J U D G M E N T

(Judgment of the Court was made by P.D.AUDIKESAVALU, J.)

The intra-court appeal arises from the order dated 17.12.2018 in W.P. No.

25822 of 2014 passed by the Learned Judge of this Court.

2. The First Respondent had retired from Government Service and has availed the benefits of the New Health Insurance Scheme, 2014 (hereinafter referred to as 'NHIS' for short) of the Government of Tamil Nadu in G.O. Ms. No. 171, Finance (Pension) Department dated 26.06.2014 from the Appellant/Insurance Company by making periodical contributions towards insurance premia from his pension. According to the First Respondent, he had underwent treatment at St. Isabel Hospital, Chennai from 11.10.2017 to 03.11.2017 for which he had incurred medical expenses of Rs. 2,63,154/-, and when he made a claim for reimbursement of the said medical expenses under the New Health Insurance Scheme, 2014, the Appellant by letter dated 13.08.2018 addressed to the Third Respondent stated that as the treatment was taken in a non-network hospital, it could not be considered as per G.O. Ms. No. 171, Finance (Pension) Department dated 26.06.2014 issued by the Government of Tamil Nadu.

3. In that factual backdrop, the First Respondent had filed W.P. No. 32618 of 2018 before this Court challenging the letter dated 13.08.2018 sent by the Appellant to the Third Respondent rejecting his claim for medical reimbursement and had sought for consequential direction to the Appellant to make payment of the said sum of Rs. 2,63,154/- towards reimbursement of medical expenses with interest at the rate of 9% per annum from the date of making the claim till actual payment. The Writ Court by order dated 17.12.2018 disposed the Writ Petition by directing the Appellant to consider the claim of the Petitioner in the light of another G.O. Ms. No. 222, Finance (Pension) Department dated 30.06.2018 which was stated to cover the treatment in Non-Network Hospital and pass orders within a period of four weeks from the date of receipt of a copy of that order, aggrieved by which the Appellant has preferred this appeal.

4. Since the First Respondent died on 14.07.2020 after the filing of the Writ Appeal, his wife, son and daughters have been impleaded as the Fifth to Eight Respondents in the Writ Appeal in his place by order dated 05.08.2021 in C.M.P. No. 11716 of 2021 passed by the Court. After the death of the Sixth Respondent on 16.09.2021, her husband and sons have been impleaded as the Ninth to Twelfth Respondents by order dated 06.09.2022 in C.M.P. No. 12055 of 2022 passed by the Court.

5. We have heard Mr. T.Shanmugam, Learned Counsel for the Appellant, Mrs. M.Geetha Thamaraiselvan, Learned Special Government Pleader appearing for the Second to Fourth Respondents and Mrs. Sangeetha Rajkumar, Learned Counsel for the Fifth and Seventh to Twelfth Respondents and perused the materials placed on record, apart from the pleadings of the parties.

6. It is vehemently pleaded by Learned Counsel for the Appellant that the Writ Court ought not to have fastened any liability on the Appellant when it was not liable under the New Health Insurance Scheme for any treatment taken at Non-Network Hospitals in view of the decision the Division Bench of this Court in Star Health and Allied Insurance Company -vs- A.Chokkar [(2010) 2 LW 90], which has been followed by other Division Benches of this Court in India Healthcare Services (TPA) Limited -vs- K.Parameshwari (Order dated 16.12.2016 in W.A. (MD) No. 1579 of 2016) and Director of Pension -vs-

B.Sarada (Order dated 09.11.2017 in W.A. (MD) No. 1382 of 2017).

7. In the decision of the Division Bench of this Court in Star Health and Allied Insurance Company Limited -vs- A.Chokkar [(2010) 2 LW 90], the legal position relating to reimbursement of the medical expenses by the Insurance Company has been explained as follows:-

“24. In the present case, what we have to decide is whether the State is bound to reimburse the claim, whether the insurance company is bo