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W.P.No.30187 of 2025IN THE HIGH COURT OF JUDICATURE AT MADRASDated : 22.08.2025CORAMTHE HONOURABLE Ms. JUSTICE P.T. ASHAW.P.No.30187 of 2025and WMP.Nos.33867 & 33870 of 2025J.Kamalakumari... PetitionerVs1.The Government of Tamil Nadu Represented by its Principal Secretary Finance Department, Fort St.George, Chennai - 600 009.2.The Principal Secretary / Commissioner of Treasuries and Accounts III Floor, Integrated Office Complex for Finance Department Veterinary Hospital Campus, Anna Salai Nandanam, Chennai - 600 035.3.United India Insurance Co. Ltd., Rep. by its Chairman cum Managing Director Head Office, 24, Whites Road Chennai - 600 014.4.MD India Health Insurance TPA Private Limited Rep by its Director Guna Complex New Door Nos.443 & 445, Old Door Nos.304 & 305 Anna Salai, Teynampet, Chennai - 600 018.1/9 https://www.mhc.tn.gov.in/judis W.P.No.30187 of 20255.Asian Institute of Nephrology and Urology Rep by its Executive Director and Senior Consultant No.21, Dr.Thirumurthy Nagar Main Road Nungambakkam, Chennai - 600 034. ... RespondentsPrayer: Writ Petition filed under Article 226 of the Constitution of India praying to issue a Writ of Certiorarified Mandamus calling for the entire records from the fourth respondent ending with Letter of Administration 1 dated 28.07.2025 issued by the fourth respondent and quash the same and direct the respondents to provide cashless payment of Rs.2,00,000/- to the fifth respondent for the medical treatment of Mr.J.Jason Joseph, the spouse of the petitioner as per the New Health Insurance Scheme 2022 for pensioners (including spouse) / family pensioners.For Petitioner: Mr.D.Moses JayakaranFor Respondents : Mr.V.Jeeva Giridharan Additional Government Pleader for R1 & R2 Mr.Raghavan for R3 Mr.Vishnu Manoharan for R5 R4 - No appearance ORDERThe petitioner herein seeks to quash the order passed by the fourth respondent dated 28.07.2025 and to direct the fourth respondent to provide cashless payment of Rs.2,00,000/- to the fifth respondent for the treatment of petitioner's husband Mr.J.Jason Joseph, as per the New Health Insurance 2/9 https://www.mhc.tn.gov.in/judis W.P.No.30187 of 2025Scheme, 2022.2. The facts are briefly set out herein below :a)The petitioner had served as B.T.Assistant teacher in Government Model Higher Secondary School, Triplicane, Chennai for over 17 years. She had retired on 31.12.2017, and had been receiving her pension since then.b)The petitioner would submit that in the year 2018, the Government of Tamil Nadu had introduced New Health Insurance Scheme 2018 to the pensioners (including spouse)/ Family Pensioners [N HISP], vide G.O.Ms.No.222 Finance (Pension) Department dated 30.06.2018, providing cashless treatment to pensioners and their spouse. The same Health Scheme was subsequently extended from 01.07.2022 to 30.06.2026 and the coverage amount was also enhanced vide G.O.Ms.No.142 dated 24.05.2022.c)This cashless health scheme is introduced for the pensioners including their spouse, to enable the pensioners to undergo medical treatment for the ailments covered under the scheme, without insisting upon them to pay the hospital expenses, if they are 3/9 https://www.mhc.tn.gov.in/judis W.P.No.30187 of 2025covered under the scheme. d)The Government of Tamil Nadu for effective functioning of this health scheme, had entered into an arrangement with the United India Insurance Co.Ltd., the third respondent herein. The fourth respondent herein is a coordinating company for the approval of the insurance scheme from the pensioners. e)The petitioner have registered herself under this cashless scheme, and her spouse is also eligible to avail the cashless treatment. f)The petitioner would submit that her husband J.Jason Joseph, who was 72 years old, was diagnosed with recurring urinary tract infection. He was advised to undergo immediate surgical treatment by way of circumcision and HoLEP (Holmium Laser Enucleation of the Prostrate) by the 5th respondent-Hospital. A medical