Madras High Court
Ali Akbar vs The Principal Secretary To Government on 29 November, 2017
Author: S.S.Sundar
Bench: S.S.Sundar
BEFORE THE MADURAI BENCH OF MADRAS HIGH COURT Dated: 29.11.2017 Reserved on : 14.06.2017 Delivered on : 29.11.2017 CORAM THE HONOURABLE MR.JUSTICE S.S.SUNDAR W.P(MD).Nos.4404 of 2014, 3390, 4705 & 5494 of 2015, 3587, 4906, 14468 & 19407 of 2016, 1449, 3510, 3513, 4542, 5738, 6352 to 6354, 6623, 6456, 6726, 6769, 6951, 7343, 7943, 7956, 8405, 8611 and 10614 of 2017 and M.P.(MD) Nos.1 of 2015, W.M.P.(MD) Nos.2840, 5009, 6163, 6405, 6533, 6534 of 2017 W.P(MD).No.4404 of 2014 Ali Akbar ... Petitioner vs. 1.The Principal Secretary to Government, Department of Finance, Secretariat, St. George Fort, Chennai. 2.The Divisional Manager, United India Insurance Company, Division Office ? 10700, Silingi Building, 134, Greams Road, Chennai ? 600 006. ... Respondents Prayer : Writ Petition filed under Article 226 of the Constitution of India, praying this Court to issue a Writ of Mandamus directing the 2nd respondent to settle the medical bill of Rs.1,87,812/- to the petitioner with 18% interest per annum at once. !For Petitioner : Mr.P.Ganapathi Subramanian ^For R1 : Mr.J.Gunaseelan Muthiah Government Advocate For R2 : Mr.G.Prabhu Rajadurai W.P(MD).No.3390 of 2015 K.Ganesh Kumar ... Petitioner vs. 1.State of Tamil Nadu, Represented by Principal Secretary, and Commissioner of Revenue Administration, Revenue Department, Ezhilagam, Chepauk, Chennai ? 5. 2.The District Collector, Tuticorin District, Tuticorin. 3.The Thasildar, Srivaikundam Taluk, Tuticorin District. 4.The Director, Star Health Insurance, No.8, New Tank Street, Valluvar Kottam, Nunkampakkam, Chennai-34. ... Respondents Prayer : Writ Petition filed under Article 226 of the Constitution of India, praying this Court, to issue a Writ of Mandamus, directing the Respondent No. 1 to provide the Medical Reimbursement, Rs. 1,40,000/- (One lakh forty thousand) with 12% interest under the Tamil Nadu Government Employees New Health Insurance Scheme within time stipulated by this Honourable Court. For Petitioner : Mr.T.Lajapthi Roy For R1 to R3 : Mr.J.Gunaseelan Muthiah Government Advocate For R4 : Mr.T.Antony Arulraj W.P(MD).No.4705 of 2015 M.Perumal ... Petitioner vs. 1.The Director of Pension, II Floor, III Block, DMS Office Complex, Teynampet, Chennai ? 600 006. 2.The Assistant Treasury Officer, Sub Treasury, Kulithalai, Karur District. 3.The Director, Kaveri Hospital, No.1 K.C.Road, Tennur, Trichy ? 17. ... Respondents Prayer : Writ Petition filed under Article 226 of the Constitution of India, praying this Court, to issue a Writ of Certiorarified Mandamus, calling for the records relating to the Proceedings in Na.Ka. No. 26/Aa1/2015, dated 29.01.2015 on the file of the 2nd Respondent and quash the same consequently directing the respondents to reimburse the amount of Rs.1,49,646/- as medical welfare scheme as per the impugned order. For Petitioner : Mr.KM.Boopathy For R1 and R2 : Mr.C.Selvaraj Special Government Pleader W.P(MD) No.5494 of 2015 C.David Rosalin ... Petitioner vs. 1.The Government of Tamil Nadu, Rep. by the Principal Secretary to Government, Finance (Pension) Department, Secretariat, Fort St. George, Chennai. 2.The Government of Tamil Nadu Rep. by the Principal Secretary to Government, Health and Family Welfare Department, Secretariat, Fort St. George, Chennai. 3.The Director of Treasuries and Accounts, Chennai. 4.United India insurance Company, 240, Whites Road, Chennai ? 600 014. 5.The Director of Medical & Health Services, DMS Compound, Chennai - 6. 6.The Deputy Director of Medical & Rural Health Services and Family Welfare Department, Government Head Quarters Hospital Compound, Nagerrcoil ? 629 001. 7.The District Elementary Officer, Kanyakumari District, Kanyakumari. 8.The District Collector Nagercoil, Kanyakumari District. 9.The Sub Treasury Officer, Sub Treasury, Karungal, Kanyakumari 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 pay a sum of Rs.1,68,985/- as reimbursement of medical bills to the petitioner with appropriate interest within a reasonable time period to be fixed by this Court. For Petitioner : Mr.R.Gowri Shankar For R1 to R3 and R5 to R9 : Mr.N.S.Karthikeyan Additional Government Pleader For R4 : Mr.C.Jawahar Ravindran *** W.P(MD).No.3587 of 2016 S.Selin ... Petitioner vs. 1.The State of Tamil Nadu Represented by its Secretary, Department of School Education, Secretariat, Fort St. George, Chennai. 2.The Chief Educational Officer, Office of the Chief Educational Officer, Thirunelveli District. 3.MD India Healthcare Services (TPA) Private Limited, No.27, Lakshmi Towers, Dr. Radhakrishnan Salai, Mylapore, Chennai - 600 004. ... Respondents Prayer : Writ Petition filed under Article 226 of the Constitution of India, praying this Court, to issue a Writ of Certiorarified Mandamus, calling for the records connected with the Order/Communication dated 28.03.2015 on the file of the 3rd respondent and quash the same as illegal consequently directing the respondent No.3 to reimburse the medical expenses incurred by petitioner within the time stipulated by this Hon'ble Court. For Petitioner : Mr.R.Alagumani For R1 and R2 : Mr.N.S.Karthikeyan Additional Government Pleader For R3 :Mr.A.Shajahan *** W.P(MD).No.4906 of 2016 N.Chudalayandi ... Petitioner vs. 1.The Managing Director, Tamil Nadu State Transport Corporation, Vannarpettai, Tirunelveli. 2.The Senior Manager ? Operations, Project Head ? TNNHIS 2012 & 2014 Projects, MD India Health Care Services (TPA) Pvt., Ltd., No.27, Lakshmi Towers, 3rd Floor, Dr. Radhakrishnan Salai, Mylapore, Chennai - 600 004. ... Respondents Prayer : Writ Petition filed under Article 226 of the Constitution of India, praying this Court, to issue a Writ of Certiorarified Mandamus, calling for the records pertaining to the impugned order passed by the 2nd respondent in his letter dated 22.06.2015 vide Ref.No.GTM0148/TNNHIS/06/2015 and quash the same and further directing the respondents to reimburse the medical expenses claim incurred by the petitioner of Rs.1,88,553/- for his medical treatment. For Petitioner : Mr.T.Selvan For R1 : Mr.Sathyasingh Standing Counsel for TNSTC For R2 :Mr.A.Shajahan *** W.P(MD).No.14468 of 2016 M.Shenbaga ... Petitioner vs. 1.The Director of Medical and Rural Health Services, Teynampet, Chennai ? 