R.Prakasam v. The Manager

BEFORE THE MADURAI BENCH OF MADRAS HIGH COURT DATED: 03.01.2023

CORAM

THE HON'BLE MR.JUSTICE K.KUMARESH BABU W.P(MD)No.10036 of 2014 R.Prakasam ..... Petitioner - Vs1. The Manager, MD India Health Care Services (TPA) Pvt Ltd., No.27, Lakshmi Towers, 3rd Floor, Dr.Radhakrishnan Salai, Mylapore, Chennai - 05.

2. The Commissioner of Treasuries and Accounts, Chennai - 15.

... Respondents PRAYER : Writ Petition filed under Article 226 of the Constitution of India, praying this Court to issue a Writ of Mandamus, to direct the respondent, to pay the amount a sum of Rs.2,08,769/- (Rupees Two Lakhs Eight Thousand Seven Hundred and Sixty Nine only) under New Health Insurance Scheme, 2012 within the stipulated period. 1/5

For Petitioner : Mr.G.Marimuthu For Respondents : Mr.V.Om Prakash Government Advocate (for R2) : No appearance (For R-1)

ORDER

The present writ petition has been filed seeking for a Mandamus to direct the respondent, to pay the amount a sum of Rs.2,08,769/- (Rupees Two Lakhs Eight Thousand Seven Hundred and Sixty Nine only) under New Health Insurance Scheme, 2012 within the stipulated period.

2. The case of the petitioner is that his wife is working as a Supervisor in the Sarva Sikshya Abiyan (Education for all) Education Department, Madurai and that in the year 2012, the state of Tamil Nadu Government introduced a Scheme called New Health Insurance Scheme, 2012. Under the said Scheme, the Government employees and their eligible 2/5

family members can avail medical treatment in the listed Hospitals to the tune of Rs.4,00,000/- (Rupees Four Lakhs only) and to that Scheme a sum of Rs.150/- (Rupees One hundred and fifty only) per month from the salary of Government employees has been deducted. On 07.02.2014, the petitioner have met with an accident while travelling in the vehicle and there has been expenditure of Rs.4,40,991.00/- (Rupees Four Lakhs Forty Thousand Nine Hundred and Ninety One only) towards treatment and during the treatment, the first respondent/Insurance Company had released a sum of Rs.1,91,231/- (Rupees One Lakhs Ninty One Thousand Two Hundred and Thirty one only) to the Hospital as a preliminary expenses and they have not released the balance amount expended by the petitioner. Therefore, he had made representations on 14.03.2014 and 16.03.2014 which has not been replied by the first respondent.

3. Considering the facts of the case, the petitioner is directed to submit a fresh representation to the first respondent within a period of two weeks from the date of receipt of a copy of this order and the first respondent is directed to dispose of the same within a period of six weeks thereafter.

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4. With the above said directions, this Writ Petition is disposed of. No costs.

03.01.2023 NCS: Yes / No Index :

Yes / No Internet :

Yes / No ebsi To

1. The Manager, MD India Health Care Services (TPA) Pvt Ltd., No.27, Lakshmi Towers, 3rd Floor, Dr.Radhakrishnan Salai, Mylapore, Chennai - 05.

2. The Commissioner of Treasuries and Accounts, Chennai - 15 4/5

K.KUMARESH BABU, J.

ebsi Order made in W.P(MD)No.10036 of 2014 03.01.2023 5/5