Santhanam, v. United India Insurance

O R D E R Heard the learned counsel on either side.

¶2The petitioner is a retired Government employee. He is a member of the New Health Insurance scheme. The petitioner suffered health break down and he got admitted in the third respondent hospital on 25.07.2014. He was 3 W.P.(MD)NO.2777 OF 2015 discharged on 07.08.2014. The petitioner had spent a sum of Rs.77,601/- towards treatment. Since the first respondent did not honour the same, the present writ petition came to be filed.

¶3The learned counsel appearing for the petitioner reiterated all the contentions set out in the affidavit filed in support of the writ petition and called upon this Court to grant relief as prayed for.

¶4As rightly pointed out by the learned Standing counsel appearing for the insurance company, the company had already informed the petitioner that the procedure undergone by the petitioner was not covered by the scheme. Therefore, the petitioner is permitted to submit an application along with all the relevant documents before the fourth respondent. The fourth respondent shall process the same within a period of three weeks from the date of receipt of a copy of this order. If within the said time limit the application is submitted, the fourth respondent shall receive the same without reference to limitation. The fourth respondent shall process the papers and 4 W.P.(MD)NO.2777 OF 2015 pay the amount due and eligible to the petitioner. The entire exercise shall be completed by the fourth respondent within a period of twelve weeks from the date of receipt of application of the petitioner. The case of the petitioner shall be considered in terms of the Tamil Nadu Medical Attendance Rules. This writ petition stands disposed of. No costs.

11.07.2023 NCC : Yes / No Index : Yes / No Internet : Yes / No PMU To: The District Level Empowered Committee, Ramanathapuram District. 5 W.P.(MD)NO.2777 OF 2015 G.R.SWAMINATHAN,J. PMU W.P.(MD)No.2777 of 2015

11.07.2023

1 W.P.(MD)NO.2777 OF 2015 BEFORE THE MADURAI BENCH OF MADRAS HIGH COURT DATED: 11.07.2023 CORAM THE HONOURABLE MR.JUSTICE G.R.SWAMINATHAN W.P.(MD)No.2777 of 2015 Santhanam ... Petitioner Vs. 1. United India Insurance Co. Ltd., Divisional Office, 5th Floor, PLA Rathna Tower, 212, Anna Salai, Chennai. 2. M/s. MD India Health Care Services Pvt. Ltd., No.27, Lakshmi Towers, III Floor, Dr. Radhakrishnan Salai, Mylapore, Chennai -4. 3. Meenakshi Mission Hospital and Research Centre, Rep. By its Chairman, Lake Area, Melur Road, Madurai – 625 107. 4. The District Level Empowered Committee, Ramanathapuram District. (R-4 is suo motu impleaded vide order dated 11.07.2023) ... Respondents Prayer: Writ petition is filed under Article 226 of the Constitution of India, to issue a Writ of Certiorarified Mandamus, to call for the records on the file of the 2nd 2 W.P.(MD)NO.2777 OF 2015 respondent communication vide letter dated 02.08.2014 denial of authorization Letter and quash the same and direct the respondents to reimburse the medical expenses of Rs.77,601/- to the petitioner under the Tamil Nadu Government Servant Medical Welfare Scheme for the Petitioner's treatment in UROSEPSIS WITH CEREBRAL VASCULAR ACCIDENT MULTIPLE CEREBRAL CHRONIC MICROBLEED and for such other reliefs to the petitioner s within a specific time frame that may be as prescribed by this Court. For Petitioner : Mr.R.Murugan For R-4 : Mr.N.Satheesh Kumar, Additional Government Pleader. For R-1 & R-2 : Mr.A.Shajahan For R-3 : Mr.M.Thirupathy * * *