Madras High Court
J.Samuel vs The Director Of School Education on 10 December, 2014
Author: C.S.Karnan
Bench: C.S.Karnan
IN THE HIGH COURT OF JUDICATURE AT MADRAS CAV ON 04/06/2014 DATED: 10/12/2014 CORAM THE HONOURABLE MR.JUSTICE C.S.KARNAN W.P.No.11608 of 2008 & M.P.No.1 of 2009 J.Samuel ... Petitioner vs. 1.The Director of School Education, Chennai-6. 2.The Joint Director of Health Services, Thiruvallur District, Thiruvallur. 3.The Chief Educational Officer, Thiruvallur, Thiurvallur District. 4.The District Educational Officer, Thiruvallur, Thiruvallur District. ... Respondents PRAYER: Writ Petition filed under Article 226 of the Constitution of India for a Writ of Certiorarified Mandamus to call for the records pertaining to the order in O.Mu.No.3265/A3/06, dated 17.11.2006, passed by the third respondent, quash the same and to direct the respondents to sanction medical aid to the petitioner under the provisions of Tamil Nadu Government Employees Health Fund Scheme for a sum of Rs.96,899/-. For Petitioner : Mr.G.Jeremiah For Respondents : Mr.T.N.Rajagopalan Spl.Govt. Pleader * * * * * O R D E R
The prayer in the writ petition is for issuance of a writ of certiorarified mandamus to quash the order, dated 17.11.2006, passed by the third respondent, and to direct the respondents to sanction medical aid to the petitioner under the provisions of Tamil Nadu Government Employees Health Fund Scheme for a sum of Rs.96,899/-.
2. The short facts of the case are as follows:
The petitioner submits that he is working as Headmaster in-charge in C.S.I.High School, Thiruttani and he is a subscriber to the Tamil Nadu Government Employees Health Fund Scheme from the inception of G.O.Ms.No.1023, Health and Family Welfare Department, dated 17.06.1980. His wife Elizabeth Rathamani, who was also working as a Teacher in Government Higher Secondary School, Arakkonam, fell ill with a serious headache and she was admitted in C.M.C.Hospital, Vellore, on 04.04.1998, for treatment. The Doctors diagnosed his wife and found that she was suffering from brain tumor. She also underwent a shunt operation on 10.05.1998 and tumor operation on 08.07.1998 and after a period of three months, she had also underwent Stereotatic radio therapy.
3. Further the petitioner submits that he incurred expenditure a sum of Rs.3.5 Lakhs for the above operation and medical expenses. On 25.08.1998, he made an application to the Management for medial aid under the said scheme restricting his claim to Rs.96,899/- and the Management forwarded his application to the fourth respondent on 30.08.1998 and the fourth respondent forwarded the same to the second respondent on 09.08.1999. On receipt of the same, the second respondent directed the petitioner's wife to appear before Medical Board for examination on 28.09.1999. In the meanwhile, on 27.08.1999, she died and hence she could not appear before the Medical Board. Subsequently, the second respondent instructed the fourth respondent to send the medical aid application sent by the petitioner to the Commissioner of Treasuries of Accounts directly for necessary action. As such, the fourth respondent sent the proposal to the Commissioner of Treasuries and Accounts on 25.11.1999.
4. The petitioner further submits that the fourth respondent, by proceedings dated 19.12.1999, addressed the first respondent seeking certain clarifications with regard to the financial assistance for the surgeries and treatment for major ailment for his wife on the ground that the Commissioner of Treasuries and Accounts had returned the proposal for the reasons that the officer, who is drawing the scale of pay of Rs.10,000/- and more can sanction the medical aid assistance. In this regard, the fourth respondent requested the first respondent to get clarification from the Government. The first respondent, by proceedings dated 17.02.2000, asked the fourth respondent some particulars and to submit non-drawal certificate in the correct name of his wife and the fourth respondent also sent the non-drawal certificate along with the particulars, which were required, to the first respondent. On receipt of the same, the first respondent directed the fourth respondent to submit the same to the third respondent for necessary action by letter dated 02.07.2000 and based on which, the fourth respondent forwarded the proposal to the third respondent on 31.07.2000. But, the petitioner could not get any relief from the respondents and hence he sent representation to the Chief Minister Special Cell on 16.03.2001. Again, on 20.07.2001, the fourth respondent addressed the first respondent to get clarification from the Government for sanction of medical aid, which was followed by reminder on 13.09.2001 and on 18.11.2002, he had been asked to submit copies of the proposals to the fourth respondent and the same were also submitted immediately. On receipt of the same, the fourth respondent forwarded same again to the third respondent on 14.01.2003. But, the third respondent, by the impugned order dated 17.11.2006, rejected the claim made by the petitioner on the ground that since his wife was working as a Teacher in Government Girls Higher Secondary School, Arakkonam, the claim for medical aid ought to have been made through the said School and the claim should have been made within two months as per the Rules.
