Madras High CourtWP/23585/2024disposed of

N.Abrar Ahmed Shah v. The Additional Chief Secretary To

2024-08-20Honourable Mr Justice N. Anand Venkatesh6 pages

IN THE HIGH COURT OF JUDICATURE AT MADRAS

DATED: 20.08.2024

CORAM

THE HONOURABLE MR.JUSTICE N.ANAND VENKATESH N.Abrar Ahmed Shah S/o.Nawab Zatha ... Petitioner Vs.

1.The Additional Chief Secretary to Government of Tamilnadu, Finance Department, Fort St.George, Secretariat, Chennai - 600 009.

2.The Commissioner of Treasuries and Accounts, O/o.Directorate of Treasuries and Accounts, Integrated Office Complex for Finance Department, 3rd Floor, Veterinary Hosptial Campus, Anna Salai, Nandanam, Chennai - 600 035.

3.The District Collector, District Collector Office, Master Plan Complex, J.N.Road, Tiruvallur - 602 001.

4.United India Insurance Company Limited, Divisional Office:010600, 5th Floor, PLA Rathna Tower, 212, Anna Salai, Chennai - 600 006.

5.MDIndia Healthcare Services (TPA) Pvt. Ltd., No.117, Ground Floor, Delta Wing, Raheja Towers, Unit 005, beside LIC, Chennai - 600 002.

... Respondents 1/6

Writ Petition filed under Article 226 of the Constitution of India seeking issuance of a Writ of Mandamus directing the respondents to address the petitioner grievance regarding the partial denial of medical expenses claim and to settle the petitioner's claim in full along with interest based on the petitioner's representation dated 03.03.2024. For Petitioner : Mr.N.Elayaraja For Respondents : Mr.M.Bindran Additional Government Pleader [R1 to R3] *****

O R D E R

This writ petition has been filed seeking issuance of a writ of mandamus directing the respondents to consider the representation made by the petitioner on 03.03.2024 wherein the petitioner has sought for the reimbursement of the amount incurred towards medical expenses.

2. Heard Mr.N.Elayaraja, learned counsel for petitioner and Mr.M.Bindran, learned Additional Government Pleader appearing for respondents 1 to 3.

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3. The case of the petitioner is that he is covered under the New Health Insurance Scheme (NHIS) for the period between 2021 and 2025 and he has also paid the premium towards the corpus fund and every month, money is deducted from his salary. The petitioner suffered a health set back on 10.02.2024 and therefore, he was immediately taken to the hospital and a surgical procedure was performed on 12.02.2024. The petitioner incurred total medical expenses of Rs.2,43,726.55. When this was communicated to the fifth respondent by the hospital, the fifth respondent had approved only a sum of Rs.54,600/-. The grievance of the petitioner is that till date, the fifth respondent is not providing any clarification as to why the expenses was limited to Rs.54,600/-. That apart, the petitioner has also made a complaint to the third respondent for intervening in this matter and to give necessary directions to the fifth respondent to settle the balance amount also. Since the same did not evoke any response, this writ petition has been filed seeking for appropriate directions.

4. Taking into consideration the facts and circumstances of the case and the materials placed before this Court, this Court deems it appropriate to direct the third respondent to deal with the representation 3/6

made by the petitioner on 03.03.2024 and take a decision and convey the same to the petitioner and respondents 4 and 5 within a period of four (4) weeks from the date of receipt of a copy of this order.

5. The petitioner is directed to submit a fresh representation to the third respondent along with all relevant documents and also a copy of this order.

This writ petition is disposed of with the above direction. No costs.

20.08.2024 Index: yes/no Speaking Order/Non-Speaking Order gm To 1.The Additional Chief Secretary to Government of Tamilnadu, Finance Department, Fort St.George, Secretariat, Chennai - 600 009.

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3.The District Collector, District Collector Office, Master Plan Complex, J.N.Road, Tiruvallur - 602 001.

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N.ANAND VENKATESH, J gm 20.08.2024 6/6