Dinesh Lambart Rajan S Vs The District Collector

a writ of certiorarified Mandamus to call for the records pertaining to the impugned order in claim in Ref:010600/CR-478/21/2024, dated 07.02.2025 issued by the second respondent and quash the same as illegal and consequently direct the second respondent to process and reimburse the medical claim of the petitioner.

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For Petitioner : Mr.G.M.Xavier For Respondents : Mr.F.Deepak Spl Govt., Pleader for RR1 &R3 Mr.Robert Chandrakumar for R2

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O R D E R

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This Writ Petition had been filed to quash impugned order, dated 07.02.2025 issued by the second respondent as illegal and consequently direct the second respondent to process and reimburse the medical claim of the petitioner.

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Heard Mr.G.M.Xavier, the learned counsel appearing for the petitioner and Mr.F.Deepak, learned Special Government Pleader appearing for the first & third respondents and Mr.Robert Chandrakumar, learned counsel appearing for the second respondent.

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3.The learned counsel appearing for the petitioner would submit that

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the petitioner's mother was the pensioner covered under the Employee Pensioner Scheme of the second respondent. The mother had underwent an Valve Replacement surgery on 15.02.2021, but had unfortunately passed

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away during the treatment on 27.02.2021. The petitioner had made a claim for medical reimbursement along with all the original bills with the third respondent. The said claim had been forwarded by the third respondent to the first and second respondents. Under the impugned order, the claim of the petitioner had been rejected as being made belatedly. He would submit that the delay had not occurred at his behalf, but only as there was a delay in processing by the third and the first respondents. He would further submit that no notice of hearing was given to the petitioner before rejecting the claim made by the petitioner. Therefore, he seeks indulgence of this Court.

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Countering his arguments, the learned counsel appearing for the second respondent would contend that for treatment that had been taken in the month of February 2021, the petitioner had submitted his claim on 30.05.2022 and the claim was forwarded by the third respondent as the claim had reached beyond the cut off date namely 31.12.2023 as per the proceedings of the Secretary to Government, Finance Department, dated

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20.11.2023. As per the said communication, Pensioners who had taken treatment between 01.07.2021 till 30.06.2022 ought to have submitted their forms prior to 31.12.2023, and therefore, he would submit that there is no error in the order impugned herein.

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That apart, he would submit that even under the order impugned herein, the petitioner had been informed that he can make appropriate application before the Grievance Cell formed by the Government in that regard. Hence, he would submit that the Writ Petition as prayed for by the petitioner need not be entertained as the petitioner has got an effective alternative remedy before the Grievance Cell. Hence, he prays this Court to dismiss the Writ Petition.

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I have considered the submissions made by the learned counsels appearing on either side and perused the materials placed on record.

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The claim made by the petitioner of medical reimbursement that had been incurred to the petitioner's mother, who was the pensioner, had been rejected as the application had reached the second respondent after the cut off date namely 31.12.2023.

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It is not disputed that the petitioner's claim for medical reimbursement had been made by the petitioner to the third respondent as early as during May 2022. However, the third respondent had forwarded the communication only on 03.01.2025. In the counter affidavit filed by the second respondent it has been categorically admitted that the petitioner had submitted his claim form with the third respondent on 30.05.2022. When that being so, the delay in forwarding the claim form of the petitioner to the second respondent by the third respondent belatedly cannot be put against the petitioner. It is also to be noted that the claim made by the petitioner had been approved by the District Level Empower Committee as per the bye-laws. Reliance placed on the Government Communication dated 20.11.2023, would further indicate that what has been envisaged therein is that the Commissioner of Treasuries and Accounts should issue necessary instructions to the Subordinate Officers to communicate to the employees and pensioners to forward their original medical documents under the claim is recommended by the District Level Empower Committee, meetings conducted from 01.04.2023 to 30.09.2023 by 31.12.2023. The same does not envisage that the recommendations thereafter should not be considered by the

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Insurance Company, namely the second respondent. A further clarification has also been given in the same letter that if there are any orders made by the Court then the same should be processed and should be settled by the second respondent Insurance company. In this background analysing the case of the petitioner, the petitioner cannot be held responsible for the delay that had been caused by the third respondent in forwarding its recommendations to the second respondent for the claim made by the petitioner for the medical treatment taken by his mother. The said letter relied upon by the second respondent also do not foreclose the claim of the petitioner as belatedly.

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For the foregoing reasons, the Writ Petition stands allowed and the impugned order made by the second respondent dated 07.02.2025 stands set aside and as a sequel, the second respondent is directed to consider the claim of the petitioner based upon the recommendations made by the third respondent/the District Level Empower Committee and pass orders on merits and in accordance with law within a period of Twelve (12) weeks from the date of receipt of a copy of this order. Consequently, connected Miscellaneous Petition is closed. However, there shall be no order as to costs.

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Index : Yes / No Internet : Yes / No Pbn

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