600 006. 2.The Joint Director of Medical and Rural Health Services, Sivagangai District, Sivagangai ? 630 562. 3.The Director of Treasuries and Accounts, Panagal Building, Saidapet, Chennai ? 600 015. 4.The District Treasury Officer, District Treasury, Sivagangai - 630 562, Sivagangai District. 5.The Divisional Officer, United India Insurance, Divisional Office- VI, PLA Rathna Towers, 5th Floor, Anna Salai, Chennai - 600 006. ... Respondents Prayer : Writ Petition filed under Article 226 of the Constitution of India, praying this Court, to issue a Writ of Cetiorarified Mandamus to call for the records relating to the impugned order passed by the 1st respondent in Na.Ka.No.57305/KAPI 1/3/2015 dated 11.09.2015 and the consequential order of the 5th Respondent dated 26.05.2016 and quash both as illegal and direct the respondents to sanction a sum of Rs.1,25,519/- being the reimbursement of cost of emergency medical treatment taken for the son of the petitioner without further delay. For Petitioner : Mr.N.Tamilmani For R1 and R4 : Mr.N.S.Karthikeyan Additional Government Pleader For R5 :Mr.A.Shajahan *** W.P(MD).No.19407 of 2016 G.Kamalabai ... Petitioner vs. 1.The Government of Tamil Nadu, Represented by its Secretary, Finance (Salary) Department, Fort St.George, Chennai ? 600 009. 2.Assistant Vice President, STAR Health and Allied Insurance Co., Ltd., Tamilnadu Government Employees New Health Insurance Scheme, Old No.64A, New No.2A, Ganga Nagar Road, Opp. BSNL Office, Kodambakkam, Chennai ? 24. 3.The United India Insurance Co., Ltd., Represented by its Deputy Manager, Divisional Office, No.010700, 1st Floor, Silingi Building, No.134, Greams Road, Chennai. 4.The Director of Collegiate Education, College Road, E.V.K.Sambath Building, Chennai-6. ... 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 give medical reimbursement for a sum of Rs.20,85,980/- on the basis of the representation given by the petitioner dated 13.09.2016. For Petitioner : Mr.G.Balakrishnan For R1 and R4 : Mr.J.Gunaseelan Muthiah Government Advocate For R3 : Mr.G.Prabhu Rajadurai For R2 : No Appearance *** W.P(MD).No.1449 of 2017 S.Manoharan ... Petitioner vs. 1.The Government of Tamil Nadu, Represented by its Secretary, Fort St. George, Chennai ? 600 009. 2.The District Collector, Dindigul District, Dindigul. 3.The Joint Director, Medical and Rural Health Services Department, Dindigul District Head Quarters, Dindigul District. 4.The Husur Treasury Officer, District Treasury, Dindigul. 5.MD Indian Health Care Services Private Ltd., (Unit of United India Insurance Company Ltd.,), Represented through its Assistant Manager, Division Office VI, PLA Rathna Towers, 5th Floor, 212, Anna Salai, Chennai ? 06. ... Respondents Prayer : Writ Petition filed under Article 226 of the Constitution of India, praying this Court, to issue a Writ of Certiorarified Mandamus, calling for the records pertaining to the impugned orders passed by the 5th respondent dated 20.10.2016 received on 07.11.2016 and quash the same and consequently direct the respondents to reimburse a sum of 2 lakhs to the petitioner towards the medical expenses incurred by medical treatment between 07.10.2015 and 04.12.2015 at Hannah Joseph Hospital, Madurai. For Petitioner : Mr.M.Ramu For R1 to R4 : Mr.N.S.Karthikeyan Additional Government Pleader For R5 : Mr.A.Shajahan *** W.P(MD).No.3510 of 2017 M.Muthupandi ... Petitioner vs. 1.The Principal Secretary to the Government, Finance (Pension) Department, Secretariat, Chennai ? 9. 2.The Director of Treasuries and Accounts, Chennai ? 15. 3.The District Treasury Officer, Collectorate Complex, Madurai -20. 4.The Divisional Manager, United India Insurance Company Ltd., PLA Ratna Towers, 5th Floor, 212, Anna Salai, Chennai ? 6. ... Respondents Prayer : Writ Petition filed under Article 226 of the Constitution of India, praying this Court, to issue a Writ of Certiorarified Mandamus, calling for the records relating to the impugned communication vide: Nil dated 10.02.2016 sent by the 4th respondent and consequential impugned order passed by the 3rd respondent in his proceedings OO.Mu.No.55/2015/M1, dated 30.06.2016 and quash the same as illegal and consequently to direct the respondents to reimburse a sum of Rs.1,21,917/- the medical expenses incurred by the petitioner for his surgery and treatment. For Petitioner : Mr.V.P.Rajan For R1 to R3 : Mr.J.Gunaseelan Muthiah Government Advocate For R4 : Mr.A.Shajahan *** W.P(MD).No.3513 of 2017 A.Thankaraj ... Petitioner vs. 1.The Government of Tamil Nadu, Represented by its Secretary, Finance (Pension) Department, Fort St. George, Chennai ? 600 009. 2.The Director of Pension, 259, Anna Salai, 3rd Block, 2nd Floor, D.M.S. Campus, Teynompet, Chennai ? 600 006. 3.The Assistant Treasury Officer, Assistant Treasury Office, Kalkulam at Thuckalay & Post, Kanyakumari District. ... Respondents Prayer : Writ Petition filed under Article 226 of the Constitution of India, praying this Court, to issue a Writ of Certiorarified Mandamus, calling for the records of the impugned order of the 2nd respondent dated 22.11.2016 bearing Ref. File No.K.Dis. No. 22783/16/E 16 of Directorate of Pension, Chennai- 600 006 and quash the same and further issue necessary direction to the 2nd respondent or other respondents to consider the petitioners application for medical reimbursement a sum of Rs.77,602/- (Rupees Seventy Seven Thousand Six Hundred and Two only). For Petitioner : Mr.G.Balakrishnan For Respondents : Mr.J.Gunaseelan Muthiah Government Advocate *** W.P(MD).No.4542 of 2017 P.Nagarajan ... Petitioner vs. 1.The Secretary to Government, Government of Tamil Nadu Finance (Salaries) Department, Fort St.George, Chennai ? 