M.D.Venugopall vs The Director General Of Police on 28 August, 2014

[Cites 2, Cited by 0]

Madras High Court

M.D.Venugopall vs The Director General Of Police on 28 August, 2014

2.The petitioner was appointed as Junior Assistant in the respondent Department on 03.06.1981 and retired from service as Office Superintendent in the Office of the Joint Commissioner of Police, South Zone, Chennai on 30.04.2012.

3.The petitioner is a severe Cardiac patient since 2005. The same is not in dispute. It is also not in dispute that the Senior Cardiologists advised him to undergo Angiogram followed by a by-pass surgery. But the petitioner was not willing to undergo an invasive treatment since both his father and brother died while performing Angiogram test. Hence, his family members did not opt for Angiogram followed by a by-pass surgery for the petitioner.

4.In these circumstances, the petitioner opted to undergo a non-invasive treatment called EECP (Enhanced External Counter Pulsation Therapy). He approached Oxymed Hospital, which is also an approved Hospital for the aforesaid non-invasive treatment. The Hospital stated that the estimated cost would come around Rs.1,27,000/-.

5.The Joint Commissioner of Police, Chennai sent a letter dated 13.08.2010 to the General Manager, Star Health and Allied Insurance Co., Limited, Chennai, to which the petitioner was insured, to approve the estimated cost so as to undergo the treatment. But the Star Health and Allied Insurance Co., Limited sent a reply dated 23.08.2010 stating that the said Hospital has been collecting excess amount from the patients covered under the Scheme, who took treatment in the said Hospital and suggested four other Hospitals for the said treatment.

6.It is stated that those Hospitals suggested only invasive treatment for which the petitioner is not agreeable.

7.While so, the petitioner suffered severe neck pain and chest pain and immediately, he got admitted in SAAOL Heart Centre at T.Nagar, on 15.09.2010. He was discharged from the said hospital on 13.11.2010. In the said Hospital, he was treated with 35 sittings of ECP (External Counter Pulsation) and 18 infusions of BCA (Biochemical Angioplasty). After the said non-invasive treatment, the petitioner got relieved from the neck and chest pain. The hospital charged him Rs.90,400/- for the aforesaid treatment.

8.The Commissioner of Police, sent a letter dated 03.12.2010 to the Director General of Police recommending to sanction Rs.90,400/- towards cost for the aforesaid non-invasive treatment. The Commissioner of Police recommended to the Director General of Police that the said amount could be paid from the Tamil Nadu Police Benevolent Fund as a special case.

9.On receipt of the aforesaid letter from the Commissioner of Police, the Director General of Police, Chennai directed him to appear before the Medical Board to sanction the amount as recommended by the Commissioner of Police.

10.Accordingly, the petitioner appeared before the Medical Board. After examination of the Medical Board, the Director General of Police, passed an order dated 17.08.2011 rejecting the request of the petitioner for reimbursement of the medical expenses that was recommended by the Commissioner of Police, based on the report of the Medical Board. The report of the Medical Board was also enclosed along with the aforesaid order dated 17.08.2011 of the Director General of Police. The Medical Board, in its report has stated that the treatment taken by the petitioner was unorthodox and post treatment CT showed 60-70% block in RCA.

11.In these circumstances, the petitioner has filed this writ petition to quash the aforesaid order dated 17.08.2011 of the Director General of Police and for a consequential direction to the respondent to pay medical reimbursement of Rs.90,400/- as per Government Order issued in G.O.No.174, Finance (Salaries) Department, dated 28.04.2008.

12.A counter affidavit is filed by the respondent reiterating the contentions that are found in the impugned order.

13.Heard both sides.

14.The learned counsel for the petitioner has brought to my notice G.O.Ms.No.174, Finance (Salaries) Department, dated 28.04.2008 regarding New Health Insurance Scheme for the Government employees. Annexure 4 of the New Health Insurance Scheme provides for list of diseases, treatments and surgeries classified under the broad based specialities under NHIS and the same is found at page no.9 of the typed set of papers. The first category is Cardiology and Cardio Thoracic Surgery. There are various treatments under the aforesaid category ranging from (a) to (i). The entire clause relating to Cardiology and Cardio Thoracic Surgery is extracted hereunder:

List of Diseases, Treatments and Surgeries classified under the Broad Based Specialities under NHIS I.CARDIOLOGY AND CARDIO THORACIC SURGERY:

