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2013 DIGILAW 2140 (MAD)

S. M. v. Kalaiyarasu VS State of Tamil Nadu Rep. By Secretary to Government, Chennai

2013-06-21

M.JAICHANDREN

body2013
JUDGMENT :- 1. Heard the learned counsel appearing for the petitioner, as well as the learned counsel appearing on behalf of the respondents. 2. This writ petition has been filed by the petitioner challenging the impugned order cum letter issued by the second respondent, dated 8.1.2010, stating that the petitioner, who had undergone Angioplasty, was not entitled to the benefits provided under the government order, in G.O.Ms.No.400, Finance (Salaries) Department, dated 29.8.2000. By the said communication the second respondent had stated that Angioplasty did not find a place in the list of diseases shown in the annexure appended to the government order, in G.O.Ms.No.400, Finance (Salaries) Department, dated 29.8.2000, and therefore, the petitioner would not be entitled to reimbursement of the amount that he had spent in undergoin Angioplasty unless the State Government passes appropriate orders to extend the benefits provided under the said government order, to the petitioner. 3. The petitioner has stated that he had joined the fourth respondent institute, as a Junior Instructor, on 27.7.1971. He had retired from service, after having rendered unblemished service for a period of nearly 33 years, on 31.3.2004, as a Senior Lecturer. It has been further stated that the petitioner had a heart ailment, when he was in service, in the year, 2001. He had approached the Madras Medical Mission Hospital, Mugappair, Chennai, and he had undergone the treatment, known as Angioplasty, from 19.11.2001 to 23.11.2001. He had incurred medical expenses to the tune of Rs.1,19,740/-for the treatment rendered by the Madras Medical Mission Hospital, Chennai. 4. On 23.1.2002, he had applied for reimbursement of the medical expenses to the Commissioner of Technical Education, the second respondent herein, under the Tamilnadu Government Employees Health Fund Scheme, for repayment of the said amount, as per the government order, in G.O.Ms.No.141 Finance (Salaries) Department, dated 26.2.1996. The second respondent had passed orders, on 13.5.2002, directing the third respondent to issue a crossed cheque for a sum of Rs.89,805/-, which is 75% of the total claim made by the petitioner. However, there was no response from the third respondent, for a long time. Hence, the petitioner had sent several representations requesting the authorities concerned to reimburse the medical expenses incurred by the petitioner, for undergoing the treatment of Angioplasty. However, there was no response from the third respondent, for a long time. Hence, the petitioner had sent several representations requesting the authorities concerned to reimburse the medical expenses incurred by the petitioner, for undergoing the treatment of Angioplasty. while so, by a letter, dated 16.9.2009, the third respondent had sent a reply stating that a letter had been sent to the first respondent to obtain the necessary exemption for the reimbursement of the medical expenses incurred by the petitioner, as the treatment known as Angioplasty was not covered by the Tamilnadu Government Employees Health Fund Scheme, as per the government order, in G.O.Ms.No.400, Finance (Salaries) Department, dated 29.8.2000. 5. It has been further stated that the Government of Tamilnadu had passed a government order, in G.O.No.556, Finance (Salaries) Department, dated 8.11.2004, including Angioplasty and PTCA Stent in the list of surgeries, under the Tamilnadu Government Employees Health Fund Scheme. Accordingly, Angioplasty and PTCA Stent had been included in the list under the group `Cardiology and Cardio Thoracic Surgery’ for the purpose of availing the necessary assistance under the Tamilnadu Government Employees Health Fund Scheme. In such circumstances, the petitioner is entitled to the reimbursement of the medical expenses incurred by him during his service, for the treatment known as Angioplasty. As such, the impugned order cum letter issued by the second respondent, dated 8.1.2010, is arbitrary, illegal and void, especially, in view of the passing of the government order, in G.O.Ms.No.400 Finance (Salaries) Department, dated 29.8.2000. The petitioner has further prayed that this Court may be pleased to quash the said communication of the second respondent, dated 8.1.2010, and to direct the second and the third respondents to reimburse the medical expenses incurred by the petitioner as per the sanction made in the proceedings No.3276/B5/2002, dated 13.5.2002, issued by the second respondent. 6. The learned counsel appearing on behalf of the petitioner had placed before this Court a number of decisions of this Court, wherein, the medical benefit had been extended to those who had undergone the treatment of Angioplasty, even if it had been done prior to the passing of the government order, in G.O.Ms.No.556 Finance (Salaries) Department, dated 8.11.2004. 7. The learned counsel had relied on the following decisions in support of his contentions: 7.1) In C.Nagamuthu Vs. 7. The learned counsel had relied on the following decisions in support of his contentions: 7.1) In C.Nagamuthu Vs. State of Tamil Nadu, (2006) 2 M.L.J. 747 , this Court had held that the non sanctioning of medical reimbursement to the petitioner therein, is violative of Article 14 of the Constitution of India. It had been stated that the object of the Tamilnadu Government Employees Health Fund Scheme was to give financial support to the deserving persons, who had contributed towards the said Scheme. It had been further held that it was not open to the respondent State to deny the benefit given under the said Scheme, on the ground that the treatment should have been taken only in the listed hospitals, as per the government order, in G.O.Ms.No.400, Finance (Salaries) Department, dated 29.8.2000. 