Madras High Court
K.Bala Murugesan vs The Principal Secretary To Government on 24 March, 2026
W.P(MD) No.7790 of 2026
BEFORE THE MADURAI BENCH OF MADRAS HIGH COURT
Dated : 24.03.2026
CORAM
THE HON'BLE MR.JUSTICE MUMMINENI SUDHEER KUMAR
W.P(MD) No.7790 of 2026
K.Bala Murugesan ... Petitioner
Vs.
1. The Principal Secretary to Government
Finance (Health Insurance) Department
Secretariat,
Chennai-9.
2. The Principal Secretary,
Health and Family Welfare Department
Secretariat,
Chennai-9.
3. The Director of Treasuries and Accounts
Panagal Building
Saidapet
Chennai-15.
4. The Divisional Manager
United India Insurance Co. Ltd.
Divisional Office, V Floor
P.L.A. Rathna Towers
212, Anna Salai
Chennai-6.
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W.P(MD) No.7790 of 2026
5.MD Indai Health Insurance
No.501/626, Ground Floor,
JVL Plazza, Anna Salai,
Teynampet,
Chennai-600018.
6.The District Collector
Madurai District,
Madurai District.
7.District Treasury Officer
Madurai District,
Madurai District. ... Respondents
PRAYER: Writ Petition filed under Article 226 of the Constitution of
India, praying this Court to issue a Writ of Mandamus directing the
respondents to forthwith reimburse a sum of Rs.53,770/- being the actual
medical expenditure already incurred by the petitioner towards
intravitreal injection of Aflibercept for eye treatment at Nethra Eye and
Retina Speciality Hospital, Madurai, and further direct the respondents to
reimburse the future medical expenses required for the said treatment,
based on G.O.No.204, Finance (Health Insurance) Department, dated
30.06.2022.
For Petitioner : M/s.W.Pamelin
For Respondents : Mr.S.Shaji Bino-for R1 to R3, R6 & R7
Special Government Pleader
Mr.I.Robert Chandrakumar – for R4
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W.P(MD) No.7790 of 2026
ORDER
This writ petition has been filed seeking a Writ of Mandamus directing the respondents to forthwith reimburse a sum of Rs.53,770/- being the actual medical expenditure already incurred by the petitioner towards intravitreal injection of Aflibercept for eye treatment at Nethra Eye and Retina Speciality Hospital, Madurai, and further direct the respondents to reimburse the future medical expenses required for the said treatment, based on G.O.(Ms)No.204, Finance (Health Insurance) Department, dated 30.06.2022.
2. Heard M/s.W.Pamelin, learned counsel for the petitioner, Mr.S.Shaji Bino, learned Special Government Pleader appearing for the respondents 1 to 3, 6 and 7 and Mr.I.Robert Chandrakumar, learned counsel appearing for 4th respondent 4.
3. With the consent of both the parties, the writ petition is disposed of at the admission stage itself. 3/9 https://www.mhc.tn.gov.in/judis ( Uploaded on: 26/03/2026 03:10:24 pm ) W.P(MD) No.7790 of 2026
4. The petitioner herein, while working as a Tahsildar became a member of Tamil Nadu Pensioners Health Insurance Scheme 2022, has been regularly contributing the premium to the said scheme. While being so, in the month of July 2025, the petitioner has availed a medical facility in connection with eye problem and incurred a total expenditure of about Rs.64,000/- and accordingly submitted necessary application for reimbursement under the said scheme to the 4th respondent. However, the 4th respondent reimbursed only an amount of Rs.10,230/- as against the total expenditure incurred by the petitioner Rs. 64,000/-, thereby not allowing the expenditure for the balance amount of Rs.53,770/-. Hence, the petitioner approached this Court by filling the present writ petition.
