S. v. Gopalakrishnan Nair VS The Secretary to Government, Labour and Employment Department
2011-11-04
D.HARIPARANTHAMAN
body2011
DigiLaw.ai
Judgment :- 1. The petitioner is working as Training Officer in Government I.T.I, Nagercoil, Kanyakumari. The petitioner suffered heart ailment and also had undergone a major heart surgery in Sree Uthradom Thirunal Hospital at Thiruvananthapuram on 13.02.1997. He was admitted on 11.02.1997 and considering the urgency and to save his life, heart operation was performed on 13.02.1997. He made an application on 24.03.1997 before the 3rd respondent seeking to reimburse the medical expenses of Rs.1,11,195/- under the Tamilnadu Government Employees Health Fund Scheme, 1991. 2. The 1st respondent in his letter dated 11.03.1998 directed the petitioner to give reason as to why he took treatment at Thiruvananthapuram. The petitioner explained that when he visited his brothers house at Neyyattinkarai, Thiruvananthapuram, he developed heart problem. Further, he has stated that there is no facility for cardiac Surgery at Government Headquarters Hospital at Nagercoil. Hence, he was operated at Trivandrum due to emergent situation. However, the 1st respondent passed the order dated 04.01.2001 refusing to reimburse the medical expenses on the ground that he was operated at Thiruvananthapuram and therefore, he would not be granted the amount spent towards heart surgery. Hence, the Petitioner filed O.A.No.5757 of 2001 (W.P.No.2714 of 2007), to quash the above said order and to direct the respondents to reimburse the amount as per the rules. 3. The respondents filed the counter affidavit refuting the allegations. It is stated that since he took treatment out of Tamilnadu at Sree Uthradom Thirunal Hospital at Thiruvananthapuram, which is not a recognised hospital by the Government of Tamilnadu, the petitioner is not entitled to medical reimbursement. 4. Heard both sides. 5. The petitioner is employed at Nagercoil in Kanyakumari District. According to the petitioner, he went to his brothers house, which is at Neyyattinkarai in Thiruvananthapuram, Kerala State. Neyyattinkarai is 18 Kms away from Thiruvananthapuram. The distance between Nagercoil and Thiruvananthapuram is about 60 Kms only. When he visited his brothers house according to the petitioner he developed some heart ailment and he was urgently taken to the hospital at Thiruvananthapuram, where he was admitted and thereafter a surgery was performed. When a person is struggling for life and when his family members want to save his life, no body would search for a recognised hospital for future medical reimbursement. It is not the case of the respondents that no surgery was performed.
When a person is struggling for life and when his family members want to save his life, no body would search for a recognised hospital for future medical reimbursement. It is not the case of the respondents that no surgery was performed. Having admitted that heart surgery was performed, the respondents are not correct in refusing to reimburse the medical expenses. 6. The very purpose of the health scheme is to help the ailing employees particularly when they are faced with major problems such as Heart Surgery, etc. In a similar circumstances, this Court in K.Mani Vs. Secretary to Government, Health and Family Welfare Department, Chennai and Others [ 2007(3) MLJ 34 ] and Mr.K.Balaswami Vs. Director of Pension, Chennai and Another [ 2007(3) MLJ 385 ], held that medical reimbursement should not be denied on the ground that the petitioner failed to undergo heart surgery in the hospital recognised by Government of Tamilnadu. 7. In view of the aforesaid reasons and in the light of the decisions stated above, the impugned order is labile to be quashed and accordingly, the impugned order is quashed. The 1st respondent is directed to reimburse the medical expenses which the petitioner had incurred, as per the rules within a period of six weeks from the date of receipt of a copy of this order. 8. With the above directions, the writ petition is allowed. No costs.