600 009. 2.The General Manager, United India Insurance Co., Ltd., Cilingi Building, No.134, Greams Road, Chennai ? 600 006. 3.The Divisional Manager, United India Insurance Co., Ltd., Divisional Office-VI, 5th Floor, PLA Rathna Tower, No.212, Anna Salai, Chennai ? 600 006. 4.The District Collector, Theni District, 5.The District Treasury Officer, District Treasury, Theni District 625 531. ... Respondents Prayer : Writ Petition filed under Article 226 of the Constitution of India, praying this Court, to issue a writ of Certiorarified Mandamus calling for the records relating to the impugned orders of the 5th respondent of even ref. no. Ka.Mu.No.54/2017/B1 and even dates 15.02.2017 for Rs.1,13,314/- and Rs.11,875/- in all Rs.1,25,189/- quash the same and consequently direct the respondents herein to reimburse the medical claim of Rs.1,25,189/- to the petitioner together with interest at the rate of 7.5% p.a. thereon covered by the medical records and medical bills. For Petitioner : Mr.K.Appadurai For R1 and R2 : Mr.C.Selvaraj Special Government Pleader For R3 :Mr.A.Shajahan *** W.P(MD).No.5738 of 2017 D.Senthil Kumari ... Petitioner vs. 1.The Divisional Manager, The United India Insurance Co. Ltd., Divisional Office-VI, 5th Floor, PLA Rathna Towers, 212, Anna Salai, Chennai. 2.The Regional Manager, The United India Insurance Co. Ltd., Regional Office (New Health Insurance Scheme - 2012), 7-A, West Veli Street, Madurai - 2 3.MD India Health Care Services (TPA) Ltd., Rep. by the Branch Manager, Guna Complex, New Door No.443 and 445, old door no.304 and 305, Anna Salai, Teynampet, Chennai ? 18. 4.The Secretary to Government, School Education Department, 6th floor, Namakkal Kavingar Maligai, Fort St.George, Secretariat, Chennai - 600 009. 5.The Joint Director, Medical and Rural Health Services Department, Madurai District Headquarters, Usilampatti, Madurai District. 6.The District Elementary Educational Officer, O/o. The District Elementary Education, Chief Educational Office Complex, Tallakulam, Madurai. ... Respondents Prayer : Writ Petition filed under Article 226 of the Constitution of India, praying this Court, to issue a writ of Certiorarified Mandamus calling for the records of the impugned order passed by the 1st respondent in his letter dated 23.03.2017 and quash the same and direct the 1st respondent to reimburse the Medical expenses incurred by the petitioner to a sum of Rs.75,000/- along with interest at the rate of 12% to the petitioner herein. For Petitioner : Mr.L.Prabhu For R1 to R3 :Mr.A.Shajahan For R4 to R6 :Mr.J.Gunaseelan Muthiah Government Advocate *** W.P(MD).No.6352 of 2017 R.Murugesan ... Petitioner vs. 1.The District Collector, Virudhunagar District. 2.The Sub-Treasury Officer, Rajapalayam, Virudhunagar District. 3.The United India Insurance Company, Chennai. 4.Saravana Surgery 12C, Vallalar Street, Rajapalayam. ... Respondents Prayer : Writ Petition filed under Article 226 of the Constitution of India, praying this Court to issue a Writ of Certiorarified Mandamus, to call for the records pertaining to the impugned order passed by the 1st respondent in Na.Ka.K1/26314/2016, dated 26.09.2016 and quash the same and consequently direct the 1st respondent to sanction the medical reimbursement amount of Rs.21,015/- (Rupees Twenty one Thousand and Fifteen only) to the petitioner. For Petitioner : A.Rajaram For R1 and R2 : Mr.C.Selvaraj Special Government Pleader For R3 : Mr.A.Shajahan For R4 : No appearance ***** W.P(MD).No.6353 of 2017 D.Rathinasamy ... Petitioner vs. 1.The District Collector, Virudhunagar District. 2.The Sub-Treasury Officer, Rajapalayam, Virudhunagar District. 3.The United India Insurance Company, Chennai. 4.Sakthibala Hospital, 39/1, Sevalpatti Street, Rajapalayam ? 626 117. ... Respondents Prayer : Writ Petition filed under Article 226 of the Constitution of India, praying this Court to issue a writ of Certiorarified Mandamus to call for the records pertaining to the impugned order passed by the 1st respondent in Na.Ka.K1/26314/2016, dated 02.11.2016 and quash the same and consequently direct the 1st respondent to sanction the medical reimbursement amount of Rs.37,417/- (Rupees Thirty Seven Thousand Four Hundred and Seventeen Only) to the petitioner. For Petitioner : A.Rajaram For R1 and R2 : Mr.C.Selvaraj Special Government Pleader\ For R3 : Mr.A.Shajahan For R4 : No appearance *** W.P(MD).No.6354 of 2017 S.Thirumal ... Petitioner vs. 1.The District Collector, Virudhunagar District. 2.The Sub-Treasury Officer, Srivilliputhur, Virudhunagar District. 3.The United India Insurance Company, Chennai. 4.Raja Hospital, 30-A, North Car Street, Srivilliputhur ? 626 125. ... Respondents Prayer : Writ Petition filed under Article 226 of the Constitution of India, praying this Court, to issue a Writ of Certiorarified Mandamus to call for the records pertaining to the impugned order passed by the 1st Respondent in Na.Ka.K1/26314/2016 dated 02.11.2016 and quash the same and consequently direct the 1st Respondent to sanction the medical reimbursement amount of Rs.51,874/- (Rupees Fifty one thousand eight hundred and seventy four only) to the petitioner. For Petitioner : A.Rajaram For R1 and R2 : Mr.C.Selvaraj Special Government Pleader For R3 : Mr.A.Shajahan For R4 : No appearance *** W.P(MD).No.6623 of 2017 G.Subramanian ... Petitioner vs. 1.The Director of Pension, DMS Complex, Chennai - 6. 2.The District Treasury Officer, District Treasury, Theni. 3.The Assistant Treasury Officer, Sub-Treasury, Periyakulam, Theni District. ... Respondents Prayer : Writ Petition filed under Article 226 of the Constitution of India, praying this Court, to issue a Writ of Certiorarified Mandamus, calling for the records connected with the impugned order of rejection of Medical Re- imbursement passed by the 3rd respondent in his proceedings O.Mu.No. 359/2017/A5, dated 28.03.2017 and quash the same and consequently direct the 1st respondent to reimburse a sum of Rs.72,330/- (Rupees seventy two thousands three hundred and thirty only) being the actual medical expenditure incurred by the petitioner for the treatment Laparoscopic Heller's Cardiomyotomy ? pain while eating given to the petitioner at NTC Institute of Medical Science, Madurai. For Petitioner : Mr.S.Govindan For Respondents : Mr.N.S.Karthikeyan Additional Government Pleader *** W.P(MD).No.6456 of 2017 G.Thankaraj ... Petitioner vs. 1.The Director of Treasuries and Accounts, Panagal Building, Saidapet, Chennai ? 