Madras High Court
A.C.Karuppiah vs The Principal Secretary To ... on 8 February, 2022
W.P.(MD) No.9 of 2019
BEFORE THE MADURAI BENCH OF MADRAS HIGH COURT
DATED : 08.02.2022
CORAM
THE HONOURABLE MR.JUSTICE S.M.SUBRAMANIAM
W.P.(MD) No.9 of 2019
A.C.Karuppiah ... Petitioner
Vs.
1.The Principal Secretary to Government of Tamil Nadu,
Department of Finance (Pension),
Secretariat, Chennai.
2.The Director,
Directorate of Medical and Welfare Services,
Chennai.
3.The Director of Treasuries and Accounts,
Panagal Building, 2nd Floor,
Saidapte, Chennai-15.
4.The District Collector,
Pudukkottai District.
5.The District Treasury Officer,
District Treasury Office,
Pudukottai District.
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W.P.(MD) No.9 of 2019
6.The Divisional Manager,
United India Insurance Company Limited,
Divisional Office-VI,
PLA Rathana Towers, 5th Floor,
212, Anna Salai, Chennai. ... Respondents
Petition filed under Article 226 of the Constitution of India
praying for issuance of Writ of Certiorarified Mandamus, calling for the
records of the fifth respondent in Na.Ka.No.8553/2016/E2 dated 20.10.2016
and quash the same as illegal and arbitrary and consequential direct the
respondent to sanction and reimburse the medical expenses of Rs.1,40,487/-
(Rupees One Lakh Forty Thousand Four Hundred and Eighty Seven Only)
incurred for the treatment of Coronary Angio-Plasti Surgery, PTCA with
Stent was performed at the Apollo Speciality Hospital, Trichy along with
9% interest till the date of payment, at the once.
For Petitioner : Mr.P.Ganapathi Subramanian
For Respondent : Mr.N.Satheesh Kumar
Additional Government Pleader
for RR1 to 5
No-appearance for R6
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W.P.(MD) No.9 of 2019
******
ORDER
The order impugned dated 20.10.2016 is sought to be quashed in
the present writ petition.
2. The petitioner is a retired Special Grade Office Assistant and
pensioner. Further, he is a member of Medical Reimbursement Scheme and
therefore, he is eligible for medical reimbursement. The petitioner suffered
suddenly severe chest pain and was not conscious. His relatives admitted
him in Apollo Speciality Hospital, Trichy, Coronary Angio-Plasti surgery
was performed at the hospital and PTCA with Stent was fixed. To save the
life of the petitioner, the family members requested the Doctors to perform
the surgery immediately, without knowing the fact that the hospital is not
approved for claiming medical reimbursement. The petitioner sustained the
medical expenditure of Rs.1,40,487/- (Rupees One Lakh Forty Thousand
Four Hundred and Eighty Seven Only) and filed an application for
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W.P.(MD) No.9 of 2019
reimbursement. The application was rejected on the ground that the
treatment was taken in non-network hospital.
3. Many number of judgments were delivered holding that the
Authorities Competent are bound to verify the genunity of the treatment
taken by the employee. The benefit of Medical reimbursement cannot be
denied merely on the ground that the treatment was taken in non-network
hospital. The emergency situation warranting urgent treatment for a person
is to be considered. This being the principles adopted, the Authorities
Competent cannot mechanically reject the medical reimbursement claim by
stating that the treatment was not taken in the approved hospital.
4. Providing a decent medical treatment is a right to live
enunciated under Article 21 of the Constitution of India. Thus, the medical
reimbursement claim cannot be rejected on flimsy technical grounds. The
genunity of the treatment is to be verified, but not the hospital, in which the
treatment was taken. When a person urgently needs a medical treatment, no
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W.P.(MD) No.9 of 2019
one can expect that he should be admitted in the hospitals listed out in the
Government Order. It may not be practicable in such circumstances.
5. This being the factum, the order impugned is not in consonance
with the established principles laid down by the High Court in the matter of
medical reimbursement. Consequently, the order impugned passed by the
fifth respondent in Na.Ka.No.8553/2016/E2 dated 20.10.2016 is quashed.
The respondents are directed to settle the medical reimbursement claim of
the petitioner as per his eligibility within a period of eight weeks form the
date of receipt of a copy of this order.
6. Accordingly, the Writ Petition stands allowed. No costs.
08.02.2022
ssb
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W.P.(MD) No.9 of 2019
To
1.The Principal Secretary to Government of Tamil Nadu,
Department of Finance (Pension),
Secretariat, Chennai.
2.The Director,
Directorate of Medical and Welfare Services,
Chennai.
3.The Director of Treasuries and Accounts,
Panagal Building, 2nd Floor,
Saidapet, Chennai-15.
4.The District Collector,
Pudukkottai District.
5.The District Treasury Officer,
District Treasury Office,
Pudukottai District.
6.The Divisional Manager,
United India Insurance Company Limited,
Divisional Office-VI,
PLA Rathana Towers, 5th Floor,
212, Anna Salai, Chennai.
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W.P.(MD) No.9 of 2019
S.M.SUBRAMANIAM, J.
ssb
W.P.(MD) No.9 of 2019
08.02.2022
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