7.2) In Chinnathambi Vs. The Tamilnadu State Transport Corporation (Salem) Limited, Salem, (W.P.No.22441 of 2006, dated 21.7.2006), this Court had passed an order stating that there is no time limit prescribed for the submission of the application for availing the medical benefit, by way of reimbursement of the amount spent for the said treatment. The reimbursement of the medical expenses should be made even if the treatment had been taken from a hospital, which was not found in the list of approved hospitals. 7.3) In K.Balaswami Vs. Director of Pension, (2007) 3 MLJ 385 , this Court had held that, while the object of the medical scheme is to give financial support to the deserving persons, it would not be open to the authorities concerned to suggest the manner of treatment or that it should have been undergone in a particular hospital. 7.4) In K.Mani Vs Secretary to Government, Health and Family Welfare Department, Chennai, 2007 (3) L.L.N. 473, this Court had held that the claim for reimbursement of the medical expenses incurred by the person concerned ought to be entertained, as the government order, in G.O.Ms.No.556, Finance (Salaries) Department, dated 8.11.2004, ought to be read with retroactive effect to serve the true object of the medical benefits contemplated under G.O.Ms.No.400, Finance (Salaries) Department, dated 29.8.2000. 7.5) It has also been pointed out that this Court in H.V.Krishnappa Vs. 7.5) It has also been pointed out that this Court in H.V.Krishnappa Vs. The State of Tamilnadu and two others (W.P.No.3620 of 2008, dated 12.2.2008), had rejected the claim of the respondents therein that the government order, in G.O.Ms.No.556, Finance (Salaries) Department, 8.11.2004, should be read so as to have a prospective effect. On the contrary, the said order ought to be read as a clarification of the earlier government order, in G.O.Ms.No.400, Finance (Salaries) Department, dated 29.8.2000, and the other government orders providing certain medical benefits, under the Tamilnadu Government Employees Health Fund Scheme. 8. In the counter affidavits filed on behalf of the respondents the averments made by the petitioner in the affidavit filed in support of the writ petition had been denied. It has been stated that the treatment given to the petitioner, by the Madras Medical Mission Hospital, Chennai, from 19.11.2001 to 23.11.2001, was not covered under the government order, in G.O.Ms.No.400, Finance (Salaries) Department, dated 29.8.2000. It is not in dispute that Angioplasty had been given the approval, for the purpose of reimbursement of the medical expenses, as per the government order, in G.O.Ms.No.556, Finance (Salaries) Department, dated 8.11.2004. However, the said government order had been given effect to only from 8.11.2004. Therefore, the Angioplasty treatment undergone by the petitioner, from 19.11.2001 to 23.11.2001, would not be covered under the Tamilnadu Government Employees Health Fund Scheme, as the government order, in G.O.Ms.No.556, Finance (Salaries) Department, dated 8.11.2004, was prospective in operation. 9. It had also been stated that the request of the petitioner had not been denied, totally. In fact, the representation of the petitioner had been returned to him, advising him to approach the concerned administrative department of the Secretariat, through the Heads of the Department concerned, to obtain a special sanction order under the medical assistance rule. As such, the writ petition filed by the petitioner is not maintainable, as it is devoid of merits. 10. In view of the submissions made by the learned counsels appearing for the parties concerned and on a perusal of the records available, and on considering the decisions cited supra, this Court is of the view that the petitioner would be entitled to the reimbursement of the medical expenses incurred by him for undergoing the treatment of Angioplasty, in the Madras Medical Mission Hospital, Chennai, from 19.11.2001 to 23.11.2001. 11. 11. From the decisions cited by the learned counsel appearing on behalf of the petitioner, it could be seen that G.O.Ms.No.556, Finance (Salaries) Department, 8.11.2004, should be read as a clarification issued to G.O.Ms.No.400, Finance (Salaries) Department, dated 29.8.2000, and the other government orders providing certain medical benefits, under the Tamilnadu Government Employees Health Fund Scheme. Such clarifications issued by the State Government are in tune with the march of medical science. The government order, in G.O.Ms.No.556, Finance (Salaries) Department, dated 8.11.2004, cannot be read in a manner so as to restrict the application of G.O.Ms.No.400, Finance (Salaries) Department, dated 29.8.2000. 12. The object of the government order, in G.O.Ms.No.556, Finance (Salaries) Department, dated 8.11.2004, is to extend the benefits given under G.O.Ms.No.400, Finance (Salaries) Department, dated 29.8.2000, to those who had undergone the treatment of Angioplasty, as well. While so, it cannot be said that the benefit contemplated under G.O.Ms.No.556, Finance (Salaries) Department, dated 8.11.2004, should only be prospective in nature. As such, the petitioner would be entitled to the reimbursement of the medical expenses incurred by him for undergoing the treatment of Angioplasty in the Madras Medical Mission Hospital, Chennai. In such view of the matter, this Court finds it appropriate to direct the respondents to reimburse the amount of Rs.89,805/-, which is 75% of the total medical expenses incurred by the petitioner for undergoing the said treatment, from 19.11.2001 to 23.11.2001, at the Madras Medical Mission Hospital, Chennai, along with the interest at 9% per annum, from 23.1.2002, which is the date of the application of the petitioner for the reimbursement of the medical expenses, till the date of the actual payment of the said amount. The respondents are directed to disburse the amount due to the petitioner, within a period of three months from the date of receipt of a copy of this order. Accordingly, the writ petition stands allowed, with the above directions.