certificate was also issued on 31.07.2025, advising him to undergo the clinical procedures within ten days time. g)The petitioner would also submit that the fifth respondent-Hospital finds a place in the empanelled approved list of hospitals under the NHISP scheme for the said surgery.h)When the petitioner approached the fourth respondent at the fifth 4/9 https://www.mhc.tn.gov.in/judis W.P.No.30187 of 2025respondent-Hospital, she was informed that the expected total package for the treatment would be a sum of Rs.2,00,500/-and the fourth respondent had issued an Authorisation Letter dated 28.07.2025, intimating that, under the scheme, his spouse was eligible only for a sum of Rs.20,000/-. i)The petitioner would submit that the fourth respondent, without getting any information or signature from her, they themselves had filled the form and submitted the same to the fifth respondent, and also required the petitioner to pre-deposit a sum of Rs.2,00,000/- to the fifth respondent, for getting his spouse admitted in the hospital for treatment. Challenging the said authorization letter dated 28.07.2025, the petitioner is before this Court.3. The petitioner would contend that she and her husband are entitled to a cashless treatment of Rs.5,00,000/- as contained in Annexure-I of the Guidelines of the New Health Insurance Scheme (including spouse) / Family Pensioner. In the said circumstances, the fourth respondent cannot deny the 5/9 https://www.mhc.tn.gov.in/judis W.P.No.30187 of 2025coverage of Rs.5,00,000/- and restrict the same to Rs.20,000/-. The authorisation letter was issued by the fourth respondent to the fifth respondent on 28.07.2025, without obtaining any signature from the petitioner. That apart, despite her request to the fourth respondent to furnish the authorisation letter, the same was refused, and it is only the fifth respondent who had furnished her a copy of the authorisation letter. Though the petitioner is entitled to a sum of Rs.5,00,000/-, under the health coverage plan, the fourth respondent has violated the provisions of the New Health Insurance Scheme, 2022 for Pensioner, held out by the Government of Tamil Nadu, and without any basis, had fixed the assured amount only to Rs.20,000/-. Since the impugned authorisation letter dated 28.07.2025 is contrary to the scheme held out by the Government, the petitioner is before this Court to quash the same, and to direct the respondents to provide cashless payment of Rs.2,00,000/- to the fifth respondent, for the medical treatment of her husband. 4. Heard the learned counsel appearing for the petitioner and the learned counsel appearing for the respondents.5. After hearing the counsels on either side, this Court issues the 6/9 https://www.mhc.tn.gov.in/judis W.P.No.30187 of 2025following directions :i.The fourth respondent shall on behalf of the third respondent release a sum of Rs.58,000/- for the HoLEP surgery, which the petitioner's husband has to undergo in the fifth respondent Hospital. ii.With regard to the surgical cost involved for the other two surgeries which the petitioner has to undergo after the HoLEP surgery is concluded, the petitioner has undertaken to make an application to the District Level Empowered Committee. Upon receipt of the application from the petitioner, the District Level Empowered Committee, shall dispose of the said application within a period of one month.5. With the above directions, the writ petition is disposed of. No costs. Consequently, connected miscellaneous petitions are closed.22.08.2025 Index : Yes / NoNeutral Citation : Yes / NodsTo :7/9 https://www.mhc.tn.gov.in/judis W.P.No.30187 of 20251.The Government of Tamil Nadu Represented by its Principal Secretary Finance Department, Fort St.George, Chennai - 600 009.2.The Principal Secretary / Commissioner of Treasuries and Accounts III Floor, Integrated Office Complex for Finance Department Veterinary Hospital Campus, Anna Salai Nandanam, Chennai - 600 035.8/9 https://www.mhc.tn.gov.in/judis W.P.No.30187 of 2025P.T. ASHA, J, dsW.P.No.30187 of 202522.08.20259/9
