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Madras High CourtWP/40933/2025disposed of with direction

J.Banukumar v. The Additional Secretary

2025-11-03Honourable Mr Justice M.Dhandapani6 pages

IN THE HIGH COURT OF JUDICATURE AT MADRAS

DATED: 03-11-2025

CORAM

THE HONOURABLE MR JUSTICE M.DHANDAPANI J.Banukumar S/o. Late. Jayarao Nainar, No. 6, 1st Cross Street, Raghavan Colony, Ashok Nagar, Chennai - 600 083 Petitioner(s) Vs

1. The Additional Secretary & Director General, Central Government Health Scheme, Room No 157-A, Nirman Bhawan, Maulana Azad Road, New Delhi.

2.The Additional Director Office Of The Additional Director , Central Government Health Scheme, D Block, 3rd Floor, Rajaji Bhavan, Besant Nagar, Chennai - 600 090.

3.The Director C.G.H.S E-2 C, Rajaji Bhavan, Besant Nagar, Chennai - 600 090.

Respondent(s)

PRAYER: This Writ Petition is filed under Article 226 of the Constitution of India, seeking for a Writ of Mandamus directing the respondents herein to reimburse the balance amount of Rs. 3,29,705/- (i.e. Rs. 3,54,242/- minus Rs. 24,537/- already paid) incurred by the petitioner towards taking medical treatment for the petitioner at Sri Ramachandra Medical College and Hospital, Iyyappanthangal, Along with interest at the rate of 12% per annum from 27.07.2024 until the date of actual reimbursement, within a time frame as may be stipulated by this Hon'ble court, by considering the petitioner's legal notice dated 29.07.2025.

For Petitioner(s):

Ms.Samuthira Vijayan For Respondent(s):

Dr.K.Kannan, Special Panel Counsel

ORDER

This Writ Petition has been filed seeking for a Writ of of Mandamus directing the respondents herein to reimburse the balance amount of Rs. 3,29,705/- (i.e. Rs. 3,54,242/- minus Rs. 24,537/- already paid) incurred by the petitioner towards taking medical treatment for the petitioner at Sri Ramachandra Medical College and Hospital, Iyyappanthangal, along with interest at the rate of 12% per annum from 27.07.2024 until the date of actual reimbursement, within a time frame as may be stipulated by this court, by considering the petitioner's legal notice dated 29.07.2025.

2.The case of the petitioner is that the petitioner is a retired Central Government employee, who is aged about 99 years. The petitioner has enrolled under the Central Government Health Scheme (CGHS) for life and has got a valid CGHS health card for his lifetime. While so, the petitioner was admitted in Sri Ramachandra Medical College and Hospital for emergency treatment, as he fell down at his residence and underwent treatment as an in-patient for 9 days in the said hospital and was finally discharged on 27.07.2024. The petitioner had incurred a sum of Rs.3,54,242 towards hospitalization expenses. 3.The petitioner thereafter, filed a medical reimbursement claim with the respondents for reimbursement of the said amount and a claim vide S.No.284/2024 dated 27.09.2024 was registered and a Claim Reference No.M.R.C.No.

2812/2024/CHE/CH06 was allotted. The petitioner thereafter was intimated that the said claim was found to be complete 'provisionally' and was forwarded to the office of the Additional Director General, CGHS on 04.10.2024. Thereafter, the petitioner received a sum of Rs.24,537/- and is yet to receive the balance amount.

29.07.2025 to the respondents seeking for reimbursement of the balance amount to the petitioner. However, there is no reply from the respondent till date. Hence, the petitioner has filed the present Writ Petition to direct the respondents herein to reimburse the balance amount of Rs.3,29,705/- to the petitioner. 4.The learned counsel for the petitioner would submit that after the filing of the Writ Petition by the petitioner, the second respondent has issued a notice dated 18.08.2025 directing the petitioner to submit (1) implant invoice, (2) Pharmacy Break Bill and (3) Ambulance Certificate for processing the claim made by the petitioner as per CGHS rules and guidelines. 5.In view of the submissions made by the learned counsel for the petitioner, the petitioner is now required to produce the above said documents before the second respondent, within a period of two (2) weeks from the date of receipt of a copy of this order and thereafter, the second respondent is directed to pass appropriate orders on the claim made by the petitioner, within a period of four (4) weeks thereafter.

6.The Writ Petition is disposed of in the above terms. No costs. 03-11-2025 Tsg Index:Yes/No Speaking/Non-speaking order Internet:Yes To

1. The Additional Secretary & Director General, Central Government Health Scheme, Room No 157-A, Nirman Bhawan, Maulana Azad Road, New Delhi.

2.The Additional Director Office Of The Additional Director , Central Government Health Scheme, D Block, 3rd Floor, Rajaji Bhavan, Besant Nagar, Chennai - 600 090.

3.The Director C.G.H.S E-2 C, Rajaji Bhavan, Besant Nagar, Chennai - 600 090.

M.DHANDAPANI J.

Tsg 03-11-2025