600 015. 2.The Director of Pension, DMS Campus, 3rd Block, 2nd Floor, 259, Anna Salai, Chennai ? 600 006. 3.The District Treasury Officer, Kanyakumari District at Nagercoil. 4.The Head Project Officer, No.27, Laxmi Tower, 3rd Floor, Dr. Radhakrishnan Salai, Mylapore, Chennai ? 600 004. 5.The Senior Manager / Convener, United India Insurance Company, (under the New Health Scheme 2014), Nagercoil, Kanyakumari District. 6.The District Collector, Kanyakumari District, at Nagercoil. ... 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 consider the petitioner's representation dated 06.03.2017 and to disburse the amount of Rs.2,87,909/- being the medical expenses incurred by the petitioner for the angeoplasting and further treatments under the Tamil Nadu Government Pensioners Health Insurance Scheme within the time stipulated by this Court. For Petitioner : Mr.M.R.Sreenivasan For R1 to R4 : Mr.N.S.Karthikeyan Additional Government Pleader For R5 :Mr.Dilip Kumar *** W.P(MD).No.6726 of 2017 E.Muthulakshmi ... Petitioner vs. 1.The Principal Secretary to Government, Finance (Salaries) 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 Co. Ltd., Divisional Office, V Floor, PLA Rathna Towers, 212, Anna Salai, Chennai-6. 5.The District Collector, Thoothukudi District, Thoothukudi District. 6.The Joint Director of Medical and Rural Health Services, Thoothukudi District, Thoothukudi. 7.The District Treasury Officer, Thoothukudi District, Thoothukudi. ... Respondents Prayer : Writ Petition filed under Article 226 of the Constitution of India, praying this Court, to issue a Writ of Certiorarified Mandamus calling for the records connected with impugned order passe by the 7th respondent in his proceedings Na.Ka.No.2827/2016/R3, dated 15.11.2016 and quash the same and consequently direct the 1st respondent to reimburse Rs.66,500/- (Rupees Sixty Six Thousands Five hundred only) being the actual medical expenditure incurred by the petitioner for the treatment given to her at Sri Hospital, Ettayapuram, Kovilpatti. For Petitioner : Mr.V.P.Pamelin For R1 to R3 and R5 to R7 : Mr.N.S.Karthikeyan Special Government Pleader For R4 : Mr.A.Shajahan *** W.P(MD).No.6769 of 2017 Y.Chandra Sekaran ... Petitioner vs. 1.The District Collector, Virudhunagar, Virudhunagar District. 2.The Joint Director, Medical and Rural Health Services, Virudhunagar, Virudhunagar District. 2.The Treasury Officer, District Treasury, Virudhunagar, Virudhunagar District. 4.The Director of Treasuries and Accounts, Panagal Building, Saidapet, Chennai ? 600 015. 3.The United India Insurance Company, Divisional Manager, Divisional Office IV, PLA Rathna Towers, 5th Floor, No.212, Anna Salai, Chennai ? 600 006. ... Respondents Prayer : Writ Petition filed under Article 226 of the Constitution of India, praying this Court, to issue a writ of Certiorafied Mandamus, calling for the records in connection with the impugned order passed by the 1st respondent in Na.Ka.K1/26314/2016 dated 14.02.2017 and quash the same and consequently to direct the 4th respondent to sanction and reimburse the medical expenses of Rs.1,03,811/- towards fracture in neck of right femur, surgery undergone by the petitioner with interest. For Petitioner : Mr.S.Vinayak For R1 to R4 : Mr.C.Selvaraj Special Government Pleader For R5 : Mr.A.Shajahan *** W.P(MD).No.6951 of 2017 R.Sundar raj ... Petitioner vs. 1.The Government of Tamil Nadu, Represented by its Secretary, Department of Health and Family Welfare, Fort St.George, Chennai ? 9. 2.The Additional Director of Medical and Rural Health Services, Office of the Additional Director of Medical and Rural Health Services, Chennai ? 6. 3.The District Collector, Collectorate, Madurai District. 4.The Divisional Engineer, Office of the Divisional Engineer, Alagar Kovil Road, K.Pudur, Madurai. ... 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 provide medical reimbursement to the tune of Rs.2,82,927/- (Two Lakhs Eighty Two Thousand Nine Hundred and Twenty Seven Only) under Tamil Nadu New Employees Health Insurance Scheme within the time stipulated by this Court. For Petitioner : Mr.T.Lajapathi Roy For Respondents : Mr.N.S.Karthikeyan Special Government Pleader *** W.P(MD).No.7343 of 2017 T.Ponnalagan ... Petitioner vs. 1.The District Collector, Dindigul, Dindigul District. 2.The Joint Director, Medical and Rural Health Services, Dindigul, Dindigul District. 3.The Treasury Officer, District Treasury, Dindigul, Dindigul District. 4.The Director of Treasuries and Accounts, Panagal Building, Saidapet, Chennai ? 600 015. 5.The United India Insurance Co., Ltd., Divisional Manager, Divisional Office IV, P.L.A. Rathna Towers, 5th Floor, No.212, Anna Salai, Chennai ? 600 006. ... 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 1 to 5 to reimburse the medical expenditure borne by the petitioner within the time limit that may be stipulated by this Court. For Petitioner : Mr.S.Vinayak For R1 to R4 : Mr.N.S.Karthikeyan Additional Government Pleader For R5 :Mr.A.Shajahan *** W.P(MD).No.7943 of 2017 G.Renga Ramanujam ... Petitioner vs. 1.The State of Tamil Nadu represented by its Secretary, Department of Rural Development and Panchayat Raj, Fort St.George, Chennai ? 600 009. 2.The Director of Local Fund Accounts, 4th floor, Kuralagam, Chennai - 600 108. 3.The District Collector Tiruchirapalli District, Tiruchirapalli. 4.The Joint Director Medical and Rural Health Services, No.4, VOC Street, Tiurchirapalli. 