W.P.No.30187 of 2025IN THE HIGH COURT OF JUDICATURE AT MADRASDated : 22.08.2025CORAMTHE HONOURABLE Ms. JUSTICE P.T. ASHAW.P.No.30187 of 2025and WMP.Nos.33867 & 33870 of 2025J.Kamalakumari... PetitionerVs1.The Government of Tamil Nadu Represented by its Principal Secretary Finance Department, Fort St.George, Chennai - 600 009.2.The Principal Secretary / Commissioner of Treasuries and Accounts III Floor, Integrated Office Complex for Finance Department Veterinary Hospital Campus, Anna Salai Nandanam, Chennai - 600 035.3.United India Insurance Co. Ltd., Rep. by its Chairman cum Managing Director Head Office, 24, Whites Road Chennai - 600 014.4.MD India Health Insurance TPA Private Limited Rep by its Director Guna Complex New Door Nos.443 & 445, Old Door Nos.304 & 305 Anna Salai, Teynampet, Chennai - 600 018.1/9 https://www.mhc.tn.gov.in/judis W.P.No.30187 of 20255.Asian Institute of Nephrology and Urology Rep by its Executive Director and Senior Consultant No.21, Dr.Thirumurthy Nagar Main Road Nungambakkam, Chennai - 600 034. ... RespondentsPrayer: Writ Petition filed under Article 226 of the Constitution of India praying to issue a Writ of Certiorarified Mandamus calling for the entire records from the fourth respondent ending with Letter of Administration 1 dated 28.07.2025 issued by the fourth respondent and quash the same and direct the respondents to provide cashless payment of Rs.2,00,000/- to the fifth respondent for the medical treatment of Mr.J.Jason Joseph, the spouse of the petitioner as per the New Health Insurance Scheme 2022 for pensioners (including spouse) / family pensioners.For Petitioner: Mr.D.Moses JayakaranFor Respondents : Mr.V.Jeeva Giridharan Additional Government Pleader for R1 & R2 Mr.Raghavan for R3 Mr.Vishnu Manoharan for R5 R4 - No appearance ORDERThe petitioner herein seeks to quash the order passed by the fourth respondent dated 28.07.2025 and to direct the fourth respondent to provide cashless payment of Rs.2,00,000/- to the fifth respondent for the treatment of petitioner's husband Mr.J.Jason Joseph, as per the New Health Insurance 2/9 https://www.mhc.tn.gov.in/judis W.P.No.30187 of 2025Scheme, 2022.2. The facts are briefly set out herein below :a)The petitioner had served as B.T.Assistant teacher in Government Model Higher Secondary School, Triplicane, Chennai for over 17 years. She had retired on 31.12.2017, and had been receiving her pension since then.b)The petitioner would submit that in the year 2018, the Government of Tamil Nadu had introduced New Health Insurance Scheme 2018 to the pensioners (including spouse)/ Family Pensioners [N HISP], vide G.O.Ms.No.222 Finance (Pension) Department dated 30.06.2018, providing cashless treatment to pensioners and their spouse. The same Health Scheme was subsequently extended from 01.07.2022 to 30.06.2026 and the coverage amount was also enhanced vide G.O.Ms.No.142 dated 24.05.2022.c)This cashless health scheme is introduced for the pensioners including their spouse, to enable the pensioners to undergo medical treatment for the ailments covered under the scheme, without insisting upon them to pay the hospital expenses, if they are 3/9 https://www.mhc.tn.gov.in/judis W.P.No.30187 of 2025covered under the scheme. d)The Government of Tamil Nadu for effective functioning of this health scheme, had entered into an arrangement with the United India Insurance Co.Ltd., the third respondent herein. The fourth respondent herein is a coordinating company for the approval of the insurance scheme from the pensioners. e)The petitioner have registered herself under this cashless scheme, and her spouse is also eligible to avail the cashless treatment. f)The petitioner would submit that her husband J.Jason Joseph, who was 72 years old, was diagnosed with recurring urinary tract infection. He was advised to undergo immediate surgical treatment by way of circumcision and HoLEP (Holmium Laser Enucleation of the Prostrate) by the 5th respondent-Hospital. A medical certificate was also issued on 