5. Further the petitioner in respect of these queries submits that it is a fact that he made the claim only through the Management of an Aided School and the amount claimed is only as per the bill issued by C.M.C.Hospital authorities and therefore the rejection of claim after a period of eight years is arbitrary, illegal and non-application of mind. He has also explained to the respondents that the bill dated 07.11.1999 was an error and that the bill was dated 07.01.1999 and he brought to the notice of the respondents that his earliest application had been made on 25.08.1998, which was well within the period of two months. Therefore, he has filed this writ petition seeking the relief as stated above.
6. The third respondent filed a counter affidavit stating that the petitioner was working as Headmaster in-charge in C.S.I.Aided High School, Tiruttani and while he was working as such, he made a medical claim totally for Rs.96,899/- restricted for 75% of Rs.72,574/- towards the medical expenditure incurred for the illness of his wife Elisabeth Rathnamani. The petitioner submitted his application to the fourth respondent on 12.07.1999 belatedly without providing adequate particulars. When there is a condition to prefer the medical claim within 60 days from the date of discharge, the petitioner submitted his claim only after lapse of nearly one year. The institution, where the petitioner worked, was an aided institution. The scheme of Government Employees Health Fund Scheme was extended to Aided School employees only from 01.07.1997, vide G.O.Ms.No.341/Fin/allow, dated 09.10.1997. Accordingly, the petitioner incepted to the scheme only from 01.07.1997 and not from 1980. Apart from this, the petitioner has not furnished sufficient reason for not claiming the assistance through the Government Girls Higher Secondary School, Arakkonam, where his wife was employed. Though there is a provision to claim the assistance at either one end where both are Government servants, the petitioner might have made the claim only through the Government Girls Higher Secondary School, Arakkonam, as his wife was the full member of the Scheme whereas the petitioner was incepted to the Scheme only from 01.07.1997. His wife was admitted in C.M.C.Hospital, Vellore, on 26.06.1998 and discharged from hospital on 13.07.1998. As per Rules, the claim of medical assistance under this scheme should have been preferred by the petitioner's wife to the Government Girls Higher Secondary School, Arakkonam, on or before 12.09.1998, i.e., within 60 days from the date of discharge. But, she failed to do so and the petitioner made the claim on 12.07.1999, after lapse of nearly one year from the date of discharge from hospital on 13.07.1998.
7. Further, the third respondent submits that the petitioner made application for medical assistance to Tiruvallur District Educational Officer, Tiruvallur, Thiruvallur District, which has no jurisdiction to consider the claim, instead of applying to the Government Girls Higher Secondary School, Arakkonam, Vellore District, where his wife was working as School Assistant. The patient's name mentioned in the cash bills as Elisabath, whereas the claim was made in respect of Elisabath Rathinamani. Though the petitioner made application for medical assistance on 12.07.1999, he himself recorded that his first application was sent on 25.08.1988 to the District Educational Officer, Tiruvallur. But, he stated in his affidavit that his first date of application was 25.08.1998 further he attached a bill for Rs.2,190/- dated 07.11.1999 in his claim. In his affidavit, the petitioner himself also confessed that date of the bill was 07.01.1999 and not 07.11.1999, while so he could not have preferred the claim on 25.08.1998 for the bill amount purchased on 07.01.1999. Hence, it is invariably ascertained that the claim was preferred only after 12.07.1999 and not on 25.08.1998. Hence, he submits that the order passed by the third respondent, dated 17.11.2006, is according to the Rules as the claim was not made to the Department in time to sanction and the claim was made by the petitioner after one year of discharge of the patient for the treatment undergone in the year 1998 and the petitioner filed the writ petition during 2008 and the prescribed period to prefer claim is only 60 days. Therefore, he prays this Court to dismiss the writ petition.
8. Replying to the counter affidavit filed by the third respondent, the petitioner submits that this Court in 2006 (3) MLJ 461 has held that delay in submitting the application for financial assistance cannot be a ground as the scheme has been framed for the benefit of the employees. In support of the contention that his wife was employed in Adi Dravidar Welfare School and she did not submit any claim for medical reimbursement from the said school, where she was employed, the petitioner has filed additional typed set of papers. The allegation that his wife could have applied through the school, in which she was employed, is untenable in view of the fact that she expired on 27.08.1999 and hence it was not possible for her to make an application. Further, since both the petitioner and his wife were members of the Scheme, there is no legal impediment, if the applications had been submitted by him through his Department as the scheme covers the entire family of the members. Therefore, he prays this Court to allow this writ petition.
