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BEFORE THE MADURAI BENCH OF MADRAS HIGH COURT
Reserved on : 03.08.2018
Pronounced on : 28.05.2019
CORAM:
THE HON'BLE MR. JUSTICE R.SURESH KUMAR
W.P.(MD).Nos.13429 of 2013, 16503 of 2013, 14165 of 2015,
420 of 2016, 839 of 2016, 4640 of 2016, 14983 of 2016,
21297 of 2016, 21803 of 2016, 24455 of 2016, 2610 of 2017,
4062 of 2017, 4148 of 2017, 4623 of 2017, 4783 of 2017,
7942 of 2017, 10747 of 2017, 10773 of 2017, 10868 of 2017,
10904 of 2017, 11051 of 2017, 11210 of 2017, 11733 of 2017,
11982 of 2017, 12075 of 2017, 12369 of 2017, 12855 of 2017,
13742 of 2017, 14467 of 2017, 15443 of 2017, 15468 of 2017,
18660 of 2017, 19316 of 2017, 19732 of 2017, 19814 of 2017,
19816 of 2017, 20054 of 2017, 20390 of 2017, 20391 of 2017,
21128 of 2017, 21183 of 2017, 21184 of 2017, 21190 of 2017,
21333 of 2017, 21644 of 2017, 21748 of 2017, 21822 of 2017,
21937 of 2017, 22093 of 2017, 22455 of 2017, 22879 of 2017,
23173 of 2017, 23422 of 2017, 23982 of 2017, 343 of 2018,
1811 of 2018, 6357 of 2018, 7038 of 2018, 7064 of 2018,
7065 of 2018, 7270 of 2018, 7931 of 2018, 8814 of 2018,
9087 of 2018, 9148 of 2018, 9535 of 2018, 9819 of 2018,
10098 of 2018, 11912 of 2018, 11927 of 2018, 12336 of 2018,
12389 of 2018, 12820 of 2018, 12858 of 2018, 13179 of 2018,
13180 of 2018, 13379 of 2018, 13380 of 2018, 13484 of 2018,
13512 of 2018, 13514 of 2018, 13918 of 2018, 14050 of 2018,
14723 of 2018, 15365 of 2018, 15521 of 2018, 16591 of 2018,
16795 of 2018, 16923 of 2018, 17404 of 2018 and 17332 of 2018
and connected miscellaneous petitions
W.P.(MD).No.13429 of 2013
In order to reconsider all these claim made by the respective writ petitioners for medical reimbursement, by remitting the matters back, the following directions are issued:
(i) All the impugned orders in the respective writ petitions in this batch of cases, are hereby quashed.
(ii) The writ petitions where impugned orders are quashed as well as the writ petitions where mandamus sought for, are hereby remanded with directions to the concerned District Level Empowered Committee, before whom, these matters shall be placed and the Committee shall reconsider every individual case.
(iii) While reconsidering, the Committee shall not reject any claim merely on the reason of non network hospital or non listed disease.
(iv) The Committee, wherever possible, shall give suitable direction to the Insurance Company to reimburse the claim made by the respective claimant / employee / pensioner.
(v) If the Committee finds some cases where the Insurance Company cannot be directed to reimburse, in those cases, suitable orders shall be passed directing / recommending the State authorities to reimburse the claim under Medical Attendance Rules.
(vi) Once such orders are passed, the Insurance Company shall immediately reimburse the medical claim with 6% interest from the date of due till date of payment, within a period of thirty days from the date of receipt of such order to be passed by the Empowered Committee of the District concerned.
(vii) On receipt of such orders / recommendation from the Empowered,Committee the Sanctioning authority / State authority/ High Power Committee in the State Level shall pass necessary orders allowing the medical reimbursement claimed by the individual claimant / employee / pensioner under the Medical Attendance Rules.
(viii) While ordering medical reimbursement under Medical Attendance Rules, the rate approved, accepted or quoted by the Insurance Company under the Medical Insurance Scheme shall be taken as the rate and by calculating the reimbursement on the said rate, the reimbursement claim shall be immediately sanctioned and the amount shall be reimbursed to the claimant with 6% interest form the date of due till date of payment, within a period of thirty days from the receipt of the recommendation / order from the District Empowered Committee. Withthese directions, all these writ petitions are ordered to the terms indicated above. Consequently, connected miscellaneous petitions are closed. However there shall be no order of costs.
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IN THE HIGH COURT OF JUDICATURE AT MADRAS
DATED: 20.03.2019
CORAM
THE HON'BLE MR. JUSTICE K.RAVICHANDRABAABU
W.P.No.5284 of 2019
I find the above decision of the Division Bench is squarely applicable to the present case as well. Accordingly, the writ petition is allowed and the impugned order is set aside. Consequently, the competent Authority of the first respondent Government is directed to examine the claim made by the petitioner for medical reimbursement under the Tamilnadu Medical Attendance Rules and disburse the eligible amount towards the same with interest at the rate of 9% per annum from the date of application viz., 26.02.2018 till date of payment. Such exercise shall be done by the first respondent within a period of eight weeks from the date of receipt of a copy of this order. No costs. The connected miscellaneous petition is closed.
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