Writ Petitions Involving Disputed Questions of Fact Are Not Maintainable and Require Alternative Efficacious Remedies.

The petitioners, a surgical clinic and its Managing Director, filed a writ petition seeking a direction to HDFC ERGO General Insurance Company (Respondent Nos. 4 and 5) to pay outstanding hospitalization and treatment charges totaling Rs. 7,54,500/-.

These charges were incurred during the treatment of patients under the Below Poverty Line (B.P.L.) category as part of the Rastriya Swasthya Bima Yojana (R.S.B.Y.) Scheme, allegedly conducted on the instructions of the insurance providers.

During the proceedings, counsel for both parties reached a consensus that the dispute involved identical facts and legal questions to a previously decided matter.

Whether the petitioners are entitled to recover outstanding medical dues under the R.S.B.Y. scheme through a writ petition when the matter involves disputed questions of fact.

The court applied the principle of res integra and judicial consistency, relying on the precedent set by the Division Bench of the Patna High Court in Dr. Nita Jha v. The State of Bihar & Ors. (C.W.J.C. No. 455 of 2020).

The core legal rule established is that where a writ petition involves "disputed questions of fact," the High Court may decline to exercise its extraordinary jurisdiction under Article 226, instead requiring the petitioner to take recourse to "equally efficacious alternative remedies" available under the law.

The Court did not engage in a detailed factual inquiry into the clinical claims or the insurance company’s liability. Instead, it observed that the issue was no longer res integra (an untouched matter) because it had been squarely covered by the judgment in Dr. Nita Jha.

In that precedent, which the Court adopted, it was determined that since the recovery of dues under health schemes often involves complex factual disputes, the appropriate course of action is to permit the petitioner to withdraw the writ and approach an appropriate forum (such as a civil court or arbitration, as applicable).

Consequently, the Court found it unnecessary to adjudicate the merits of the current dispute, opting to maintain consistency with the Division Bench's approach to similar R.S.B.Y. claims.

While the Court did not adjudicate the dispute on its merits and left all questions of fact and law open, it granted the petitioners permission to pursue "equally efficacious alternative remedies" for the recovery of the Rs. 7,54,500/- claim before an appropriate forum. All pending interlocutory applications were also disposed of.