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HIGH COURT OF JUDICATURE AT MADRAS
Honourable Mr Justice M.DHANDAPANI
Velankanni.S – Appellant
Versus
The Additional Chief Secretary – Respondent
WP(MD)/364/2023
Insurance companies are liable to pay the eligible amount to the members of the New Health Insurance Scheme, 2018, as per the recommendations of the District Level Committee and the Commissioner of Treasuries and Accounts.
Headnote:
HEALTH INSURANCE - NEW HEALTH INSURANCE SCHEME, 2018 - PAYMENT OF ELIGIBLE AMOUNT - DIRECTION TO INSURANCE COMPANY - The court directed the insurance company to consider the proposal sent by the Commissioner of Treasuries and Accounts and pass appropriate orders on merits and in accordance with law within twelve weeks from the date of receipt of a copy of the order.
Fact of the Case:
The petitioner, a Graduate Teacher, was enrolled in the New Health Insurance Scheme, 2018. Her husband was admitted to the hospital with severe fever, cough, and breathlessness, and she incurred expenses of Rs. 3,00,481/- towards his treatment. The District Level Committee recommended payment of the expenditure, and the Commissioner of Treasuries and Accounts also recommended payment to the insurance company. However, the insurance company had not yet made the payment.
Finding of the Court:
The court directed the insurance company to consider the proposal sent by the Commissioner of Treasuries and Accounts and pass appropriate orders on merits and in accordance with law within twelve weeks from the date of receipt of a copy of the order.
Issues: Whether the insurance company was liable to pay the eligible amount to the petitioner as per the report sent by the Commissioner of Treasuries and Accounts and as per G.O.Ms.No.165, Finance (Health Insurance) Department, dated 01.06.2022.
Ratio Decidendi: The court relied on G.O.Ms.No.165, Finance (Health Insurance) Department, dated 01.06.2022, which provides for the payment of eligible amount to the members of the New Health Insurance Scheme, 2018.
Final Decision: The court directed the insurance company to consider the proposal sent by the Commissioner of Treasuries and Accounts and pass appropriate orders on merits and in accordance with law within twelve weeks from the date of receipt of a copy of the order.
W.P.(MD)No.364 of 2023
BEFORE THE MADURAI BENCH OF MADRAS HIGH COURT
DATED : 06.01.2023
CORAM
THE HONOURABLE MR.JUSTICE M.DHANDAPANI
W.P.(MD)No.364 of 2023
S.Velankanni
... Petitioner
Vs.
1. The Additional Chief Secretary,
Finance (Health Insurance) Department,
Secretariat,
Chennai - 600 009.
2. The Commissioner of Treasuries and Accounts,
3rd Floor, Anbazhagan Maaligai,
571, Anna Salai,
Nandanam,
Chennai – 600 035.
3. The Divisional Manager,
United India Insurance Company,
Divisional Office VI,
5th Floor, PLA Rathina Tower,
212, Anna Salai,
Chennai – 600 006.
... Respondents
_________
Page 1 of 6
https://www.mhc.tn.gov.in/judis
W.P.(MD)No.364 of 2023
PRAYER : Petition filed under Article 226 of the Constitution of India
praying for issuance of Writ of Mandamus directing the respondents 2 and
3, i.e., the Commissioner of Treasuries and Accounts, Chennai and the
Divisional Manager, United India Insurance Company Limited, Chennai to
make payment of the eligible amount to the petitioner as per the report sent
by the Commissioner of Treasuries an Accounts, Chennai also in his Letter
No.RC.6629/NHIS-1/2022, dated 27.07.2022 and as per G.O.Ms.No.165,
Finance (Health Insurance) Department, dated 01.06.2022.
For Petitioner
:
Mr.S.Visvalingam
For Respondents
:
Mrs.K.Christy Theboral
Addl. Govt. Pleader for R1 and R2
Mr.C.Karthik for R3
O R D E R
This Writ Petition has been filed for a direction to the respondents
2 and 3, i.e., the Commissioner of Treasuries and Accounts, Chennai and the
Divisional Manager, United India Insurance Company Limited, Chennai to
make payment of the eligible amount to the petitioner as per the report sent
by the Commissioner of Treasuries an Accounts, Chennai also in his Letter
No.RC.6629/NHIS-1/2022, dated 27.07.2022 and as per G.O.Ms.No.165,
Finance (Health Insurance) Department, dated 01.06.2022.
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W.P.(MD)No.364 of 2023
2. The case of the petitioner is that the petitioner is working as
Graduate Teacher in the Panchayat Union Middle School, Keezhappidavoor,
Manamadurai Union, Sivagangai District. The petitioner has been enrolled
as a member of the New Health Insurance Scheme, 2018 and a sum of
Rs.300/- is deducted every month from her salary towards subscription for
the said Scheme. While so, the petitioner's husband was suffering from
severe fever, cough and breathlessness and he was admitted in the hospital.
The petitioner has spent a sum of Rs.3,00,481/- (Rupees Three Lakhs Four
Hundred and Eighty One only) towards her husband's treatment. Hence, the
District Level Committee has recommended payment of the expenditure
incurred by her, vide letter dated 09.08.2021 to the Divisional Manager,
United India Insurance Company, Chennai, for making payment and also the
Commissioner of Treasuries and Accounts, Chennai, has recommended to
the Divisional Manager, United India Insurance Company Limited,
Chennai, for making payment vide letter No.Rc.No.6629/NHIS-1/2022,
dated 27.07.2022. However, till date, the same has not been considered by
the United India Insurance Company, Chennai. Therefore, the petitioner has
filed the present Writ Petition with the aforesaid prayer.
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W.P.(MD)No.364 of 2023
3. The learned counsel appearing for the petitioner would submit
that it would suffice, if the third respondent is directed to consider the
proposal sent by the second respondent dated 27.07.2022, in terms of
G.O.Ms.No.165, Finance (Health Insurance) Department, dated 01.06.2022
on merits and in accordance with law, within a specified period.
4. The learned counsel appearing for the respondents has no
serious objection for such an order being passed by this Court.
5. Considering the limited request made by the learned counsel for
the petitioner, this Court, without going into the