5.The Deputy Manager, United India Insurance Co.Ltd, Divisional Office, Tiruchirapalli, Tiruchirapalli District. ... Respondents Prayer : Writ Petition filed under Article 226 of the Constitution of India, praying this Court, to issue a Writ of Certiorarified mandamus, calling for the records relating to the impugned proceedings issued by the 3rd respondent herein in Mu.Mu.J3/1532/2016, dated 02.03.2016, quash the same and further direct the respondents 1 & 2 herein to disburse forthwith a sum of Rs.1,00,000/- (Rupees one lakh only) to the petitioner along with appropriate interest towards the medical expenses incurred towards permanent pacemaker implantation treatment from 29.06.2015 to 07.07.2015 in Apollo Hospital, Tiruchirapalli. For Petitioner : Mr.E.V.N.Siva For R1 to R4 : Mr.J.Gunaseelan Muthiah Government Advocate For R5 : Mr.A.Shajahan *** W.P(MD).No.7956 of 2017 K.Ayyappan Thampi ... Petitioner vs. 1.The Government of Tamil Nadu, represented by its Secretary, Department of Finance (Pension) Fort St. George, Chennai ? 600 009. 2.United India Insurance Co., Ltd., Divisional Office VI, V Floor, P.L.A. Rathna Towers, 212, Anna Salai, Chennai ? 600 006, Represented by its Divisional Manager. 3.The Third Party Administrator, (Under the Control of U.I.I.C.(Limited), MD India Health Care Services (TPA) Pvt., Ltd., New Health Insurance Scheme 2014 for Pensioners including Spouse / Family Pensioners, Head Project Office, No.27, Laxmi Tower, III Floor, Dr.Radhakrishnan Salai, Mylapore, Chennai ? 600004. 4.The Treasury Officer, Nagercoil, Kanyakumari District. ... Respondents Prayer : Writ Petition filed under Article 226 of the Constitution of India, praying this Court, to issue a writ of Certiorarified mandamus calling for the records of the 2nd respondent pertaining to its order no.Nil dated 21.04.2016 addressed to the petitioner and the records of the 3rd respondent pertaining to its subsequent order No. Nil dated 27.04.2016 addressed to the petitioner on its file and quash the same directing the respondents to pay to the petitioner the amount of Rs.2,57,075/- being the amount of medical expenses, incurred for his medical treatment from 07.03.2016 till 10.03.2016 along with interest thereon at the rate of 9% per annum. For Petitioner : Mr.K.N.Thambi For R1 & R4 : Mr.N.S.Karthikeyan Additional Government Pleader For R2 : Mr.A.Shajahan *** W.P(MD).No.8405 of 2017 Dr.J.Joel ... Petitioner vs. 1.The State of Tamil Nadu represented by its Secretary, Department of Higher Education, Fort St. George, Chennai ? 600 009. 2.The Empowered Committee, Represented by the District Collector, Tirunelveli District at Tirunelveli. 5.The Managing Director, United India Insurance Co., Ltd., MD India Health Services (TPA) Pvt., Ltd., No.27, Lakshmi Towers, 3rd Floor, Dr. Radha Krishnan Salai, Mylapore, Chennai ? 600 004. 4.The Additional Treasury Officer, The District Treasury Office, Tirunelveli, Tirunelveli 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 1st respondent to disburse a sum of Rs.7,11,895/- (Rupees Seven Lakhs Eleven Thousand Eight Hundred and Ninety Five only) or maximum amount of a sum of Rs.4 Lakhs as prescribed in the New Health Insurance Scheme towards the medical reimbursement to the petitioner with interest at the rate of 12%. For Petitioner : Mr.S.Xavier Rajini For R1, R2 and R4 : Mr.N.S.Karthikeyan Additional Government Pleader For R3 : Mr.A.Shajahan *** W.P(MD).No.8611 of 2017 M.Balusamy ... Petitioner vs. 1.The State of Tamil Nadu represented by its Secretary, Department of School Education, Fort St. George, Chennai ? 600 009. 2.The Empowered Committee, Represented by the District Collector, Virudhunagar District at Virudhunagar. 3.The Managing Director, The United India Insurance Co., Ltd., MD India Health Services (TPA) Pvt., Ltd., No.27, Lakshmi Towers, 3rd Floor, Dr. Radha Krishnan Salai, Mylapore, Chennai ? 600 004. 4.The Assistant Treasury Officer, The Sub-Treasury Office, Rajapalayam, Virudhunagar District. ... Respondents Prayer : Writ Petition filed under Article 226 of the Constitution of India, praying this Court, to issue a Writ of Certiorarified Mandamus, calling for the records relating to the impugned proceedings issued by the 2nd respondent Empowering Committee in Na.Ka.No.5767/M.Ku/2016, dated 09.11.2016, quash the same and further direct the respondents to disburse a sum of Rs.1,67,417/- (Rupees One Lakh Sixty Seven Thousand Four Hundred and Seventeen) towards the medical reimbursement to the petitioner with interest at the rate of 12%. For Petitioner : Mr.S.Xavier Rajini For R1, R2 and R4 : Mr.C.Selvaraj Special Government Pleader For R3 : Mr.A.Shajahan *** W.P(MD).No.10614 of 2017 I.Vellaisamy ... Petitioner vs. 1.The District Collector, Virudhunagar District. 2.The Sub-Treasury Officer, Rajapalayam, Virudhunagar District. 3.The United India Insurance Company, Chennai. 4.Meenkshi Mission Hospital and Research Centre, Lake Area, Melur Road, Madurai - 107. ... Respondents Prayer : Writ Petition filed under Article 226 of the Constitution of India, praying this Court, to issue a Writ of Certiorarified Mandamus, to call for the records pertaining to the impugned order passed by the 1st respondent in Na.Ka.K1/26314/2016 dated 13.02.2017 and quash the same and consequently direct the 1st respondent to sanction the medical reimbursement amount of Rs.2,31,469.93/- (Rupees Two Lakshs Thirty One Thousand Four Hundred and Sixty Nine and Ninety Three paise) to the petitioner. For Petitioner : Mr.A.Rajaram For R1 and R2 : Mr.C.Selvaraj Special Government Pleader For R3 and R4 : No appearance :COMMON ORDER
Writ Petition (MD).Nos.4705 of 2015, 3587, 4906 & 14468 of 2016, 1449, 3510, 3513, 4542, 5738, 6352 to 6354, 6623, 6726, 6769, 7943, 7956, 8405, 8611 & 10614 of 2017 have been filed by the respective petitioners challenging the rejection of their claim for medical reimbursement. The petitioners are all either retired Government employees or employees of Government organisations or persons in service in Government Departments or Government organisations governed by various schemes for medical assistance.
