Madras High Court
Krishna Chetty vs The State Of Tamilnadu on 3 January, 2024
Author: V.Bhavani Subbaroyan
Bench: V.Bhavani Subbaroyan
W.P.No.7733 of 2017
IN THE HIGH COURT OF JUDICATURE AT MADRAS
Dated : 03.01.2024
CORAM
THE HON'BLE MRS.JUSTICE V.BHAVANI SUBBAROYAN
W.P.No.7733 of 2017
Krishna Chetty ... Petitioner
Vs.
1. The State of Tamilnadu
Rep. By the Special Commissioner & Secretary,
to Government, Home Department,
Fort St.George, Chennai – 9
2. The Director General of Police,
Kamarajar Salai,
Chennai
3. The Joint Director of Medical Service
Krishnagiri District
Krishnagiri
4. The Superintendent of Police,
Krishnagiri District
Krishnagiri. ... Respondents
Writ Petition filed under Article 226 of Constitution of India for
issuance of a Writ of Mandamus directing the respondents to disburse the
medical claim amount of Rs.1,10,178/- to the petitioner based on the
representation dated 23.08.2016 on the basis of recommendation of the 4th
respondent dated 20.01.2010 and pass further orders.
1/11
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W.P.No.7733 of 2017
For Petitioner : Mr.K.Gandhikumar
For Respondents : Mr.Muthusamy for R1 to R4
Government Pleader
ORDER
The present Writ Petition is filed for issuance of a Writ of Mandamus
directing the respondents to disburse the medical claim amount of
Rs.1,10,178/- to the petitioner based on the representation dated
23.08.2016 on the basis of recommendation of the 4th respondent dated
20.01.2010 and pass further orders.
2. The brief facts of the case is as follows:-
(i) The petitioner was initially joined as a Junior Assistant in the
Police Department on 30.09.1976 and rendered his service without any
remarks and he was given promotion periodically based on his
performance and also length of service and finally he worked as a P.A.
Admin to Superintendent of Police.
(ii) While the petitioner was in service, on 28.01.2008, he was
admitted in 'Appollo Hospital' at Chennai for Paralysis and he was
discharged on 13.02.2008 and he spent a sum of Rs.1,10,178/- as a
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medical expenditure and thereafter, he made an application on 03.03.2008
through 4th respondent for reimbursement of his medical expenditure from
the respondents 1 and 2. The said application was returned on 19.04.2008
by stating that the hospital which he took treatment was not on the
approved list. Thereafter, on receipt of clarification letter and the
necessary documents, the 2nd respondent was requested to get suitable
action for reimbursement of petitioner's medical account.
(iii) Further, the 2nd respondent forwarded the letter requesting the 1st
respondent to sanction the petitioner's medical reimbursement. The
petitioner has also paid the monthly subscription properly and also
sufficient amount is available in Tamilnadu Police Medical Scheme, but,
thereafter, the 1st respondent did not paid the amount.
(iv) That apart, a representation dated 03.09.2012 was sent to the
District Collector by requesting to direct the 4th respondent to get the
petitioner's medical claim amount from the 1st respondent and stated the
inability of the petitioner to maintain day today life, however, the medical
reimbursement has not been received till date, hence this petition.
3. The learned counsel for the petitioner submits that though several
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representations were sent to the respondents, no action has been taken till
date and the petitioner is fighting for the money, which he has actually
spent on account of his ill health. Further is suffering to maintain his day
today activities, thereby pleaded to allow the present petition.
4. Per contra, the learned Government Advocate appearing for the
respondents would contend that since the treatment undergone by the
petitioner does not fall under G.O.377 dated 13.10.2005, the 1st respondent
had reimbursed under Rule 10(c) of Tamilnadu Medical Attendance Rules,
as amended in G.O.Ms.1023 Health and Family Welfare Department dated
17.06.1980 to the petitioner. As per the Rules and letter of Dean, Rajiv
Gandhi Govt., General Hospital dated 16.09.2015, a sum of Rs.4,287/- was
sanctioned to the petitioner for his medical reimbursement and passed the
G.O.(D) No.984 dated 17.10.2016. Since the said amount was sent to the
petitioner vide registered post dated 15.06.2017, the letter requesting the
amount was retured as refused, thereby pleaded to dismiss the petition.
