Madras High CourtWP(MD)/11501/2022allowed

Ponnusamy.A v. The Commissioner Of

2022-07-01Honourable Mr Justice M.S. Ramesh8 pages

BEFORE THE MADURAI BENCH OF MADRAS HIGH COURT DATED : 01.07.2022

CORAM

THE HONOURABLE MR.JUSTICE M.S.RAMESH and W.M.P.(MD).Nos.8155 & 8156 of 2022 A.Ponnusamy ... Petitioner Vs.

1.The Commissioner of Treasuries and Accounts, The Department of Finance, 3rd Floor, Integrated Office Complex, No.571, Anna Salai, Nandanam, Chennai - 600 035.

2.The District Collector, Sivagangai, 3.The Joint Director, Medical & Rural Health Services (FAF), Sivagangai, 4.The Senior Divisional Manager, United India Insurance Co.Ltd., Divisional Office VI, No.212, Pala Rathna Towers, 5th Floor Anna Salai, Chennai - 600 006.

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5.The Block Educational Officer, Sa.Pudur - 630 410, ... Respondents PRAYER : Writ petition filed under Article 226 of the Constitution of India to issue a writ of Certiorarified Mandamus, calling for the records relating to the impugned Government Orders issued by the 1st respondent Commissioner of Treasuries in RC.No.23422/NHIS-1/2021, dated 25.01.2022, quash the same and further direct the respondents herein to reimburse the medical expenses to the tune of Rs.1,72,608/- to the petitioner towards the treatment undergone by the petitioner for the COVID-19 positive Sivakasi COVID-19 Health Centre Hospital, Sivakasi.

For Petitioner : Mr.K.Prabhu For Respondents : Mr.A.Kannan for R1 to R3 and R5 Additional Government Pleader Mr.C.Karthik for R4

O R D E R

Through the impugned order dated 25.01.2022, the petitioner's claim for medical reimbursement for the expenses incurred for testing positive for Covid-19 Virus, was rejected by the first respondent herein on the ground that 2/8

treatment was non-critical in nature and the treatment was taken in a nonnetwork hospital. 2.At that time, when the impugned order was passed, there was no regulation, facilitating the claim for reimbursement for COVID-10 positive cases. However, subsequently, the Government, in G.O.Ms.No.165, Finance [Health Insurance] Department dated 01.06.2022, had accepted the proposals of the Commissioner of Treasuries and Accounts for reimbursement of expenses incurred for COVID-19 cases. The relevant portion of the aforesaid Government Order is extracted hereunder:

"8. The Government after careful examination of the proposal of Commissioner of Treasuries and Accounts, have decided to accept the same and accordingly issue the following orders:- (i) Sanction is accorded for an adhoc amount of Rs.10.00 crore (Rupees ten crore only) to clear the claims of the eligible expenses incurred by the Government Employees and their eligible family members and Pensioners (including spouse) / Family Pensioners under Non-Critical COVID care treatment undertaken in Non-Network hospitals by creating two 3/8

Corpus Funds one for Rs.6.00 crore [Rupees six crore only) for Pensioners (including spouse) / Family Pensioners and Rs.4.00 crore [Rupees four crore only] for Government Employees and their eligible family members considering the welfare of the Employees/ Pensioners. There shall be no change in the existing modalities followed in respect of reimbursement claims settled by United India Insurance Company Limited from the funds released by Government under these Corpus Fund.

(ii) Government Employees/Pensioners who have already taken treatment for Non-Critical COVID care in Non-empanelled Hospitals from 01.03.2020 till date are directed to submit their claims for to reimbursements by applying to the Commissioner of Treasuries and Accounts, Chennai. The Commissioner of Treasuries and Accounts shall forward the applications along with documents to the United India Insurance Company Limited to reimburse the eligible amount from the Corpus Fund provided by the Government as is followed as per the G.Os first and second read above without reference to the District Level Empowered Committee."

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3.Since the Government Order was not in existence when the impugned order was passed, the order cannot be strictly found fault with. However, in view of the subsequent passing of the Government Order in G.O.Ms.No.165, Finance [Health Insurance] Department dated 01.06.2022, the petitioner would be entitled for reimbursement of the medical expenses incurred by him in this regard. Through the present impugned order, the application was returned to the petitioner herein by the first respondent. 4.Accordingly, the petitioner is at liberty to re-submit his application to the first respondent herein and on receipt of such application, the first respondent shall scrutinize and forward the same to the fourth respondent and accordingly, reimburse the eligible amount incurred by the petitioner in accordance with G.O.Ms.No.165, Finance [Health Insurance] Department dated 01.06.2022, within a period of four (4) weeks from the date of receipt of a copy of this order.

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5.With the above observations, this Writ Petition stands allowed. There shall be no order as to costs. Consequently, connected miscellaneous petitions are closed.

01.07.2022 Index : Yes / No Speaking Order/ Non Speaking Order TM To 1.The Commissioner of Treasuries and Accounts, The Department of Finance, 3rd Floor, Integrated Office Complex, No.571, Anna Salai, Nandanam, Chennai - 600 035.

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5.The Block Educational Officer, Sa.Pudur - 630 410, 7/8

M.S.RAMESH,J.

TM 01.07.2022 8/8