2.The Government of Tamil Nadu received several representations from Government employees regarding their grievances with regard to the existing Government Employees Health Fund Scheme which was implemented pursuant to G.O.Ms.No.18, Finance (Allowances) Department, dated 09.01.1992. Thereafter, new health insurance schemes were introduced by the Government. One of the important features of the scheme is that it would be a cashless facility. The scheme enumerated list of diseases, treatments and surgeries which would be covered under the scheme and the scheme also notify certain hospitals for applicability of the schemes. The beneficiaries of this scheme are employees of Government of Tamil Nadu, State Public Sector undertakings, local bodies, universities, statutory bodies, police department, etc., which are under the control of Government of Tamil Nadu. It appears that the Government has an agreement with the insurance company who are bound to indemnify / reimburse the medical expenses spent by the beneficiaries under the scheme subject to certain limitations. Since the insurance company and the Government have entered into a contract, the insurance company is bound to satisfy all the claims of the beneficiaries subject to the terms and conditions of the scheme which is also in tune with the agreement of the Government had with the insurance companies. Since the insurance company is bound to indemnify the Government only if the treatment was taken in the net-work hospitals mentioned in the scheme and the schemes specifically provides for the procedures and treatment for which the insurance company is liable to indemnify, the applications submitted by the petitioners in this case were rejected on the following grounds:
(a) the hospital in which the claimant had undertaken treatment is not covered under the scheme; or
(b) that the treatment / procedure is not included in the list / schedule the insurance scheme provides;
3.Apart from the above grounds, application for medical reimbursement is also turned down in case the treatment is taken by the Government employee by paying cash. Sum and substance, the claim of the petitioners in these Writ Petitions were rejected in view of the specific conditions in the medical reimbursement / insurance schemes.
4.Writ Petition (MD) Nos.4404 of 2014, 3390, 5494 of 2015, 19407 of 2016, 6456, 6951 and 7343 of 2017 are for issuing mandamus directing the Government and the department to reimburse the medical expenses of the petitioners for the treatment underwent by the petitioners. Since their medical reimbursement claim is not being considered by the respondents, the Writ Petitions are for issuing a writ of mandamus.
5.In all the above Writ Petitions, the issue arise for consideration is common and hence, they are disposed of by a common order.
6.The learned counsels appearing for the petitioners have submitted that the rejection of medical reimbursement claim on the ground that the treatment underwent by the petitioners is not included in the list of treatment or procedure provided in the Government scheme is illegal. It is stated that after new inventions and periodical introduction of several mode of treatment, the procedure for treatment approved by the State Government cannot be a ground to take away the right of the petitioners having regard to the object of the scheme. Similarly it was further contended that the claim for medical reimbursement cannot also be rejected for the reasons that the hospital in which the claimant had undergone treatment is not covered under the scheme. The learned counsel for the petitioners have relied upon several judgments of this Court before and after the introduction of medical reimbursement schemes involving insurance companies.
7.The learned Single Judge of this Court in the case of S.Radhakrishnan v. The Director General of Police, Chennai -4 in W.P.No.1175 of 2004 dated 14.03.2005 has held that grant or refusal of medical reimbursement would be only with reference to whether the petitioner had underwent treatment and not the procedure. It is reiterated that the claim for medical reimbursement cannot be rejected merely on the ground that the procedure or treatment is not included in the list approved by the State Government. It is further stated that the very object of the scheme would be frustrated if the claim for medical reimbursement is rejected on that ground. The judgment of the learned Single Judge in W.P.No.1175 of 2004 is also upheld by the Division Bench of this Court in W.A.No.280 of 2005 by a judgment dated 04.07.2005.
8.In yet another judgment of a learned Single Judge of this Court in the case of R.Krishnaswamy v. The Superintendent of Police, Thanjavur, Thanjavur District, in W.P.No.6110 and 7664 of 2005, the learned Single Judge of this Court has held as follows:
?20.I am of the considered view that considering nature and scope of the schemes, the hospitals listed in the schedule are only illustrative in nature. It is a very curious to note that in respect of the Madurai Corporation when Apollo Hospital, Madurai has been listed for the existing employees of the Corporation the same has not been listed for the purpose of pensioners. It is also seen that even under the scheme Apollo hospital, Chennai has been included but not Apollo hospital in Madurai. This only shows that the list of hospital given in the annexures are only illustrative in nature and the scheme cannot be construed as if only those hospitals listed should be hospitals capable of giving proper medical treatment.
21.There is one another situation, in all these cases, either of a heart failure or other major the ailments the attack is sudden, in such circumstances, when the people in the family of such patient are in distress, one cannot expect that they are to search for the hospital which is listed under the scheme for the purpose of getting treatment such a construction will be not only inhuman but also will be totally opposed to tohe basic purpose of such schemes.
22.The respondents cannot shut their responsibilities saying as if it is the policy of the Government. It is relevant to point out that the policy of the Government is not relating to the fixing of the hospital but it can only be relating to the providing of medical treatment. There cannot be a policy of the Government to fix a particular hospital alone or list of hospitals, especially in all these cases, the private hospitals are listed which itself brings out the obvious reason that wherever special treatment is given such treatment must be made available. When that is the object of the scheme one cannot restrict the object by listing down the hospitals.?
9.A learned Single Judge of this Court in yet another judgment in the case of S.Mookan Servai v. The Secretary to Government and others, in W.P.(MD)No.5313 of 2006, has allowed the writ petition challenging the rejection of petitioner's application for medical reimbursement, accepting the principles laid down by the learned Single Judge of this Court in W.P.No.1175 of 2004, above referred to.
10.The learned Counsel for the petitioners relied upon a judgment of the Honourable Supreme Court in the case of Consumer Education & Research Centre and others v. Union of India and others reported in 1995 II L.L.J. 768 wherein it has been held that right to life envisaged under Article 21 of the Constitution of India enlarges its sweep to encompass human personality in its full blossom with invigorated health which is a wealth to the workman to earn his livelihood to sustain the dignity of person and to live a life with dignity and equality. In paragraphs 26 and 27, the Honourable Supreme Court, has further observed as follows:
?26. The right to health to a worker is an integral facet of meaningful right to life to have not only a meaningful existence but also robust health and vigour without which worker would lead life of misery. Lack of health denudes his livelihood. Compelling economic necessity to work in an industry exposed to health hazards due to indigence to bread-winning to himself and his dependents, should not be at the cost of the health and vigour of the workman. Facilities and opportunities, as enjoined in Article 38, should be provided to protect the health of the workman. Provision for medical test and treatment invigorates the health of the worker for higher production or efficient service. Continued treatment, while in service or after retirement is a moral, legal and constitutional concomitant duty of the employer and the State. Therefore, it must be held that the right to health and medical care is a fundamental right under Article 21 read with Articles 39(c), 41 and 43 of the Constitution and make the life of the workman meaningful and purposeful with dignity of person. Right to life includes protection of the health and strength of the worker is a minimum requirement to enable a person to live with human dignity. The State, be it Union or State government or an industry, public or private, is enjoined to take all such action which will promote health, strength and vigour of the workman during the period of employment and leisure and health even after retirement as basic essentials to live the life with health and happiness. The health and strength of the worker is an integral facet of right to life. Denial thereof denudes the workman the finer facets of life violating Art.21. The right to human dignity, development of personality, social protection, right to rest and leisure are fundamental human rights to a workman assured by the Charter of Human Rights, in the Preamble and Arts.38 and 39 of the Constitution. Facilities for medical care and health against sickness ensures stable manpower for economic development and would generate devotion to duty and dedication to give the workers' best physically as well as mentally in production of goods or services. Health of the worker enables him to enjoy the fruit of his labour, keeping him physically fit and mentally alert for leading a successful life, economically, socially and culturally. Medical facilities to protect the health of the workers are, therefore, the fundamental and human rights to the workmen.
