IN THE HIGH COURT OF JUDICATURE AT MADRAS

DATED : 04.12.2025

CORAM

THE HONOURABLE MR.JUSTICE M.DHANDAPANI

M.Kizer Mohammed ... Petitioner

Vs.

1.The Government of Tamil Nadu,

Rep.by its Principal Secretary,

To Government, Finance (Salaries) Department,

Secretariat,

Chennai-600 009.

2.The Commissioner of Treasuries and Accounts,

Chennai-25.

3.The Treasury Officer,

District Treasury,

Coimbatore.

4.The Deputy Director,

Annamalai Tiger Reserve,

Pollachi, Coimbatore District.

5.The District Collector/Chairman District Level Empowered Committee,

National Health Insurance Scheme,

Coimbatore-18.

6.The United India Insurance Company Limited, Divisional Office IV, 212, Anna Salai, Chennai-6.

....Respondents PRAYER : Writ Petition filed under Article 226 of the Constitution of India praying for issuance of a Writ of Mandamus, to direct the first respondent to pass appropriate orders for disbursing Rs.2,15,921/- towards medical reimbursement forthwith.

For Petitioner : Mr.T.Dharani For Respondents : Mr.P.Balathandayutham Special Government Pleader

O R D E R

The petitioner seeks a direction to the first respondent to disburse a sum of Rs.2,15,921/- incurred towards medical reimbursement for the treatment taken by him.

2. The petitioner, who is a Forest Guard in Annamalai Tiger Reserve Division, Pollachi Range, Coimbatore District, suffered from illness and was admitted in the hospital in the year 2021. He underwent surgery and incurred a total sum of Rs.2,95,740/-. He was covered under the National Health Insurance Scheme by the United India Insurance Company Limited and the monthly premium payable to the Insurance Company was deducted from his salary. The petitioner after discharged from the hospital has submitted necessary document to the fourth respondent for reimbursement under the National Health Insurance Scheme. He had availed cashless treatment benefits under the National Health Insurance Scheme to the tune of Rs.79,820/-. The fourth respondent, in letter dated 18.12.2022, informed the petitioner that the matter be placed before the District Level Empowered Committee headed by the District Collector along with the Joint Director of Medical and Rural Health Services and the District Treasury Officer. Later, the third respondent informed that the application of the petitioner was also recommended by the District Level Empowered Committee/fifth respondent and that the Insurance Company has remitted a sum of Rs.79,820/- under cashless treatment basis to the hospital, the balance of Rs.2,15,921/- has to be settled by the Government. Thereafter, the petitioner has sent a representation on 07.09.2022 to the respondents seeking reimbursement of Rs.2,15,921/-, however, the same was not considered so far. Hence, the petitioner is before this Court.

3. Heard the learned counsel appearing for the petitioner and the learned Special Government Pleader appearing for the respondents.

4. The counter affidavit is filed on behalf of the second respondent stating that since the maximum eligible amount of Rs.79,820/- has already been settled to the petitioner by the sixth respondent, as per G.O.(Ms).No.202, Finance (Salaries) Department, dated 30.06.2016 under the New Health Insurance Scheme, 2016, the claim of the petitioner herein for the remaining amount would not be considered.

5. Considering the submission made by both sides, this Court is of the view that the petitioner is covered under the New Health Insurance Scheme, 2016, and the total amount incurred by him is Rs.2,95,740/-, of which, Rs.79,820/- has already been settled to the petitioner by the sixth respondent. Therefore, the petitioner has to pursue the disburse of the remaining amount before the concerned Authority by producing the relevant documents in the manner known to law.

6. Accordingly, this Writ Petition is dismissed. There shall be no order as to costs. 04.12.2025 NCC: Yes / No Index : Yes / No Speaking Order : Yes / No ssb To

1.The Government of Tamil Nadu, Rep.by its Principal Secretary, To Government, Fina