NEW DELHI: Satya Vati, a 67-year-old battling breast cancer, has found a glimmer of hope after being denied treatment under the Employees’ State Insurance Corporation (ESIC) scheme, with the Delhi High Court stepping in to seek an explanation from the agency.Hearing the plea, the court on Tuesday issued notice to ESIC and asked why super specialty treatment (SST) was denied to the patient, who requires urgent chemotherapy and surgery. The matter is now listed for April 29.According to the petition, Satya Vati’s diagnosis followed a series of referrals across ESIC facilities. Her nephew Rajesh Rajora told TOI that she first approached the ESIC dispensary in Nand Nagri two months ago after detecting a lump in her right breast. She was referred to Jhilmil hospital in east Delhi, where doctors advised a Fine Needle Aspiration Cytology (FNAC) test. As the test was not available there, it was conducted in the private sector.After reviewing the FNAC report, doctors referred her to ESIC Medical College and Hospital, Faridabad, where further tests, including a biopsy, were conducted, while the PET scan was done in the private sector. Reports confirmed first-stage breast cancer, and doctors advised chemotherapy followed by surgery. April 15 was scheduled for initiating chemotherapy.However, when she reached the hospital for admission, treatment was denied on the ground that the super specialty treatment clause was not active, allegedly due to a brief break of a few months in employment of her son, Gaurav, in 2025.“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,” her nephew Rajesh Rajora told TOI. “Since the next court date is at the end of April, we had no option but to rush her to GTB Hospital to start treatment.”Rajora said that despite the brief gap, Gaurav and his dependents continue to be ESIC beneficiaries, and denying treatment in such a case was unjustified.The petition stated that the denial of treatment is contrary to ESIC’s 2024 policy mandating super specialty treatment for insured persons and their dependents from the first day of employment, subject to case-based assessment.Appearing for the petitioner, advocate Ashok Agarwal told the court that Satya Vati — a dependent of an insured worker — was refused treatment despite clear medical advice, on grounds of “non-entitlement”.Calling the denial “illegal and arbitrary”, the plea argues that withholding life-saving care violates the fundamental right to life and health under Articles 14 and 21 of the Constitution. It also cites previous High Court rulings underscoring the state’s obligation to ensure treatment in serious illnesses such as cancer.With no response to a legal notice sent earlier this month, the family moved the High Court seeking immediate and uninterrupted treatment.The case is expected to test the implementation of ESIC’s super specialty treatment framework, particularly in high-risk cases involving dependents.