5. The Tamil Nadu Pensioners Health Insurance Scheme, 2022 has been introduced pursuant to the orders issued by the Government in G.O.(Ms)No.204 Finance (Health Insurance Department) dated 30th June 2022. In terms of the said scheme, in case of any grievance, there was a grievance redressal mechanism that was provided 4/9 https://www.mhc.tn.gov.in/judis ( Uploaded on: 26/03/2026 03:10:24 pm ) W.P(MD) No.7790 of 2026 under paragraph No.15 of the annexure to the said Government Order. In terms of Clause 7 of paragraph No.15 of the annexure. The Grievance Redressal Officer has been appointed to look after the grievances of any of the Members of the scheme. The relevant clauses 7 and 8 read as under :
“(7) The Grievance Redressal Officer shall examine the claims to verify if the claims relate only to Eligible Medical Expenses and recommend to the District Level Empowered Committee for reimbursement of such sums of money that relate to Eligible Medical Expenses. In case of claims relating to Non-Network Hospital, he shall examine and submit to the District Level Empowered Committee with his opinion as to whether the claim relates to Emergency Care or treatment/surgery undergone following an Accident or non-emergency care. The Grievance Redressal Officer shall submit his report with his opinion to District Level Empowered Committee within a period of one month from the date of receipt of claim from the Beneficiary.
(8) The District Level Empowered Committee shall examine claims with reference to the recommendations and opinions of the Grievance Redressal Officer and approve all such sums for reimbursement that it finds to 5/9 https://www.mhc.tn.gov.in/judis ( Uploaded on: 26/03/2026 03:10:24 pm ) W.P(MD) No.7790 of 2026 be Eligible Medical Expenses, satisfying the requirements of clauses 11 and 12(2)(c) of these Guidelines within a period of one month from the date of receipt of the report from the Grievance Redressal Officer.” In the light of the above, the petitioner instead of availing the said internal mechanism that provided under the very scheme has approached this Court by filling the present writ petition.
6. The learned counsel appearing for the respondent No.4 has submitted that incase if the petitioner has got any grievance, the petitioner has got a efficacious remedy under scheme itself and therefore, the writ petition cannot be entertained.
7. In the light of the above, this Court is also of the considered view that the petitioner ought to have availed the remedy provided under paragraph No.15 of the annexure to the above said Government Order by duly filing a grievance petition before the Grievance Redressal Officer in terms of Clauses 7 and 8 of paragraph No.15 extracted hereinabove.
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8. In the light of the above, this Court is of the considered view that this writ petition cannot be entertained at this stage and accordingly, the writ petition is disposed of permitting the petitioner to avail the remedy available under the scheme by filing appropriate representation before the Grievance Redressal Officer within a period of three (3) weeks from the date of receipt of a copy of this order. In case if any such grievance is raised by the petitioner, the concerned Authority shall consider the same and pass appropriate orders thereon as expeditiously as possible, at any rate within a period of six (6) weeks from the date of submission of representation by the petitioner. No costs.
24.03.2026 Index : Yes / No Internet : Yes / No rm 7/9 https://www.mhc.tn.gov.in/judis ( Uploaded on: 26/03/2026 03:10:24 pm ) W.P(MD) No.7790 of 2026 To
1.The Principal Secretary to Government Finance (Health Insurance) Department Secretariat, Chennai-9.
2.The Principal Secretary, Health and Family Welfare Department Secretariat, Chennai-9.
3.The Director of Treasuries and Accounts Panagal Building Saidapet, Chennai-15.
4.The Divisional Manager United India Insurance Co. Ltd.
Divisional Office, V Floor P.L.A. Rathna Towers 212, Anna Salai Chennai-6.
5.MD Indai Health Insurance No.501/626, Ground Floor, JVL Plazza, Anna Salai, Teynampet, Chennai-600018.
6.The District Collector Madurai District, Madurai District.
7.District Treasury Officer Madurai District, Madurai District.
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RM W.P(MD) No.7790 of 2026 24.03.2026 9/9 https://www.mhc.tn.gov.in/judis ( Uploaded on: 26/03/2026 03:10:24 pm )