Kalyani v. The District Level Empowered Committee

BEFORE THE MADURAI BENCH OF MADRAS HIGH COURT DATED : 18.04.2024

CORAM

THE HONOURABLE MS.JUSTICE R.N.MANJULA Kalyani ... Petitioner Vs.

1.The District Level Empowered Committee, Rep. by its Chairman/District Collector, Collectorate, Chennai - 600 001.

2.The Chief Internal Audit Officer, Tamil Nadu Generation and Distribution Corporation Limited(TANGEDCO), No.144, Anna Salai, Chennai - 600 002.

3.The Divisional Manager, United India Insurance Co. Ltd., 5th floor, PLA Rathna Tower, Raji Buildings, No.212, Anna Salai, Chennai - 600 006.

... Respondents PRAYER: Writ Petition filed under Article 226 of the Constitution of India for issuance of Writ of Mandamus, directing the respondents 2 and 3 to grant medical reimbursement of a sum of Rs.3,92,421/- to the petitioner based on the recommendation of the first respondent with interest at 12% within time stipulated by this Court. 1/5

For Petitioner : M/s.P.Selvakamatchi For R-1 : Mr.J.Ashok Additional Government Pleader For R-2 : Mr.B.Ramanathan For R-3 : Mr.I.Robert Chandrakumar

O R D E R

This Writ Petition has been filed for issuance of Writ of Mandamus seeking direction against the respondents 2 and 3 to grant medical reimbursement of a sum of Rs.3,92,421/- to the petitioner based on the recommendation of the first respondent with interest at 12%.

2. Heard M/s.P.Selvakamatchi, learned counsel for the petitioner, Mr.J.Ashok, learned Additional Government Pleader for the 1st respondent, Mr.B.Ramanathan, learned counsel for the 2nd respondent and Mr.I.Robert Chandrakumar, learned counsel for the 3rd respondent.

3. M/s.P.Selvakamatchi, learned counsel for the petitioner submitted that the petitioner is the wife of the deceased Kailasam who worked as Line Inspector in Tamil Nadu Generation and Distribution Corporation Limited (TANGEDCO) covered under the Tamil Nadu New 2/5

Health Insurance Scheme. The petitioner got admitted in the KIMS Hospital, Thiruvananthapuram from 24.02.2020 to 03.03.2020 for taking treatment and had spent a sum of Rs.3,92,421/-. Even though the petitioner is the dependant of the deceased husband who has coverage under the New Health Insurance Scheme, the reimbursement was denied because the treatment was undertaken in the non network hospital and thereafter, as per the guidelines, the matter was placed before the District Level Empowered Committee and positive recommendation was made to the second respondent on 25.05.2021. In accordance with the requirements, the petitioner has also submitted all the medical bills. Since the petitioner has not got any response from the 2nd and 3rd respondents so far, she has preferred this Writ Petition.

4. It appears from the order of the Director of Medical and Rural Health Services dated 17.06.2021, the petitioner was advised to make a claim under the Tamil Nadu Medical Attendant Rules. It is learnt from the submissions made by the second respondent that the claim so made by the petitioner pursuant to the above direction of the Director of Medical and Rural Health Services, is pending with the second respondent. Since, the petitioner's treatment pertains to the year 2020 and her husband is also no more, it is obligatory on the part of the second 3/5

respondent to consider the claim of the petitioner. Hence, the second respondent is directed to consider the claim of the petitioner and pass orders for disbursement of the eligible amount to the petitioner within a period of six weeks from the date of receipt of a copy of this order.

5. With the above direction, this Writ Petition is disposed of. No costs.

18.04.2024 NCC:yes/no Index:yes/no Internet:yes/no Nsr To:

1.The Chairman/District Collector, District Level Empowered Committee, Collectorate, Chennai - 600 001.

2.The Chief Internal Audit Officer, Tamil Nadu Generation and Distribution Corporation Limited(TNGEDCO), No.144, Anna Salai, Chennai - 600 002.

3.The Divisional Manager, United India Insurance Co. Ltd., 5th floor, PLA Rathna Tower, Raji Buildings, No.212, Anna Salai, Chennai - 600 006.

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R.N.MANJULA, J.

Nsr 18.04.2024 5/5