of 1-5 years. For children between 5-10 years, only 80% of above amount is admissible and for children from 11-16 years only 50% of the amount is admissible. I have sent my case for reimbursement and CGHS had rejected the claim as my son is 18 years old and is not eligible. In this regard, I want to file a court case due to following reasons: -
(i) My son was not born deaf and was not required to cochlear implant at the age of 1-16 years.
(ii) Whereas for other costly surgeries/implants there is no such limit.
(iii) I am a soldier, it was when posted in a remote area of West Bengal in the year 1996, when my son's condition from loose motions deteriorated, the available doctor had given overdose of Gentamicin Injection due to which my son's hearing got affected.
I want to know whether I will be able to win the case and get the amount reimbursed from CGHS.
K SURESH KUMAR
1 Answer from Attorneys
Phase contact with compete papers for assistance.