Insured may claim reimbursement for individually purchased medical item covered free by law.

The Supreme Court ruled that an insured person can claim reimbursement from the health insurance fund for a medical item purchased individually upon hospital request. The insured, hospitalized for hip replacement, bought the prosthesis herself because the hospital required it, but the insurance fund refused payment citing lack of funds and contractual pricing. The court held that the insured's right to free treatment transforms into a claim for reimbursement when the provider forces the patient to bear costs outside statutory limits.