Madras High CourtWP(MD)/13763/2021disposed of

Anbarasan.K v. The District Collector

2022-02-28Honourable Mr Justice S.M. Subramaniam2 pages

W.P.(MD) No.13763 of 2021 BEFORE THE MADURAI BENCH OF MADRAS HIGH COURT DATED: 28.02.2022

CORAM:

THE HONOURABLE MR.JUSTICE S.M.SUBRAMANIAM W.P.(MD) No.13763 of 2021 K.Anbarasan ... Petitioner vs.

1.The District Collector Dindigul District 2.The Joint Director of Medical and Rural Welfare Service Dindigul District 3.The Divisional Officer United India Insurance Company 5th Floor, PLA Rethinam Towers 212, Anna Salai Chennai-600 004 ... Respondents PRAYER: Writ Petition filed under Article 226 of the Constitution of India for issuance of writ of certiorari call for records in Na.Ka.No.5250/2020/F2, dated 16.07.2021, on the file of the 1st respondent, and quash the same as illegal. Further directing to the respondents to reimburse the medical expenditure of Rs.2,64,327/- with interest at the rate of 9% per annum forthwith. For Petitioner :

Mr.Kumar.S.

For Respondents :

Mr.N.Satheesh Kumar Additional Government Pleader for R1 & R2 Mr.A.Shajahan for R3

O R D E R

The order dated 16.07.2021, passed by the first respondent, rejecting the claim of the petitioner for medical reimbursement, is under challenge in this writ petition.

2. The reason for rejection for the petitioner's claim is that the diagnosis of amelo blastoma of left mandible and the line of management is not covered under the Health Fund Scheme. Therefore, the claim of the petitioner was rejected under the terms and conditions of G.O.Ms.No.202, Finance (Salaries) Department, dated 30.06.2016.

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W.P.(MD) No.13763 of 2021

3. In cases, where the medical reimbursement claim was rejected on the ground that the treatment undergone is not covered under the list of approved treatments in the Government Order, then the medical reimbursement application is to be submitted under the Tamil Nadu Medical Attendance Rules. The procedures contemplated under the Health Fund Scheme is entirely different wherein the Insurance Company is liable to settle the claims. When the case of the petitioner and the treatment undergone is not falling under the list of treatments covered by the Health Fund Scheme, then the petitioner has to to approach the Authority competent under the Tamil Nadu Medical Attendance Rules. This being the factum, this Court does not find any infirmity in the order impugned in this writ petition. However, the petitioner is at liberty to approach the Authority competent under the Tamil Nadu Medical Attendance Rules for the purpose of claiming medical reimbursement.

4. Accordingly, the writ petition is disposed of. No costs.

Sd/- Assistant Registrar (CS-III) // True Copy // / /2022 Sub Assistant Registrar(CS) krk To:

1.The District Collector, Dindigul District.

2.The Joint Director of Medical and Rural Welfare Service, Dindigul District.

+1 CC to M/s.S.KUMAR, Advocate ( SR-9560[F] dated 02/03/2022 ) +1 CC to M/s.A.SHAJAHAN, Advocate ( SR-9358[F] dated 01/03/2022 ) +1 CC to M/s.SPL GP ( SR-9223[F] dated 01/03/2022 ) W.P.(MD) No.13763 of 2021 28.02.2022 MA(CO) GC(11.03.2022) 2P 6C https://hcservices.ecourts.gov.in/hcservices/ 2/2