S.VENKITTUSAMY Vs. GOVERNMENT OF TAMILNADU

JUDGEMENT

(1.) The petitioner is aggrieved against the proceedings of the fourth respondent dated 28.08.2018, wherein and whereby, his medical claim was rejected on the ground that the petitioner has taken the treatment in a non network hospital in respect of a non scheduled treatment. Consequently, the petitioner seeks for a direction to the respondents to reimburse the medical expenses of Rs.2,81,629/- incurred by him for taking treatment at G.Kuppusamy Naidu Memorial Hospital, Coimbatore with interest at the rate of 9% from 26.2.2018.

(2.) It is seen that the petitioner, who retired from the Revenue Department, seeks reimbursement of medical expenses met out by him in pursuant to the treatment, he has taken from G.Kuppusamy Naidu Memorial Hospital, Coimbatore on 19.02.2018. It is stated that the petitioner was admitted on 16.02.2018 and discharged on 20.02.2018. In between, it is stated that the petitioner had undergone his surgery on 19.02.2018. The petitioner seeks the reimbursement benefit under the Scheme introduced by the Government National Health Insurance Scheme, 2014. However, the claim of the petitioner for reimbursement was rejected by passing the impugned order only on the reason that the petitioner took the treatment in a non network hospital, which was not approved by the above said scheme.

(3.) Learned counsel for the petitioner by relying on recent decision of the Division Bench in W.A.No.2729 of 2018 dated 04.02.2019 submitted that if the Insurance Company is not liable to pay, it is for the Government to consider the claim and reimburse the petitioner.