Delhi High Court Demands Answers from ESIC Over Denied Cancer Care
The Delhi High Court has stepped in to address a critical healthcare issue, issuing a notice to the Employees’ State Insurance Corporation (ESIC) after it denied super speciality treatment to Satya Vati, a 67-year-old woman battling breast cancer. The court has asked ESIC to explain why the urgent chemotherapy and surgery required by the patient were refused, with the matter scheduled for a hearing on April 29.
Diagnosis and Referral Journey Across ESIC Facilities
Satya Vati's medical ordeal began two months ago when she detected a lump in her right breast and visited the ESIC dispensary in Nand Nagri. From there, she was referred to Jhilmil hospital in east Delhi, where doctors recommended a Fine Needle Aspiration Cytology (FNAC) test. Since the test was unavailable at that facility, it was conducted in the private sector.
After reviewing the FNAC report, doctors directed her to ESIC Medical College and Hospital in Faridabad for further evaluation. Additional tests, including a biopsy, were performed there, while a PET scan was carried out privately. The results confirmed first-stage breast cancer, and medical professionals advised immediate chemotherapy followed by surgery, with treatment set to commence on April 15.
Sudden Denial of Treatment Based on Employment Gap
However, when Satya Vati arrived at the hospital for admission, she was informed that super speciality treatment was not accessible to her. The denial was allegedly due to a brief employment break of a few months in 2025 by her son, Gaurav, despite both he and his dependents remaining ESIC beneficiaries.
Her nephew, Rajesh Rajora, expressed frustration, stating, "We were given a date for chemotherapy, and then suddenly told she is not eligible. How can treatment be denied in a cancer case? The break was only for a few months, and she is still a beneficiary. We can’t wait for paperwork when the disease won’t wait." With the next court date at the end of April, the family had no choice but to rush her to GTB Hospital to initiate treatment.
Legal Arguments and Policy Violations Highlighted
Advocate Ashok Agarwal, representing the petitioner, argued in court that Satya Vati, as a dependent of an insured worker, was unjustly refused treatment based on "non-entitlement" grounds. The petition contends that this denial is illegal and arbitrary, violating the fundamental right to life and health under Articles 14 and 21 of the Constitution.
It further cites ESIC's 2024 policy, which mandates super speciality treatment for insured persons and their dependents from the first day of employment, subject to case-based assessment. The plea emphasizes that withholding life-saving care contradicts previous High Court rulings that underscore the state's obligation to ensure treatment in serious illnesses like cancer.
Broader Implications for ESIC's Healthcare Framework
This case is poised to test the implementation of ESIC's super speciality treatment framework, particularly in high-risk scenarios involving dependents. The family had sent a legal notice earlier this month but received no response, prompting them to approach the High Court for immediate and uninterrupted care.
The outcome could set a precedent for how healthcare policies are enforced, ensuring that bureaucratic hurdles do not compromise urgent medical needs for vulnerable patients.
