Kerala High Court
Vipinlal M.K vs The Additional Chief Secretary ... on 5 April, 2024
WPC 13903/24
1
IN THE HIGH COURT OF KERALA AT ERNAKULAM
PRESENT
THE HONOURABLE MR.JUSTICE BASANT BALAJI
FRIDAY, THE 5TH DAY OF APRIL 2024 / 16TH CHAITHRA, 1946
WP(C) NO. 13903 OF 2024
PETITIONER/S:
VIPINLAL M.K, AGED 26 YEARS S/O. BABU, MEETHALE KUTTIYIL
HOUSE, CHERAPURAM.P.0 KAKKATTIL, KOZHIKODE DIST.,
PIN - 673507
BY ADV ANILKUMAR V. (VAZHARAMBIL)
RESPONDENT/S:
1 THE ADDITIONAL CHIEF SECRETARY (FINANCE- HEALTH
INSURANCE) SECRETARIAT, GOVERNMENT OF KERALA
THIRUVANANTHAPURAM, KERALA., PIN - 695001
2 THE REGIONAL MANAGER THE ORIENTAL INSURANCE COMPANY LT:D
METRO PALACE, NORTH RAILWAY STATION ROAD, ERNAKULAM
NORTH, ERNAKULAM., PIN - 682018
3 THE GENERAL MANAGER BADAGARA SAHAKARANA ASUPATHRI LTD
VADAKARA P.O. KOZHIKODE DT., PIN - 673101
4 THE GENERAL MANAGER ASTER MIMS HOSPITAL, GOVINDAPURAM
P.O. KOZHIKODE DT., PIN - 673016
5 THE CONVENER (DISTRICT COLLECTOR) THE DISTRICT LEVEL
GRIEVANCE REDRESSAL COMMITTEE COLLECTORATE, KOZHIKODE
THRISSUR DISTRICT., PIN - 673020
OTHER PRESENT:
SC SMT K.S SANTHI, SR GP SMT MARY BEENA JOSEPH
THIS WRIT PETITION (CIVIL) HAVING COME UP FOR ADMISSION
ON 05.04.2024, THE COURT ON THE SAME DAY DELIVERED THE
FOLLOWING:
WPC 13903/24
2
JUDGMENT
(Dated this the 5th day of April, 2024)
The petitioner challenges rejection of the MEDISEP
reimbursement by the 2nd respondent Insurance Company.
The petitioner joined the MEDISEP scheme with I.D.
No.2367558/Policy No. 441200/48/2024/335 (Employer
ID 889324) and was regularly paying the monthly
subscription without any default. The petitioner's wife was
taken to the 3rd respondent hospital due to stroke, and was
referred to the 4th respondent hospital in Neurology
department and was treated there from 22.11.2023 to
27.11.2023. On discharge of the patient from the 4th
respondent hospital, an amount of Rs.2,96,003/- was paid
as hospital bill. The claim for reimbursement was partly
allowed and only an amount of Rs.42,800/- was sanctioned
by the Insurance company. For reimbursement of the
balance amount, the petitioner filed Ext.P8 representation
before the 5th respondent.
2. The counsel for the petitioner submits that a
direction may be issued to the 5th respondent to take up
Ext.P8 and pass appropriate orders.
3. In the facts and circumstances of the case and since
the petitioner has already approached the 5th respondent
Grievance Redressal Committee with Ext.P8
representation, there will be direction to the 5th respondent
to consider the same, within a period of 2 months from the
date of receipt of a copy of this judgment.
With the above direction, the Writ Petition is
disposed of.
Sd/-
BASANT BALAJI,
JUDGE
dl/
APPENDIX OF WP(C) 13903/2024
PETITIONER EXHIBITS
Exhibit P1 TRUE COPY OF THE MEDISEP CARD ID NO. 2367558 OF THE
PETITIONER DATED NIL
Exhibit P2 TRUE COPY THE EMPANELLED PRIVATE HOSPITALS IN
KOZHIKODE DISTRICT DATED NIL
Exhibit P3 TRUE COPY OF MRI SCAN REPORT DATED 22.11.2023 ISSUED
BY THE 3RD RESPONDENT HOSPITAL
Exhibit P4 TRUE COPY OF THE DISCHARGE SUMMARY DATED 27.11.2023
ISSUED BY THE 4TH RESPONDENT HOSPITAL
Exhibit P5 TRUE COPY OF THE EMERGENCY CERTIFICATE DATED
30.11.2023 ISSUED BY THE 4TH RESPONDENT HOSPITAL
Exhibit P6 TRUE COPY OF THE MEDICAL BILL DATED 27.11.2023 ISSUED
BY THE 4TH RESPONDENT HOSPITAL
Exhibit P7 TRUE COPY OF THE PAYMENT ADVICE DATED 23.02.2024
ISSUED BY THE 2ND RESPONDENT COMPANY TO THE
PETITIONER
Exhibit P8 TRUE COPY OF THE RELEVANT PAGE OF THE COMPLAINT FILED
BY THE PETITIONER BEFORE THE 5TH RESPONDENT COMMITTEE
