K P RAMALINGAM Vs. DISTRICT COLLECTOR, VELLORE DISTRICT

JUDGEMENT

(1.) By way of filing this writ petition, the petitioner seeks a direction to the respondents to reimburse his Medical Bill Amount under the Pensioners New Health Insurance Scheme, 2014, for a sum of Rs.1,43,709/- with accrued interest at 9% per annum.

(2.) It is submitted by the learned counsel for the petitioner that the petitioner was a retired government servant, who worked as Assistant Agriculture Officer in Government Agriculture Department. He has been receiving his pension in P.P.O.No.C261837/AGM through Indian Overseas Bank, Allapuram Branch, Vellore, bearing Account No.13556. Whileso, the Government of Tamil Nadu had issued a G.O.Ms.No.171, Finance (Pension) Department, dated 26.06.2014, introducing New Health Insurance Scheme, 2014, for Pensioners (including spouse) Family Pensioners (in short "Scheme"). The petitioner had also subscribed the above said scheme so as to get Health Insurance Benefits. As per the said scheme, one has to take treatment in the approved hospital for the List of Accredited Treatments and Surgeries as per the Annexure II of the said G.O., therefore, it is stated that he is covered under the said scheme.

(3.) While the matter stood above, the grievance of the petitioner is that on 05.12.2014, due to chest pain, he was admitted into the Christian Medical College Hospital, Vellore, which is one of the approved hospitals under the said scheme, and on the said day itself, he was treated for Transradid Coronary Angiogram and Primary PTCA with stenting of RCA-PLB, and thereafter, he was discharged from the said hospital on 08.12.2004 on payment of Rs.1,43,709/- paid by him. Subsequently, he had sent a detailed representation dated 112.2014 to the third respondent requesting reimbursement of the said sum paid by him and he has also enclosed all the Original Bills, Insurance Scheme Approved Chit, Christian Medical College Hospital Medical Expenses Bill, Stamped Receipts, Discharge Certificate, Pension Book Copy and New Insurance Scheme Approved Letter. In turn, the third respondent, vide his proceedings dated 05.01.2015, sent a proposal to the fourth respondent to place it before the District Level Empowered Committee for its decision by recommending the claim of the petitioner. Thereafter, on 007.2015, the fourth respondent had recommended to the first respondent to reimburse the said medical bill amount under the said Scheme to all those 23 persons including the petitioner. The third respondent, in his proceedings dated 10.09.2015, called the petitioner to attend the meeting to be presided by the first respondent District Collector on 14.09.2015 to consider his claim for reimbursement of the said medical bill amount under the New Medical Insurance Scheme, 2014. Finally, on the date of the meeting, the petitioner was informed by the District Collector about the sanction of the said sum for reimbursement along with others and that the list of beneficiaries was also published in the newspaper on 14.09.2015 under the said Scheme. However, when the petitioner approached the third respondent for issuance of a cheque, he did not get proper reply from the said authority.