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Madras High Court

P.T.Selvam vs The Secretary To The Government on 8 April, 2025

Author: V.Bhavani Subbaroyan

Bench: V.Bhavani Subbaroyan

                                                                                                W.P.No.15973 of 2023

                                   IN THE HIGH COURT OF JUDICATURE AT MADRAS

                                                     Dated: 8/4/2025

                                                         CORAM

                                  The Hon'ble Mrs.JUSTICE V.BHAVANI SUBBAROYAN

                                            Writ Petition No.15973 of 2023


                     P.T.Selvam                                   ...                  Petitioner

                                                                Vs


                     1. The Secretary to the Government
                        Home (Police) II Department
                        Fort St. George
                        Chennai 9.

                     2. The Director General of Police
                        Dr. Radhakrishnan Salai
                        Mylapore
                        Chennai 4.

                     3. The Superintendent of Police
                        Villupuram District
                        Villupuram.

                     4. The Nodal Officer
                        United India Insurance Company Ltd
                        No.9 II Floor
                        District Collector Officer
                        Villupuram.




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                                                                                                     W.P.No.15973 of 2023

                     5. The United India Insurance Health
                          Care (TPAA Pvt Ltd)
                        United India Insurance Company Ltd
                        27 Laxmi Tower, III Floor
                        Dr. Radhakrishnan Salai
                        Mylapore
                        Chennai 4.                       ...                                  Respondents


                     PRAYER: Petition filed under Article 226 of the Constitution of India

                     praying for the issuance of a writ of mandamus to direct the respondents to

                     draw and disburse a sum of Rs.5,78,564/- towards medical expenses

                     incurred by the petitioner for the heart surgery performed to him at Institute

                     of Cardiology disease (unit of Madras Medical Mission Hospital),

                     Mugappair, Chennai 37.



                                  For petitioner                ...                Mr.K.Venkataramani
                                                                                   Senior Advocate
                                                                                   for Mr.M.Muthappan

                                  For respondents               ...                Mr.R.U.Dinesh Rajkumar
                                                                                   Additional Government Pleader
                                                                                   for R.R.1 to 3.

                                                                                   Mr.P.Sankaranarayanan
                                                                                   for R.R.4 and 5

                                                                      -----




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                                                                                             W.P.No.15973 of 2023

                                                                ORDER

This writ petition has been filed to direct the respondents to draw and disburse a sum of Rs.5,78,564/- towards medical expenses incurred by the petitioner for the heart surgery performed to him at Institute of Cardiology disease (unit of Madras Medical Mission Hospital), Mugappair, Chennai 37.

2. The case of the petitioner is that the petitioner having undergone treatment in the listed hospital for heart ailment, State Government having arrangement with Insurance Company with a limit of Rs.10,00,000/- are liable to pay the entire medical expenses incurred by the petitioner. As the respondents have failed to pay the remaining amount of Rs.5,78,564/-

incurred by the petitioner towards medical expenses in Madras Medical Mission Hospital for Cardiology surgery, along with interest @ 9% p.a., the petitioner has come forward with the instant writ petition.

3. Heard Mr.K.Venkataramani, learned Senior Advocate for the petitioner, Mr.R.U.Dinesh Rajkumar, learned Additional Government Pleader for the respondents 1 to 3 and Mr.P.Sankaranarayanan, learned counsel for the respondents 4 and 5.

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4. The learned counsel appearing for the respondents 4 and 5 would submit that the petitioner was admitted for palpitation and mitigation at Indira Gandhi General Hospital, Puducherry, where initial baseline treatment was performed and later shifted to MMM Hospital, Chennai.

They have performed with AICD implant through Radio frequency ablation.

5. He would further submit that the technique of Radio frequency ablation will not cover under the scheme. At the time of final approval itself, the respondents have mentioned in their remarks column that they will approve only for pace maker charges and radio frequency charges will not cover. Thus, it is clear that approval of Rs.1,30,000/- stands valid only for PPI and not for AICD implantation and Radio Frequency ablation.

6. He would further submit that if the petitioner is having any grievance, he can very well approach the Joint Director of Medical and Rural Health Services of the District concerned for placing before District Level Empowered Committee for redressal. The said Committee is headed by the District Collector with the Joint Director of Medical and Rural 4/8 https://www.mhc.tn.gov.in/judis ( Uploaded on: 28/04/2025 03:50:57 pm ) W.P.No.15973 of 2023 Health Services, the District Treasury Officer and a representative of the Insurance Company as members.

7. Perused the materials available on record.

8. A bare perusal of G.O.Ms.No.202 dated 30/6/2016 under Annexure II, under S.No.6 it is clearly mentioned that permanent and temporary pace maker implantation is only covered, whereas the patient performed with AICD implant which is an advanced version and this will be a part of pacemaker.

9. In view of the submission made by the learned counsel appearing for the respondents 4 and 5, this Court directs the petitioner to submit a representation, ventilating his grievance with regard to the claim of the petitioner, to the District Level Empowered Committee, within a period of four weeks, from the date of receipt of a copy of this order and on receipt of the same, the District Level Empowered Committee shall consider the case of the petitioner and pass appropriate orders on merits and in accordance with law, within a period of twelve weeks thereafter.

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10. With the above direction, this writ petition is disposed of. No costs.

8/4/2025 mvs.

Index: Yes/No Neutral Citation: Yes/No 6/8 https://www.mhc.tn.gov.in/judis ( Uploaded on: 28/04/2025 03:50:57 pm ) W.P.No.15973 of 2023 To

1. The Secretary to the Government Home (Police) II Department Fort St. George Chennai 9.

2. The Director General of Police Dr. Radhakrishnan Salai Mylapore Chennai 4.

3. The Superintendent of Police Villupuram District Villupuram.

4. The Nodal Officer United India Insurance Company Ltd No.9 II Floor District Collector Officer Villupuram.

5. The United India Insurance Health Care (TPAA Pvt Ltd) United India Insurance Company Ltd 27 Laxmi Tower, III Floor Dr. Radhakrishnan Salai Mylapore Chennai 4.

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W.P.No.15973 of 2023

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