9. The highly competent counsel Mr.G.Jeremiah appearing for the petitioner submits that the petitioner has been working as Headmaster in the CSI High School, Tiruttani and he was a subscriber to the Tamil Nadu Government Employees Health Fund Scheme from the inception of the said scheme in G.O.Ms.No.1023, Health & Family Welfare Department dated 17.06.1980. His wife Mrs.Elizabeth Rathnamani was also working as a teacher in the Government Higher Secondary School, Arakkonam. While so, his wife suddenly fell ill with a serious headache and she had been admitted in the Christian Medical College Hospital, Vellore on 04.04.1998. The doctors diagnosed the patient and found that she was suffering from a brain tumor. Hence, she underwent a shunt operation on 10.05.1998, and tumor operation on 08.07.1998. After a period of three months, she had also underwent Stereotatic radio therapy.
10. The highly competent counsel appearing for the petitioner further submits that the petitioner had spent a sum of Rs.3.5 lakhs towards medical expenses. He made an application to the Management for medical benefits under the Health Fund Scheme, on 25.08.1988, restricting his claim to only Rs.96,899/-. The Management was pleased to forward his application to the District Educational Officer, Tiruvallur, along with original medical bills, requesting to grant medical aid. In turn, the fourth respondent / District Educational Officer forwarded the said papers to the second respondent, viz., Joint Director of Health Services, who directed the petitioner's wife to appear before him on 28.09.1999. In the meanwhile, his wife expired on 27.08.1999. Hence, she could not appear before the Medical Board. The same was communicated to the second respondent.
11. The highly competent counsel appearing for the petitioner further submits that the fourth respondent by his proceedings dated 19.12.1999 addressed the first respondent, seeking certain clarifications pertaining to the financial assistance for the said surgeries and treatment for major ailment for his wife on the ground that the Commissioner of Treasuries and Accounts had returned the proposal for the reason that the Officer, who is drawing the scale of pay of Rs.10,000/- and more can sanction the medical aid assistance. The petitioner also had sent details regarding his wife's service particulars to the respondents. However, the petitioner could not get any relief from the respondents and he made representation to the Hon'ble Chief Minister's Special Cell for his relief. Finally, the third respondent / Chief Educational Officer rejected his medical claim. Hence, the highly competent counsel entreats the Court to allow the above writ petition.
12. The highly competent Special Government Pleader Mr.T.N.Rajagopalan appearing for the respondents submits that the petitioner was working in CSI Aided High School, Tiruttani and he preferred a medical claim totally for Rs.96,899/- restricted for 75% of Rs.72,574/- towards the medical expenditure incurred for treatment of illness of his wife. The petitioner submitted his medical claim petition without providing adequate particulars, and the same was submitted after 60 days i.e., beyond the limitation period. Further, the petitioner had not given sufficient reason for not claiming the assistance through the Adi Dravidar Welfare Department, wherein the patient was working. The highly competent Special Government Pleader further submits that the petitioner had approached without proper jurisdiction and without Medical Board Reports which are necessary for sanctioning the medical bills.
13. On considering the facts and circumstances of the case and arguments advanced by the highly competent counsels on either side and on perusing the typed-set of papers, this Court is of the view that the petitioner can claim the medical aid from the respondents either through his employer viz., Management or from the Adi Dravidar Department, wherein his wife was working as a teacher. It is also seen that the respondents had not raised any objections that the petitioner's wife had received treatment at CMC Hospital, Vellore for treatment of brain tumor. Hence, it is evident that the medical claim is a bonafide one. As per the counter statement filed by the respondents, it is seen that the petitioner's medical claim is totally for Rs.96,899/- and he had restricted it to 75% i.e., Rs.72,574/-, towards medical expenditure incurred for the illness of his wife, Late Mrs. Elizabeth Rathnamani. Therefore, this Court directs the respondents to pay the said amount i.e., a sum of Rs.72,574/- to the petitioner by way of pay order, within a period of 30 days from the date of receipt of a copy of this order and deliver the same at the petitioner's doorsteps through Special Messenger considering that the petitioner is a senior citizen. The second respondent's medical Board report does not arise in the instant case, since the petitioner's wife had expired before the date of appearance for medical examination. Accordingly, the above writ petition is allowed. Consequently, the order passed by the third respondent dated 17.11.2006 is set-aside. There is no order as to costs. Consequently, connected miscellaneous petition is closed.
10/12/2014
Index : Yes.
Internet : Yes.
r n s
C.S.KARNAN, J.
r n s
To:
1.The Director of School Education,
Chennai-6.
2.The Joint Director of Health Services,
Thiruvallur District, Thiruvallur.
3.The Chief Educational Officer,
Thiruvallur, Thiurvallur District.
4.The District Educational Officer,
Thiruvallur, Thiruvallur District.
Pre-Delivery Order in
W.P.No.11608 of 2008 &
M.P.No.1 of 2009
10/12/2014