31.07.2025, advising him to undergo the clinical procedures within ten days time. g)The petitioner would also submit that the fifth respondent-Hospital finds a place in the empanelled approved list of hospitals under the NHISP scheme for the said surgery.h)When the petitioner approached the fourth respondent at the fifth 4/9 https://www.mhc.tn.gov.in/judis W.P.No.30187 of 2025respondent-Hospital, she was informed that the expected total package for the treatment would be a sum of Rs.2,00,500/-and the fourth respondent had issued an Authorisation Letter dated 28.07.2025, intimating that, under the scheme, his spouse was eligible only for a sum of Rs.20,000/-. i)The petitioner would submit that the fourth respondent, without getting any information or signature from her, they themselves had filled the form and submitted the same to the fifth respondent, and also required the petitioner to pre-deposit a sum of Rs.2,00,000/- to the fifth respondent, for getting his spouse admitted in the hospital for treatment. Challenging the said authorization letter dated 28.07.2025, the petitioner is before this Court.3. The petitioner would contend that she and her husband are entitled to a cashless treatment of Rs.5,00,000/- as contained in Annexure-I of the Guidelines of the New Health Insurance Scheme (including spouse) / Family Pensioner. In the said circumstances, the fourth respondent cannot deny the 5/9 https://www.mhc.tn.gov.in/judis W.P.No.30187 of 2025coverage of Rs.5,00,000/- and restrict the same to Rs.20,000/-. The authorisation letter was issued by the fourth respondent to the fifth respondent on 28.07.2025, without obtaining any signature from the petitioner. That apart, despite her request to the fourth respondent to furnish the authorisation letter, the same was refused, and it is only the fifth respondent who had furnished her a copy of the authorisation letter. Though the petitioner is entitled to a sum of Rs.5,00,000/-, under the health coverage plan, the fourth respondent has violated the provisions of the New Health Insurance Scheme, 2022 for Pensioner, held out by the Government of Tamil Nadu, and without any basis, had fixed the assured amount only to Rs.20,000/-. Since the impugned authorisation letter dated 28.07.2025 is contrary to the scheme held out by the Government, the petitioner is before this Court to quash the same, and to direct the respondents to provide cashless payment of Rs.2,00,000/- to the fifth respondent, for the medical treatment of her husband. 4. Heard the learned counsel appearing for the petitioner and the learned counsel appearing for the respondents.5. After hearing the counsels on either side, this Court issues the 6/9 https://www.mhc.tn.gov.in/judis W.P.No.30187 of 2025following directions :i.The fourth respondent shall on behalf of the third respondent release a sum of Rs.58,000/- for the HoLEP surgery, which the petitioner's husband has to undergo in the fifth respondent Hospital. ii.With regard to the surgical cost involved for the other two surgeries which the petitioner has to undergo after the HoLEP surgery is concluded, the petitioner has undertaken to make an application to the District Level Empowered Committee. Upon receipt of the application from the petitioner, the District Level Empowered Committee, shall dispose of the said application within a period of one month.5. With the above directions, the writ petition is disposed of. No costs. Consequently, connected miscellaneous petitions are closed.22.08.2025 Index : Yes / NoNeutral Citation : Yes / NodsTo :7/9 https://www.mhc.tn.gov.in/judis W.P.No.30187 of 20251.The Government of Tamil Nadu Represented by its Principal Secretary Finance Department, Fort St.George, Chennai - 600 009.2.The Principal Secretary / Commissioner of Treasuries and Accounts III Floor, Integrated Office Complex for Finance Department Veterinary Hospital Campus, Anna Salai Nandanam, Chennai - 600 035.8/9 https://www.mhc.tn.gov.in/judis W.P.No.30187 of 2025P.T. ASHA, J, dsW.P.No.30187 of 202522.08.20259/9