27. Therefore, we hold that right to health, medical aid to protect the health and vigour to a worker while in service or post retirement is a fundamental right under Article 21, read with Articles 39(e), 41, 43, 48A and all related Articles and fundamental human rights to make the life of the workman meaningful and purposeful with dignity of person.?
11.In yet another judgment of the Honourable Supreme Court in the case of Surjit Singh v. State of Punjab reported in 1996(1) SLR 789 the Honourable Supreme Court has quoted the following views expressed by the Division Bench of Punjab and Haryana in the case of Sadhu R. Pall v. State of Punjab wherein it has been held that when the treatment for a Government servant is required, one cannot sit at home and think in a cool and calm atmosphere for getting medical treatment at a particular hospital or wait for admission in some Government medical institute. In such a situation, decision has to be taken forthwith by the person or his attendants if precious life has to be saved.
12.Again in another judgment of the Hon'ble Supreme Court in the case of Paschim Banga Khet Mazdoor Samity and others v. State of West Bengal and another reported in AIR 1996 SC 2426 it has been held as follows:
?9.The Constitution envisages the establishment of a welfare state at the federal level as well as at the state level. In a welfare state the primary duty of the Government is to secure the welfare of the people. Providing adequate medical facilities for the people is an essential part of the obligations undertaken by the Government in a welfare state. The Government discharges this obligation by running hospitals and health centres which provide medical care to the person seeking to avail those facilities. Article 21 imposes an obligation on the State to safeguard the right to life of every person. Preservation of human life is thus of paramount importance. The Government hospitals run by the State and the medical officers employed therein are duty bound to extend medical assistance for preserving human life. Failure on the part of a Government hospital to provide timely medical treatment to a person in need of such treatment results in violation of his right to life guaranteed under Article 21. In the present case there was breach of the said right of Hakim Seikh guaranteed under Article 21 when he was denied treatment at the various Government hospitals which were approached even though his condition was very serious at that time and he was in need of immediate medical attention. Since the said denial of the right of Hakim Seikh guaranteed under Article 21 was by officers of the State in hospitals run by the State the State cannot avoid its responsibility for such denial of the constitutional right of Hakim Seikh. In respect of deprivation of the constitutional rights guaranteed under Part III of the Constitution the position is well settled that adequate compensation can be awarded by the court for such violation by way of redress in proceedings under Articles 32 and 226 of the Constitution.?
13.In yet another judgment in the case of State of Punjab and others v. Ram Lubhaya Bagga and others reported in 1998 II LLJ 867 the Hon'ble Supreme Court elaborated on the role of Government in a Welfare State in relation to Article 21 of the Constitution of India. The occasion for the discussion arose in connection with the entitlement towards medical expenses of the Punjab Government employees and pensioners as per relevant rules and the Government policy. The Hon'ble Supreme Court has approved the claim of the Government servant for total reimbursement of their medical expenses incurred in a private hospital.
14.The Hon'ble Division Bench of this Court in a batch of cases in the case of Star Health and Allied Insurance Co. Ltd., v. A.Chokkar and another reported in 2010-2-L.W. 90 has held as follows:
?25.The Tamil Nadu Medical Attendance Rules ("the Rules" in short) clearly lay down the rules regarding dependents and who is entitled to medical concessions under the Rules. It also defines who is a well to do person. The Rules lay down the manner in which claims can be made. According to the learned Advocate General, these Rules are still in force and therefore when it is a claim not covered by the present Insurance Scheme, the Government Servants have the right to make their claims under the Rules. Therefore, as regards Category-A, where treatment has been taken in a non-network hospital, the insurance company cannot be asked to cover the expenses, since the scheme itself makes the network hospitals as intrinsic. However, the petitioners/claimants were also not no remediless and that is why we will issue directions to the claimants to make an application under the Rules or go before the Redressal Committee.
26.Before taking up the individual cases, we must record that there are certain situations which may arise and in fact which have arisen, for which the Government must issue clear guidelines. This the Government has to do, since it has made the Scheme obligatory for everyone and there is automatic deduction of premium to an extent of Rs.25/- per month. The directions are as follows:
(i)The State shall make it clear that if for some reason, which is satisfactory, the claimant is unable to take treatment in a network hospital but has been advised or had to go to a non-network hospital, then his claim would be considered under the Rules.
(ii)If the claimant has been advised some procedure which is not covered by the Scheme, there again, it must be made clear that he can apply under the Rules.
(iii)To safeguard duplication of payments, the Government can make sure and when they apply under the Rules, that the claimant himself certifies that he has not made claim under the Scheme or vice-versa.
(iv)The State shall inform every network hospital that if it receives complaints from claimants that money was demanded for admission or for treatment, then that hospital will be removed from the network. This warning is necessary, since, at times of crisis, the claimants will not be in a position to argue with the hospital that this is a "cashless" Scheme. We are aware that there is an officer of the Star Health Insurance Company at every network hospital to ensure that hospitals adhere to the terms of the Scheme but, yet, it is better to make this position clear to the hospitals, since one of the questions that has arisen before us is that whether the claimants will be entitled to reimbursement if, by mistake, they pay cash.
27.Now coming to the individual cases, in all the case, whatever may be the category, the petitioners/claimants have paid the amount. The scheme is a 'cashless' one and, therefore, it is only the Government which have to make the payment under the Rules. The Redressal Committee is empowered to decide the following circumstances, namely, any difficulty in availing treatment, non-availability of facilities, bogus availment of treatment for ineligible individuals, etc. It is really not clear what other complaints would be covered under the umbrella "etc.". But, however, since the Paragraph relating to 'Redressal of Grievances' starts with the sentence "The Hospitals shall extend treatment to the beneficiaries under the Scheme on a cashless basis", it is evident that the Committee cannot direct payment of cash.
