P.SARAVANAN Vs. PROJECT HEAD/THE OPERATION MANAGER

JUDGEMENT

(1.) This writ petition is filed challenging the order of the first respondent in GTMO 21/06/209, dated 29.06.2019 and quash the same and for a direction to the first respondent to reimburse the Medical Expenses of Rs.2,56,787/- incurred by the petitioner, for taking Medical treatment at G.Kuppusamy Memorial Hospital, Coimbatore, with 12% interest from the date of remittance of the amount to the Hospital, till the date of payment.

(2.) The petitioner has taken a Medical Insurance, bearing Number PMD/01/BB102/NH/S16/83143 and GPF/EPF No.7128788. While he went to Coimbatore to his relative's house, he suffered heavy pain in the chest on 05.02.2019 and immediately, he got admitted in G.Kuppusamy Naidu Memorial Hospital, Coimbatore and underwent Elective Off Pump Coronary Artery Bypass X3 Graft(s) Surgery on 07.02.2019 and was discharged on 13.02.2019. The total expenses incurred by the petitioner for the said surgery is Rs.2,56,787/- and he paid the same to the hospital, as the hospital is non-Network hospital. The petitioner submitted the bills to the second respondent with three copies to claim the amounts and requested reimbursement as per G.O(Ms)No.391 Finance (Salaries) Department, dated 10.12.2018.

(3.) Again, the petitioner forwarded all the details to the second respondent on 03.06.2019 to reimburse the medical expenses incurred by him as per the New Health Insurance Scheme. The second respondent forwarded the claim of the petitioner to the first respondent, by the proceedings, dated 27.03.2019, mentioning G.O. (Ms) No.391, Finance (Salaries) Departments, dated 10.12.2018. The claim forwarded by the second respondent was received by the first respondent on 06.04.2019. The first respondent rejected the claim by quoting G.O.No.202, dated 20.06.2016, wherein it has been stated that the hospitals approved by the insurance company under this scheme alone should be approved by first respondent.