5. Heard the learned counsels on either side and perused the
documents placed on record carefully.
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6. Admittedly, the Petitioner has taken treatment in a non-approved
Hospital on account of emergent situation, which ultimately resulted in
rejection of petitioner's claim. It is not in dispute that if the claim is
approved, the Petitioner would be paid the medical benefits based on Tamil
Nadu Medical Attendance Rules. The benefit of scheme, namely, the
contract cannot be rewritten and it is only the Government to pay the
amount incurred by the Petitioner/Employee/ patient/pensioner irrespective
of constitution of the Committee. It is pertinent to mention here that the
patient cannot search for an approved Hospital for getting admitted or for
taking treatment during emergency. Earlier, this Court in the case of N.Raja
vs. The Government of Tamil Nadu, rep. by its Secretary, Chennai and
others, reported in 2016 (3) CTC 394, has clearly held that when the
Insurance Company is not liable on account of the violation of the terms
and conditions of the contract, it is the duty of the Government to reimburse
the medical expenses incurred. Further, the Hon'ble Division Bench of this
Court also, by order dated 16.12.2016 in W.A.(MD) No.1579 of 2016 [MD
India Healthcare Services (TPA) Ltd., rep. by the Branch Manager,
Chennai, Chennai vs. K.Parameshwari and others], directed the
Government to reimburse the medical expenditure.
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7. It is relevant to point out that the above Judgments / orders cited
supra has been duly followed by this Court in W.P.(MD) No.125 of 2017,
wherein by order dated 27.02.2017 allowed the petition filed by the
petitioner / patient by directing the Government to reimburse the amount as
claimed by the petitioner therein and the said judgment was challenged
before the Hon'ble Division Bench of this Court in W.A.(MD)No.1382 of
2017 and by an order dated 09.11.2017, the Hon'ble Division Bench had
dismissed the Writ Appeal and upheld the order passed by the Learned
Single Judge. The operative portion is hereby extracted as follows:-
“34.It is to be noted that Article 47 of the Constitution of India
speaks of 'Duty of the State to raise the level of nutrition and the
standard of living and to improve public health'. In this connection, this
Court points out that in the decision of the Hon'ble Supreme Court
PASCHIM BANGA KHET MAZDOOR SAMITY AND OTHERS v.
STATE OF WEST BENGAL AND ANOTHER, reported in (1996) 4
SCC 37, it is observed that 'in a welfare State, the primary duty of the
Government is to secure the welfare of the people. It cannot be
gainsaid that a failure to provide timely medical treatment to an
individual, who is in need of such treatment is a violation of his right to
life enshrined under Article 21 of the Constitution of India'.
35.It is to be pertinently pointed out that 'Right to Health' is
anintegral part of the Right to Life and the Government is under
aConstitutional obligation to provide health welfare facilities. If
aGovernment servant underwent a requisite treatment for his ailment
and if necessary proof is produced, then it is the primordial duty of the
StateGovernment to bear the expenses incurred thereto and
reimburse the same. Just because the Government servant had
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underwent the treatment at an unapproved Hospital, the expenses
incurred thereto cannot be denied by the State Government
notwithstanding the fact that the Government servant is a member of
the scheme introduced by the Government. Also that the individual
Government servant/patient or his family members is/are the proper
persons to take a final decision as to where the treatment in question
is to be provided, as opined by this Court.
36.It cannot be brushed aside that the State Government is to
satisfy the Constitutional obligation to bear/refund the expenses
incurred by a Government servant while in service or after retirement
from service, of course, based on the policy of the Government. In
emergency cases, the treatment that is required will be
immediate/forthwith and if one has to comply with the procedure,
ultimately, 'waiting' in this regard may prove disastrous and fatal.
37.It is to be aptly pointed out that a human being is to take care
of himself and in this regard, the individual concerned is the best
Judge suited to take a final call/decision. In reality, the self
preservation of one's life is enjoined under Article 21 of the
Constitution of India, as an inviolable right, in the considered opinion
of this Court.
