The interpretation of the Scheme and Circular should align with the real intention of mitigating medical expenses for the beneficiaries, particularly when the beneficiary belongs to a weaker section of the society.

Aggrieved by the order of the respondent dated 18.10.2001, declining to reimburse the expenses incurred by the petitioner towards heart surgery done to his wife from the Labour Welfare Fund, the petitioner has filed the above writ petition to quash the same and consequently direct the respondent to reimburse the medical expenses.

2. The case of the petitioner is briefly stated hereunder

The petitioner is working as an Assistant Tradesman in the respondent - Metro Transport Corporation, Chennai 2. The conditions of service of the workmen employed in the State owned Transport Undertakings are governed by periodical settlements entered into between the Central Trade Unions and all the State Transport Corporations. In the last settlement dated 13.02.1999, entered under Section 12 (3) of the Industrial Disputes Act, 1947 (in short "the Act"), under Item 79 of the Settlement, it was agreed to introduce a "Special Medical Assistance Scheme" to the workmen in addition to the medical benefits in existence. As per Clause 79 (2), the Scheme was to be called as "Tamil Nadu Transport Corporation Employees Family Medical Assistance Scheme" (in short "the Scheme"). As per Clause 79 (3), the workmen is entitled upto a maximum of Rs.1 lakh for undergoing five special medical treatment provided therein either for himself or for his family members. In addition to the five special medical treatment / surgeries, the Board is authorised to include any other disease / surgery / treatment. The reimbursement scheme was agreed to be implemented out of the Labour Welfare Fund, for which the workman has to contribute Rs.5/- per month from his salary and the management has to pay an equal contribution to the Fund. These contributions are payable as per Clause 79 (4) and (5) respectively. Further, the names of 17 approved and recognised hospitals for taking such treatment / surgery are mentioned in the circular.

3. It is further stated that when the Special Medical Assistance Scheme was introduced, implemented and when the same was in force, his wife - Menaka suffered with a serious heart problem and she was taken to Madras Medical Mission Hospital. After examination, he was told that there was a block in Aortic valve running down from his wife's heart and informed that his wife was suffering from severe Co-Aorta amounting to interruption in Bicuspid aortic valve and advised that it has to be removed immediately by surgery. She was admitted to the hospital on 17.12.2001; operated on 18.12.2001 and discharged on 26.12.2001. He applied for medical expenses in advance to carry out heart surgery to his wife. By the impugned order dated 18.10.2001, the respondent refused to pay him the medical expenses on the ground that the surgery to be done to his wife was "closed heart surgery" and as per the Scheme, the workmen are entitled to reimbursement only in the case of "open heart surgery". Immediately after the surgery and after discharge from the hospital, once again he made a request to the respondent by letter dated 12.01.2002 to reimburse the medical expenses incurred thereon. Their Union also wrote a letter dated 30.01.2002, recommending his claim. He also met the higher officials several time in person. In the absence of any positive reply and having no other remedy, filed the present writ petition.

4. Pursuant to the direction, the Assistant Manager (Legal) of the respondent Corporation filed a counter affidavit disputing various averments made by the petitioner. It is stated that the petitioner's wife had undergone only "closed heart surgery", which disease is not included in the Circular dated 09.04.1999 of the respondent Corporation, hence the petitioner is not entitled to claim medical reimbursement, since as per the Scheme and the Circular, the medical reimbursement can be claimed in respect of the diseases mentioned therein and not in respect of all diseases pertaining to "Heart". The heart operation strictly to mean only "open heart surgery"