Heart surgery including

a)Coronary By-pass surgery (CABG)

b)Valve replacement

c)Correction of Congenital heart diseases

d)Angioplasty and PTCA Stent

e)Baloon Valvuloplasty

f)Permanent and temporary Pacemaker implantation

g)Embolectomies for Peripheral artery embolism

h)Surgeries for repair of Aneurysm

i)Enhanced External Counter Pulsation Therapy (EECP)

15.The Government Order in G.O.No.174 has approved the treatment of Enhanced External Counter Pulsation Therapy (EECP), which is a non-invasive one. Earlier, the petitioner consulted the Oxymed Hospital for the aforesaid non-invasive treatment. The said Hospital estimated the cost of Rs.1,27,000/-. The Joint Commissioner of Police, wrote a letter dated 13.08.2010 to Star Health and Allied Insurance Company Limited to approve the aforesaid estimated cost. But the Star Health and Allied Insurance Company Limited rejected the request by an order dated 23.08.2010. It is not the case of the Star Health and Allied Insurance Company Limited that the said Hospital is not an approved one. It is also not the case of the Star Health and Allied Insurance Company Limited that the treatment does not come under the New Health Insurance Scheme. But the Star Health and Allied Insurance Company Limited stated that the said Hospital collects excess amount from the patients and also has suggested four other Hospitals. Those Hospitals advised only invasive treatment for which the petitioner is not willing for the reasons stated by him.

16.In these circumstances, when the petitioner developed neck pain and chest pain, he got immediately admitted in SAAOL Heart Centre and took non invasive treatment and the said Hospital gave 35 sittings of ECP. He was discharged from the said hospital on 13.11.2010.

17.The Commissioner of Police sent a letter dated 03.12.2010 to the respondent Director General of Police recommending to sanction a sum of Rs.90,400/- towards cost for the non invasive treatment taken at SAAOL Heart Centre.

18.But the respondent Director General of Police referred the petitioner to the Medical Board. The Medical Board found that after post treatment, there was 60-70% block in RCA and also described the non invasive treatment as unorthodox treatment. According to the Medical Board, the treatment did not bring qualifiable result. Based on the said report, the respondent passed the impugned order rejecting the claim of the petitioner.

19.It is not the case of the respondent that the petitioner did not take treatment at all. It is also not the case of the respondent that the non invasive treatment is not permissible under the Tamil Nadu Police Benevolent Fund. As stated above, the non-invasive treatment, namely EECP is approved in G.O.No.174. The treatment given at the SAAOL Heart Centre is also not in dispute. The only objection is that the petitioner should not have opted for non invasive treatment, namely ECP, but he should have undergone Angiogram including by-pass surgery.

20.The case of the petitioner is that while performing Angiogram, both his father and brother died. Hence, he did not like to undergo the invasive test. In my view, it is for the patient to decide about the course of treatment, either invasive or non invasive. If a patient opts for non invasive treatment which is an approved one and the qualified Doctors gave the treatment, it is not fair on the part of the State to deny the benefit, particularly when the Commissioner of Police recommended for the same. The petitioner put in 29 years of service as stated by the Commissioner of Police. He is suffering from Cardiac problem from 2005. His family also lost 2 of its members, namely his father and brother due to Cardiac problem. In fact, as per Article 21 of the Constitution of India, no personal shall be deprived of his life or personal liberty except according to procedure established by law. Article 21 of the Constitution of India is extracted hereunder:

21. Protection of life and personal liberty.No person shall be deprived of his life or personal liberty except according to procedure established by law.

21.As extracted above, the non invasive treatment is approved by the Government in G.O.No.174. It is also not the case of the respondent that the reimbursement could not be given under the Tamil Nadu Police Benevolent Fund for non invasive treatment, if such a stand is taken, I am of the view that the same is violative of Article 21 of the Constitution of India. The right of the patient to choose the treatment should be respected. In this case, the apprehension of the petitioner to take non invasive treatment cannot be found fault with. Hence, I am of the view that the impugned order is liable to be interfered with.

22.Accordingly, the impugned order is quashed and the writ petition is allowed. The respondent is directed to pay the amount of Rs.90,400/- forthwith to the petitioner not later than six weeks from the date of receipt of a copy of this order. No costs.

28.08.2014 Index : Yes Internet : Yes TK To The Director General of Police Mylapore, Chennai 4.

D.HARIPARANTHAMAN, J.

TK W.P.NO.22222 OF 2012 28.08.2014

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