38.No doubt, a patient as a lay human being cannot pick and
choose the method/mode of surgery. It is for the Doctors/Medical
experts to determine and suggest a right course of action as to
what/which kind of surgery/treatment is suitable, ofcourse, taking into
consideration the nature of the ailment and the status/condition of the
concerned patient.
39.Although financial resources are required for providing
medical facilities to the needy, ultimately, the State Government has
the constitutional obligation to provide enough medical services to the
public. On account of financial constraints, the Constitutional
obligation to provide medical services/facilities to the people cannot be
avoided.
40.Be that as it may, in the present case, there is no dispute as
to the factum of actual expenses incurred by the
Respondent/Petitioner, which she claims in the Writ Petition.
Undoubtedly, the human being is to take necessary precautionary and
protective measure for his body. The payment/reimbursement of
medical expenses spent by the Government servant concerned or his
family is not 'Bounty', but it is an obligation of the State Government to
pay/disburse the said amount in question without harping on either
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technicalities or hyper technicalities. As such, this Court is of the
considered opinion that the Learned Single Judge was correct in
directing the First Appellant/First Respondent to sanction the medical
expenses incurred by the Respondent/Petitioner for her husband's
ailment, as per the eligibility criteria in terms of the amount under the
scheme and the same is free from any flaw. However, this Court is of
the considered view that the interest of 9% p.a. fixed by the Learned
Single Judge is slightly on the higher side and to prevent an aberration
of justice and in furtherance of substantial cause of justice, this Court
reduces the rate of interest from 9% p.a. to that of 6%.”
8. It is pertinent to point out that Article 47 of the Constitution of India
speaks of 'Duty of the State to raise the level of nutrition and the standard
of living and to improve public health'. In this connection, this Court points
out that in the decision of the Hon'ble Supreme Court PASCHIM BANGA
KHET MAZDOOR SAMITY AND OTHERS v. STATE OF WEST BENGAL
AND ANOTHER, reported in (1996) 4 SCC 37, it is observed that 'in a
welfare State, the primary duty of the Government is to secure the welfare
of the people. It cannot be gainsaid that a failure to provide timely medical
treatment to an individual, who is in need of such treatment is a violation of
his right to life enshrined under Article 21 of the Constitution of India', as
per decision laid down by the Hon'ble Division Bench of this Court in
W.A.No.1382 of 2017 dated 09.11.2017.
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9. Considering the abovesaid facts and circumstances of the case
and the cititations referred supra and fact that in the present case, there is
no dispute as to the factum of actual expenses incurred by the petitioner,
which he claims in the Writ Petition and taking note of the fact that when
the insurance company is not liable on account of the violation of terms and
conditions of the contract, it is the duty of the Government to reimburse the
medical expenses incurred, as per decision of Hon'ble Division Bench of
this Court in W.A.(MD) No.1579 of 2016 [MD, India Healthcare services
(TPA) Ltd., rep. By the Branch Manager, Chennai Vs. K.Parameshwari and
Others], this Court hereby directs the respondents concerned to sanction
the medical expenses incurred by the petitioner, as per the eligibility criteria
in terms of the amount under the scheme together with 6% interest per
annum without standing on technicalities and release the amount within a
period of eight weeks from the date of a receipt of copy of this order.
In result, the present Writ Petition is allowed. No costs.
03.01.2024
Index : Yes/No;
Internet : Yes/No
Speaking /Non-Speaking Order
ssd
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To
1. The State of Tamilnadu
Rep. By the Special Commissioner & Secretary,
to Government,
Home Department,
Fort St.George,
Chennai – 9
2. The Director General of Police,
Kamarajar Salai,
Chennai
3. The Joint Director of Medical Service
Krishnagiri District
Krishnagiri
4. The Superintendent of Police,
Krishnagiri District
Krishnagiri.
https://www.mhc.tn.gov.in/judis
V.BHAVANI SUBBAROYAN, J.,
ssd
03.01.2024
https://www.mhc.tn.gov.in/judis
