T.Rajammal v. The Registrar General

Order (Order of the Court was made by S.M.Subramaniam J.)

Writ of Mandamus has been instituted directing the respondents to reimburse the medical claim of the petitioner to the tune of Rs.15,27,000/- after adjusting the amount already paid to the tune of Rs.2,73,000/-. The petitioner is aged about 72 years,, She is a retired employee of Madras High Court and pensioner. On 07.10.2024, the husband of the petitioner suffered chest pain and was admitted in M/s.Gleneagles Health City Hospital, Sholinganallur. He was advised to undergo replacement of aortic valve. The husband of the petitioner underwent surgery on 09.10.2024. He took treatment as in-patient on 07.10.2024 and discharged from the hospital on Page3 of 6

11.10.2024. Medical expenses of Rs.18 lakhs was incurred for the treatment. The petitioner being a pensioner, submitted an application seeking reimbursement of medical expenses. However, the respondents have disbursed a sum of Rs.2.73 lakhs but not paid the actual medical expenses incurred by the petitioner.

¶2The Registrar General, High Court filed a report stating that the Government of Tamil Nadu, vide G.O.Ms.No.160, Finance (Salaries) Department dated 29.06.2026 launched a New Health Insurance Scheme to provide health insurance coverage to government employees along with their eligible family members. The Scheme operates on a cashless basis through approved network of hospitals. The implementation agency is United India Insurance Company Limited and the period of coverage is 4 years from

01.07.2021 to 30.06.2025. The standard coverage under the scheme is upto Rs.5 lakhs per employee's family for a block period of four years for specified treatments and surgeries. Enhanced coverage upto to Rs.10,00,000/- for specified critical illness was also provided. Eligible members of the family are prescribed under the scheme. Key features and benefits are also provided and a grievance redressal mechanism is contemplated. Accordingly, in case of any complaints regarding non-authorisation of cashless treatment, denial of treatment or reimbursement issues, the aggrieved person has to approach the Page4 of 6 District Level Committee chaired by the District Collector and thereafter the State Level Committee chaired by the Director of Treasuries and Accounts.

¶3In the present case, the petitioner retired on 31.03.2012 and her eligibility would fall under G.O.Ms.No.204, Finance (Health Insurance) Department dated 30.06.2022. Health care assistance is provided under the said government order to the pensioners (including spouses / family pensioners) through United India Insurance Company Limited. In the present case, medical insurance claim to the tune of Rs.2.73 lakhs has already been settled in favour of the petitioner. Under the Scheme, as the members of the family are not eligible to claim entire medical reimbursement, but only as stipulated under the Scheme. If at all any grievance exists or reimbursement is not made in consonance with the Scheme, then the petitioner is at liberty to approach the District Level Committee and thereafter State Level Committee for redressal. With the above observations, the writ petition is dismissed. No costs. (S.M.S.,J.) (N.S.,J.) 15-07-2026 Index: Yes Speaking order KST Page5 of 6 To

¶1The Registrar General Madras High Court, Chennai.

¶2The Secretary To Government Health and Family Welfare Department, Secretariat, Chennai 600 009

¶3The Additional Chief Secretary to Government Finance (Pay Cell) Departmetn, Secretairat, Chennai 600 009

¶4The Joint Director of Medical and Rural Health Service, DMS campus Teynampet, Chennai 600 018

¶5The Commissioner of Treasury and Accounts 3rd Floor, perasiriyar K. Anbazhaganmaaligai, No 571 Anna Salai, Nandanam, Chennai 600 035

¶6The Senior Division Manager United India Insurance Company Limited, 5th Floor P.L.A. Rathna Towers, 212 Anna Salai, Chennai 600 006

¶7The Chief Manager United India Insurance Co.Ltd., LBO -010600, No 134 Silingi Buildings (Behind IDBI Bank) Greams Road, Chennai 600 006 WPoNo.o22873oofo2026 S.M.SUBRAMANIAMeJ. AND N.SENTHILKUMAReJ. KST WPeNo.e22873eofe2026 15-07-2026 Page6oofo6

Page1 of 6 IN THE HIGH COURT OF JUDICATURE AT MADRAS DATED: 15-07-2026 CORAM THE HON'BLE MR JUSTICE S. M. SUBRAMANIAM AND THE HON'BLE MR.JUSTICE N.SENTHILKUMAR T.Rajammal W/o Paulraj, No 81/49, Thiruvalluvar Street, Cheliamman Nagar, Athipet, Ambattur Industrial Estate, Chennai 600 058 ..Petitioner Vs 1. The Registrar General Madras High Court, Chennai. 2. The Secretary To Government Health and Family Welfare Department, Secretariat, Chennai 600 009 3. The additional Chief Secretary to Government Finance (Pay Cell) Department, Secretariat, Chennai 600 009 4. The Joint Director of Medical and Rural Health Service, DMS campus Teynampet, Chennai 600 018 5. The Commissioner of Treasury and Accounts 3rd Floor, perasiriyar K. Anbazhaganmaaligai, No 571 Anna Salai, Nandanam, Chennai 600 035 6. The Senior Division Manager United India Insurance Company Limited, 5th Floor P.L.A. Rathna Towers, 212 Anna Salai, Chennai 600 006. Page2 of 6 7. The Chief Manager United India Insurance Co.Ltd., LBO -010600, No 134 Silingi Buildings (Behind IDBI Bank), Greams Road, Chennai 600 006. ..Respondents Prayer : Writ Petition under Article 226 of the Constitution of India praying for a Writ of Mandamus directing the respondents to reimbursement of Remaining Medical Expenses to a sum of Rs 15,27,000/- to petitioner after adjusting the amount of Rs 2,73,000/- already been paid to the petitioner. For Petitioner : Mr.S.Ravichandran For Respondents : Mr.M.Palanimuthu