K.Balasubramaniyan v. M.D.India
IN THE HIGH COURT OF JUDICATURE AT MADRAS
DATED : 27.11.2023
CORAM
THE HONOURABLE MS.JUSTICE R.N.MANJULA W.P.
No.6987 of 2020 K.Balasubramaniyan ... Petitioner Vs.
1.M.D.India New Health Insurance Private Limited, (Unit of Insurance Company Limited) Guna Complex, No.443 & 445, Anna Salai, Teynampet, Chennai 600 018.
2.The District Collector, Singaravelarmaligai, Chennai 600 001.
3.The Director of Medical and Rural Health Department, Chennai 600 006.
4.The Commissioner of Pay & Accounts, Saidapet, Chennai 600 035.
... Respondents Prayer : Writ Petition is filed under Article 226 of the Constitution of India, to issue a Writ of Mandamus, to direct the first respondent herein to reimburse medical expenses of Rs.1,56,292.50 with interest incurred Page No.1 of 6
by the petitioner for taking treatment at Gunasekaran Hospital Private Limited, 1, Cresent Park Street, T.Nagar and other medical expenses. For Petitioner : Mr.C.Vasanthakumar For Respondents :Mr.P.Sanjai Gandhi, Govt. Advocate
ORDER
This writ petition has been filed to direct the first respondent herein to reimburse medical expenses of Rs.1,56,292.50 with interest incurred by the petitioner for taking treatment at Gunasekaran Hospital Private Limited, 1, Cresent Park Street, T.Nagar and other medical expenses.
2. Heard Mr.C.Vasanthakumar, learned counsel for the petitioner and Mr.P.Sanjai Gandhi, learned Government Advocate for the respondents.
3. The petitioner who is a Government Employee is said to be a member of the New Health Insurance Scheme. According to the said scheme, the petitioner is eligible to avail the medical expenses to the tune of Rs.4,00,000/- to himself and his family members. On 17.02.2015, the Page No.2 of 6
petitioner was in serious condition due to the heavy impact of the breathlessness. Taking into consideration of the emergency of the treatment, he was admitted in Gunasekaran Hospital Pvt. Ltd., where he was admitted as inpatient, given treatment and discharged on 19.02.2015. When he filed necessary bills for medical reimbursement, the same was rejected by stating the reason that the hospital in which the petitioner had taken treatment does not fall under the accredited list of hospitals.
4. The learned Government Advocate for the respondents submitted that if the petitioner gives a representation once again, the same can be considered and orders will be passed.
5. Since the petitioner has to produce necessary medical records for getting reimbursement, it is upto the petitioner to produce the relevant record and avail the benefit of reimbursement.
6. With the above observations, this Writ Petition is disposed and the petitioner is directed to give a fresh representation along with Page No.3 of 6
necessary documents to the respondents within a period of two weeks from the date of receipt of a copy of this order and on receipt of the same, the respondents are directed to consider the same and pass appropriate orders within a period of four weeks thereafter. No costs. 27.11.2023 Index : Yes Internet : Yes/No gsk To 1.M.D.India New Health Insurance Private Limited, Page No.4 of 6
(Unit of Insurance Company Limited) Guna Complex, No.443 & 445, Anna Salai, Teynampet, Chennai 600 018.
2.The District Collector, Singaravelarmaligai, Chennai 600 001.
3.The Director of Medical and Rural Health Department, Chennai 600 006.
4.The Commissioner of Pay & Accounts, Saidapet, Chennai 600 035.
Page No.5 of 6
R.N.MANJULA , J.
gsk W.P.
No,6987 of 2020 27.11.2023 Page No.6 of 6