Palanivelu. K v. The Secretary To Government Of Tamilnadu

BEFORE THE MADURAI BENCH OF MADRAS HIGH COURT DATED : 04.07.2024

CORAM

THE HONOURABLE MS.JUSTICE R.N.MANJULA K.Palanivelu

...Petitioner

Vs 1.The Secretary to Government of Tamil Nadu, Salaries Department, Secretariat, Fort St.George, Chennai - 600 009.

2.The District Collector / District Empowered Committee, Tamil Nadu New Health Insurance Scheme, Pudukkottai District, Pudukkottai.

3.The District Treasury Officer, Office of the District Treasury Officer, Pudukkotti.

4.The United India General Insurance Co.Ltd., Represented by its, Divisional Manager, Divisional Officer VI, V PLA Towers, No.212, Annasalai, Chennai - 600 006.

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5.The Empanellment Team, Medi Assist-TPA Private Limited, 2nd Floor, 24 Nelson Manickam Road, Aminjikarai, Chennai - 600 026.

... Respondents Prayer: Writ Petition filed under Article 226 of the Constitution of India praying this Court to issue a Writ of Mandamus, directing the respondents herein to reimburse the medical bill amount of Rs.5,12,632/- after deducting the amount of Rs.1,58,772/- paid to the petitioner on the basis of medical claim submitted by the petitioner under the Tamil Nadu New Health Insurance Scheme-Pensioner within the time stipulated by this Court.

For Petitioner : Mr.P.Mahendran For R-1 to R-3 : Mr.J.Ashok Additional Government Pleader For R-4 : Mr.A.Shajahan

O R D E R

Heard Mr.P.Mahendran, learned counsel for the petitioner, Mr.J.Ashok, learned Additional Government Pleader for the respondents 1 to 3 and Mr.A.Shajahan, learned counsel for the 4th respondent. 2/6

2. This Writ Petition has been filed for issuance of Writ of Mandamus, seeking direction against the respondents to reimburse the medical bill amount of Rs.5,12,632/- after deducting the amount of Rs.1,58,772/- paid to the petitioner on the basis of medical claim submitted by the petitioner under the Tamil Nadu New Health Insurance Scheme-Pensioner.

3. Mr.P.Mahendran, learned counsel for the petitioner submitted that the petitioner undergone heart surgery ie., PTCWITHSTENDING TRANSLUMINAL CORONARY ANGEOPLASTY WITH STENDING during the period from 02.01.2024 to 05.01.2024. In this regard, the petitioner approached the respondents 4 and 5 through proper channel for reimbursement of the medical claim for a sum of Rs.5,12,632/-. The petitioner was allowed to claim only the partial amount of Rs.1,58,772/-. Now, the petitioner has filed this writ petition seeking to reimburse the remaining amount.

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4. Since the petitioner has not been given with the reasons for rejecting the remaining claim, the fourth respondent is duty bound to consider the claim of the petitioner and pass appropriate orders.

5. In view of the above, this Writ Petition is disposed of with a direction to the fourth respondent to consider the petitioner's claim for reimbursement of balance amount and pass orders within a period of two weeks from the date of receipt of a copy of this order. No costs. 04.07.2024 NCC:yes/no Index:yes/no Internet:yes/no Nsr To:

1.The Secretary to Government of Tamil Nadu, Salaries Department, Secretariat, Fort St.George, Chennai - 600 009.

2.The District Collector / District Empowered Committee, Tamil Nadu New Health Insurance Scheme, Pudukkottai District, Pudukkottai.

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3.The District Treasury Officer, Office of the District Treasury Officer, Pudukkotti.

4.The Divisional Manager, The United India General Insurance Co.Ltd., Represented by its, Divisional Officer VI, V PLA Towers, No.212, Annasalai, Chennai - 600 006.

5.The Empanellment Team, Medi Assist-TPA Private Limited, 2nd Floor, 24 Nelson Manickam Road, Aminjikarai, Chennai - 600 026.

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R.N.MANJULA, J.

Nsr 04.07.2024 6/6