Rathinavel Pandian v. The Additional Secretary To Government

IN THE HIGH COURT OF JUDICATURE AT MADRAS

DATED: 04-07-2025

CORAM

THE HONOURABLE MR.JUSTICE C.KUMARAPPAN

1. Rathinavel Pandian Retired Sub Inspector Of Police, No. C 253 Chelladurainagar, Krishnapuram, Maharajapuram Post, Palayamkottai, Thirunelveli 627 001.

Petitioner(s) Vs

1. The Additional Secretary To Government The Home, Police Department, Secretariat, Chennai 600 009.

2.The Home Secretary To The Governmetn Fort St George, Secretariat, Chennai 60 0009. 3.The Managing Director The United India Insurance Co Ltd, No. 24 Whites Road, Chennai 600 014.

4.The Chief Manager The United India Insurance Company Limited, Lbo 010600, 134 Sillingai Buildings, Behind IDBI Bank Greams Road, Chennai 60 0006.

Respondent(s) PRAYER Directing the 4 th respondent to pay the medical claim amount with interest to the petitioner based on the petitioner's representation dated 14.03.2025. For Petitioner(s):

M/s. T.Jayaramaraj For Respondent(s):

Mr.R.U. Dinesh Rajkumar Additional Government Pleader for R1 &R2 Mr.P. Athi Veera Rama Pandian For R3 & R4

ORDER

The instant writ petition has been filed to direct the 4th respondent to pay the medical claim amount with interest to the petitioner based on the petitioner's representation dated 14.03.2025.

2. The learned counsel for the petitioner would submit that he is a pensioner and he took treatment at Bethesda Hospital and spent a sum of Rs.1,62,626/-. However, the Insurance company has reimbursed only Rs.75,755/-. In respect of the remaining amount, they did not state any reasons. Hence, he had sent a representation to the Treasury.

3. At this juncture, the learned Additional Government Pleader appearing on behalf of the respondents 1 and 2 relied on the judgment of this Court in the case of S.Marimuthu Vs. The Government of Tamil Nadu, in WP.(MD).No.13429 of 2013 and batch, wherein this Court, after elaborately

considering various aspects, has observed in Paragraph No.80 as follows: "80. In order to reconsider all these claim made by the respective writ petitioners for medical reimbursement, by remitting the matters back, the following directions are issued:

(i) All the impugned orders in the respective writ petitions in this batch of cases, are hereby quashed.

(ii) The writ petitions where impugned orders are quashed as well as the writ petitions where mandamus sought for, are hereby remanded with directions to the concerned District Level Empowered Committee, before whom, these matters shall be placed and the Committee shall reconsider every individual case.

(iii) While reconsidering, the Committee shall not reject any claim merely on the reason of non network hospital or non listed disease.

(iv) The Committee, wherever possible, shall give suitable direction to the Insurance Company to reimburse the claim made by the respective claimant / employee / pensioner.

(v) If the Committee finds some cases where the Insurance Company cannot be directed to reimburse, in those cases, suitable orders shall be passed directing / recommending the State authorities to reimburse the claim under Medical Attendance Rules. (vi) Once such orders are passed, the Insurance

Company shall immediately reimburse the medical claim with 6% interest from the date of due till date of payment, within a period of thirty days from the date of receipt of such order to be passed by the Empowered Committee of the District concerned."

4. Even while looking at the impugned order, it is mentioned that if there is any grievance in respect of the impugned order, they have a right to appeal before the District Level Empowerment Committee. Therefore, by following the above judgment, this Court deems it appropriate to direct the petitioner to approach the District Level Empowerment Committee within a period of two weeks from the date of receipt of a copy of this order. If any appeal has been filed by the petitioner within that period, the District Level Empowerment Committee is directed to dispose of the same within a further period of four weeks, according to its own merits and in accordance with law.

5. With the above directions, the writ petition is disposed of. No costs. Consequently, the connected miscellaneous petitions, if any, are closed. 04-07-2025 gd Index:Yes/No Speaking/Non-speaking order Internet:Yes

To 1.The Additional Secretary To Government The Home, Police Departmetn, Secretariat, Chennai 600 009.

2.The Home Secretary To The Government Fort St George, Secretariat, Chennai 60 0009.

3.The Managing Direcotr The United India Insurance Co Ltd, No. 24 Whites Road, Chennai 600 014.

4.The Chief Manager The United India Insrance Company Limited, Lbo 010600, 134 Sillingai Buildings, Behind Idbi Bank Greams Road, Chennai 60 0006.

C.KUMARAPPAN J.

gd 04-07-2025