28.Therefore, if the claimants have made payments whether for a procedure not covered or whether at a non-network hospital or they have paid when they have been treated for a covered procedure in a network hospital, their only remedy is to approach the Government under the Rules. If, however, before they take treatment they are informed that a particular procedure is not covered, then at that stage, they may approach the Redressal Committee where the medical expert can decide whether that procedure is covered or not. The Redressal Committee may also go into the complaints regarding non-availability of facility at a network hospital, which may be available in favour of the claimant when he applies under the Rules. Otherwise, we do not think that the Redressal Committee can do much in any one of these cases, since all the petitioners/claimants before us would have made payments. But, if there is a petitioner who has not settled the claim and has come before us, then, in the event, that it is for a procedure that is not covered, he may approach the Redressal Committee. In view of the fact that there are the above lacunae in the Scheme, the Government shall not deny any claim validly made under the Rules only because the claimant is a member of the Scheme.?
15.In the above case, though it is found that the insurance company is not liable to reimburse the medical expenses to the employee, the liability of Government under the Medical Attendance Rules has been fixed and it is reiterated that the Government servants are entitled to medical reimbursement under the Tamil Nadu Medical Attendance Rules.
16.Another Division Bench of this Court also considered similar issue in W.A.(MD)No.1579 of 2016 in the case of MD India Healthcare Services (TPA) Ltd., represented by the Branch Manager, Chennai v. K.Parameshwari and others, following the judgment of the Division Bench of this Court, has confirmed the order of learned Single Judge allowing similar Writ Petition filed by the Government employee.
17.The learned counsel appearing for the petitioners also relied upon the judgment of a learned Single Judge of this Court in the case of N.Raja v. Government of Tamil Nadu reported in 2016 (3) CTC 394 wherein the writ petition with similar prayer is allowed with a direction to the State Government to sanction and reimburse the medical expenses incurred by the petitioner for his treatment with 9% interest from the date of remittance of the amount to the hospital by the petitioner till the date of payment within a period of four weeks.
18.The learned counsel appearing for the respondents have no serious objections for allowing the writ petition in terms of the judgement relied upon by the learned counsels appearing for the petitioners in the above cases. Hence, the order impugned in Writ Petition (MD) Nos.4705 of 2015, 3587, 4906 & 14468 of 2016, 1449, 3510, 3513, 4542, 5738, 6352 to 6354, 6623, 6726, 6769, 7943, 7956, 8405, 8611 & 10614 of 2017 are set aside and all the above Writ Petitions are allowed. No costs. Consequently, connected miscellaneous petitions are closed.
19.The petitioners in Writ Petition (MD).Nos.4705 of 2015, 3587, 4906 & 14468 of 2016, 1449, 3510, 3513, 4542, 5738, 6352 to 6354, 6623, 6726, 6769, 7943, 7956, 8405, 8611 & 10614 of 2017 whose application for medical reimbursement have been rejected either by the Treasury Officer of the District Treasury or by the Joint Director of Medical and Rural Health Services or by the Insurance Company are directed to submit the proposal to the respondent concerned who has communicated the rejection of claim for medical reimbursement of the petitioners concerned and on receipt of claim application by the petitioners, the respondent concerned in the respective Writ Petition is directed to forward the application for medical reimbursement to the Government or the authorised officer of the Government who has been authorised to consider and dispose of the medical reimbursement claim under the Tamil Nadu Medical Attendance Rules. The State Government or the authorised officer of the Government to whom the application is forwarded by the respondent concerned shall disburse the eligible amount to the respective petitioner with interest at the rate of 9% p.a. from the date of settlement of the medical bills by the petitioner till the amount is disbursed to the petitioner by the Government or by the department or by the officer concerned within a period six weeks from the date on which the petitioners' application is forwarded. The medical reimbursement claim cannot be rejected on the ground that treatment was taken in non-network hospitals or that the decease or procedure is not covered by the scheme or that petitioner has paid cash. In none of the case the fact that the petitioner had taken treatment / undergone treatment and spent the amount is not seriously disputed. Hence, there is no justification for keeping the application for medical reimbursement unnecessarily and further delay or rejection of claim by arbitrary orders will attract interest at the rate of 12% p.a. from this date.
20.Writ Petition (MD) Nos.4404 of 2014, 3390, 5494 of 2015, 19407 of 2016, 6456, 6951 and 7343 of 2017 filed for issuance of Writ of Mandamus are also disposed of with a direction to the respondent concerned to forward the applications which are pending before them to the State or Officer concerned forthwith and the same shall also be disposed of and amount will be disbursed with interest at 9% p.a. till the date of payment. Any unnecessary delay will make the respondents liable to pay interest at 12% p.a. from this date. No costs. Consequently, connected miscellaneous petitions are closed.
21.It is made clear that the State Government shall not reject the claim of the petitioner for medical reimbursement either on the ground that the hospital in which the claimant had undertaken treatment is not covered under the scheme or on the ground that the treatment / procedure is not included in the list / schedule for which the insurance scheme covers. The application for medical reimbursement also cannot be rejected on the ground that the claimant had taken treatment by paying cash.
22.It is further made clear that the Government or the Authorised Officer who has to decide the applications under the Tamil Nadu Medical Attendance Rules is directed to dispose of the applications within a period of three months from the date on which the applications are forwarded to the Government or the Officer concerned.
23.Assuming that the scheme is announced as a cashless scheme, it is reported that many hospitals which are included in the schedule of hospitals and bound to treat the Government servant free of cost, admit the employee as in-patient only after the Government servant pays for treatment. Hence, the Government shall examine the unreasonable rejection of claims by the insurance company on the ground that the treatment is taken by the Government servant after paying cash. Since the insurance companies have tie-up with hospitals which are included in the schedule, receipt of money by the hospitals for taking treatment cannot be a reason for rejecting such application. Hence, the Government shall insist the Insurance companies to honour the medical claims even if the treatment is taken after paying cash.
To
1.The Principal Secretary to Government, Finance (Salaries) Department, Secretariat, Chennai -9.
2.The Principal Secretary, Health and Family Welfare Department, Secretariat, Chennai -9.
3.The Director of Treasuries and Accounts, Panagadi Building, Saidapet, Chennai ? 15.
4.The Divisional Manager, United India Insurance Towers, V Floor, PLA Rathna Towers, 212, Anna Salai, Chennai-6.
5.The District Collector, Thoothukudi District, Thoothukudi District.
6.The Joint Director of Medical and Rural Health Services, Thoothukudi District, Thoothukudi District.
7.The District Treasury Officer, Thoothukudi District, Thoothukudi District.
.