IN THE HIGH COURT OF JUDICATURE AT MADRAS DATED : 18.02.2026 CORAM:

THE HONOURABLE MR. JUSTICE T.VINOD KUMAR W.P.No . 2550 of 202 2 a nd W.M.P.No.2684 of 2022 Kasthuri Bai ... Petitioner vs

1. The Government of Tamil Nadu, Rep. By its Secretary, Health Department, Fort St. George, Chennai – 600 009.

2. United India Insurance Co. Ltd.

Divisional Office VI, Rep. By its Divisional Manager, 5th Floor, P.L.A.Rathna Towers, No.212, Anna Salai, Chennai – 600 006.

3. The Commissioner of Treasuries and Accounts, 2nd Floor, Panagal Building, Jeenish Road, Chennai – 15.

4. The Joint Director, Rural Health Service, DMS Compound, Chennai – 600 006. … Respondents Prayer: Writ Petition is filed under Article 226 of the Constitution of India, praying to issue a Writ of Certiorarified Mandamus, to call for the records of the second respondent vide its letter dated 20.04.2016 and quash the same and direct the second respondent reimburse the medical claim of the petitioner for a sum of Rs.1,66,595/- (Rupees One Lakh Sixty Six Thousand Five Hundred and Ninety Five Only) along with 24% p.a interest, within the time frame as may be fixed by this Court.

For Petitioner : Mr.A.Murali For Respondents : Mr.K.Tippusulthan Government Advocate for R1, R3 & R4 : Mr.P.Sankara Narayanan Standing Counsel for R2

O R D E R

Heard the learned counsel for the petitioner and the learned Government Advocate appearing on behalf of the respondents 1,3 and 4 and the learned Standing Counsel for the second respondent and perused the records.

2. The petitioner, by the present writ petition, has assailed the action of the second respondent in issuing impugned proceedings dated 20.04.2016 by which the claim for reimbursement of medical expenses submitted by her has been rejected by the second respondent on the ground that the petitioner had obtained treatment in a non-network hospital and thus, she is not entitled for reimbursement.

3. Petitioner contends that she had served as Record Clerk in the office of the Inspector General of Prison, Government of Tamil Nadu, Egmore, Chennai and took Voluntarily Retirement from the service with effect from 09.08.2001; that on being relieved from service, she was made eligible/entitled to avail all the retirement benefits for the service rendered by her with the Government of Tamil Nadu.

4. Petitioner contends that the first respondent had made a provision for medical insurance under the Tamil Nadu Government Pensioners Health Fund Scheme, 1995; and the amount payable for providing insurance coverage was recovered on monthly basis.

5. It is the further case of the petitioner that on 17.08.2015, she had met with a road accident, which resulted in severe injuries to her right leg and while she was lying on the road side with severe pain and become unconscious, she was taken to the nearby hospital for first aid and then shifted to M/s.Agada Hospital, T.Nagar, Chennai and was admitted in casualty for emergency treatment.

6. It is the further case of the petitioner that the Doctors at the said hospital after diagnosis, had found that right femur had got fracture and was advised to undergo immediate surgery and accordingly, surgery was performed on 18.08.2015; and that the surgery performed was “open reduction internal fixation using distal femoral locking compression plate and screw”; that the petitioner was treated as inpatient on 25.08.2015 and was discharged; that at the time of discharge, the petitioner had settled the hospital bills amounting to Rs.1,66,595/- (Rupees One Lakh Sixty Six Thousand Five Hundred and Ninety Five Only) by herself.

7. Petitioner further contends that the petitioner having incurred the aforesaid expenses for getting herself treated for the injuries sustained by her in an accident, had approached the respondent authority and submitted a representation on 09.09.2015 enclosing therewith the hospital bills and sought for reimbursement of the said medical expenses incurred as she is covered by the Health Fund Scheme of the respo