WP/26752/2023 of C.PARTHIBAN Vs THE STATE OF TAMILNADU on 13 October 2026

ORDER

This Writ Petition is filed seeking a direction to the respondents to pay the petitioner the balance amount of Rs.4,31,544/- towards the reimbursement of the medical expenses incurred by the petitioner for his corona treatment.

2. Heard the learned counsel appearing for both sides.

3. The learned counsel for the petitioner would contend that according to G.O.Ms.No.280 Finance (Salaries) Department, dated 24.06.2020, there is a ceiling of Rs.4,00,000/- whenever a person is admitted for treatment for Covid 19 and in the case on hand, the petitioner has incurred a sum of Rs.6,44,544/-, whereas the respondent has settled only Rs.2,13,000/- and the petitioner is entitled to be reimbursed the remaining amount as per G.O.Ms.No.280, dated 24.06.2020.

4. However, the said contention was strongly opposed by the learned Special Government Pleader for the respondents 1 to 3 and he would rely upon the counter statement filed by the Commissioner of Treasuries and Accounts and according to the counter statement, out of Rs.6,44,544/-, the eligible amount as per the G.O.Ms.No.280, dated 24.06.2020, had been settled to the petitioner vide proceedings dated 13.07.2022. It is also the contention of the learned Special Government Pleader that the above G.O. was issued due to the unprecedented emergence of the Covid-19 during 2020 and Rs.4,00,000/- was the previous existing policy limit before Covid. Since the Covid had struck the world, in order to give benefits and protect the employees, an additional sum ranging from Rs.6,500/- to Rs.8,500/- per day was provided to the Covid patients. They were paid according to the period during which they were treated as inpatient along with the pharmacy charges. Therefore, contested nothing survives in the present Writ Petition.

5. I have given anxious consideration to the above submissions.

6. In a similar circumstances, this Court vide order dated 12.10.2026 in K.Thaniyarasu vs. The Commissioner of Treasuries and Accounts reported in 2026 MHC 4216 has considered that Rs.4,00,000/- referred to in the said G.O. is in respect of the critical care, which is for pre Covid era and such amount did not include any coverage for Covid. The relevant portion of the said order reads as follows:

“6. The entire submission of the learned counsel for the petitioner revolves around Clause 4(i)(a) of G.O.Ms.No.280, Finance (Salaries) Department, dated 24.06.2020. The relevant clause reads as follows: "4. The Government after careful examination, have decided to accept the same and accordingly issue the following orders:- i). With respect to Critical care, (ICU Ventilated & ICU Non Ventilated):

(a) The United India Insurance Company Limited shall make payments to all COVID positive cases that receive critical care as per the package rates for existing procedures covered under the New Health Insurance Scheme, subject to a ceiling of Rs.4 lakhs.“

7. According to the above clause, the maximum ceiling limit of Rs.4,00,000/- is applicable to COVID-19-positive patients who receive critical care, as per the prescribed package rate. In this regard, the submission made by the learned counsel for the fifth respondent assumes significance. He would contend that the above clause refers to the maximum ceiling limit applicable to critical care, which is otherwise available under the existing medical reimbursement scheme for the treatment of various diseases. The provision introduced in view of the COVID-19 pandemic was intended to provide additional reimbursement over and above the existing eligible amount, in view of the unprecedented circumstances prevailing at the relevant point of time.

8. The learned counsel for the fifth respondent would further draw the attention of this Court to Clause 4(ii), which deals with room charges, and contend that Clauses 4(i)(a) and 4(ii) have to be read harmoniously to determine the amount payable to the petitioner.

9. On a harmonious reading of the above clauses, this Court is of the view that the ceiling limit of Rs.4,00,000/- under Clause 4(i)(a) relates to the eligible package rate for critical care under the existing G.O.Ms.No.240, Health and Family Welfare (EAPI-I) Department, dated 05.06.2020. In view of the unprecedented nature of the COVID-19 pandemic, additional provisions were introduced to provide reimbursement for the expenses incurred under the categories specified in Clause 4(i)(b).”

7. Since unprecedented Covid struck the World during 2020, in order to give additional benefit, Covid was also included under the mediclaim policy with the further condition that for the Critical Care Covid-19 patient, ICU non ventilated, per day expenditure was admitted as Rs.6,500/-, and ICU ventilated per day expenditure was included to Rs.8,500/- and for a non critical Covid, the amount was Rs.9,500/- per day with pharmacy charges for A1 and A2 category Hospitals and Rs.7,500/- per day with pharmacy charges for A3 to A6 Hospitals.

8. From the very perusal of the above G.O. would clearly demonstrates that if there is a non critical Covid care qua admission only on account of Covid infection without any other disease, it should be Rs.9,500/- per day for A1 and A2 categories Hospital with the pharmacy charges. In this case, the learned counsel would submit that he was admitted in the Hospital for 10 days and that he has been paid a sum of Rs.2,13,000/-. Therefore, the very contention that there is a ceiling of Rs.4,00,000/- cannot be accepted at all as that Rs.4,00,000/- is for a critical care other than Covid. In respect of Covid-19 treatment, G.O.Ms.No.280, dated 24.06.2020 stipulates only per day expenditure. Such factum was dealt with by the Commissioner of Treasuries and Accounts in their counter statement and stated that entire eligible amount of the petitioner has been settled to the petitioner.

9. In such view of the above factual position, this Court absolutely does not find any merit in the present Writ Petition. Accordingly, the Writ Petition is dismissed. No costs. 13-10-2026 Index: Yes/No Speaking/Non-speaking order Neutral Citation: Yes/No PVS

To

1. The Principal Secretary To Government The State Of Tamilnadu Department Of Finance, Fort St. George, Chennai 09

2. The Commissioner Of Treasuries And Accounts / Chairman State Level Empowered Committee Integrated Complex For Finance Department Animal Husbandry Hospital Complex Perasiriyar Anbalagan Maaligai, No 571 Anna Salai Nandanam Chennai 600 035

3. The District Collector / Chairman District Level Empowered Committee Dharmapuri District Dharmapuri

4. The Divisional Manager United India Insurance Company Limited Divisional Office 010600 5th Floor, Pla Rathna Towers 5th Floor, No 212 Anna Salai Chennai 600 006

C.KUMARAPPAN, J. PVS WP No. 26752 of 2023 13-10-2026