WP/20842/2022 of K.Thaniyarasu Vs The Commissioner of Treasuries and Accounts on 12 October 2026

ORDER

The learned counsel for the petitioner would submit that the present writ petition has been filed seeking a Writ of Mandamus directing the respondents to pay a sum of Rs.3,04,240/- towards the medical expenses incurred by the petitioner for COVID-19 treatment.

2. The learned counsel for the petitioner would submit that the petitioner was affected by COVID-19 and was admitted to a private hospital for treatment, for which he incurred an expenditure of Rs.4,89,438/-. Out of the said amount, the fifth respondent has settled only a sum of Rs.1,10,260/-, and the remaining amount has not been reimbursed. It is the submission of the learned counsel for the petitioner that, as per G.O.Ms.No.280, Finance (Salaries) Department, dated 24.06.2020, particularly Clause 4(i)(a), the maximum ceiling limit is Rs.4,00,000/-, whereas only a portion of the amount claimed by the petitioner has been settled.

WP No. 20842 of 2022

3. The learned counsel for the petitioner would further rely upon the letter dated 01.02.2021 issued by the first respondent, wherein, according to the petitioner, the fourth respondent had recommended to the fifth respondent to settle a sum of Rs.4,14,500/-. However, the fifth respondent has settled only a portion of the said amount. Hence, he prays for the issuance of a Writ of Mandamus.

4. (a) The above contentions are strongly opposed by the learned Special Government Pleader appearing for the respondents 1 to 4. He would contend that, as per G.O.Ms.No.280, Finance (Salaries) Department, dated 24.06.2020, the entire amount eligible for reimbursement has already been settled by the fifth respondent and that no further amount is due to the petitioner.

(b) The said submission is reiterated by the learned counsel appearing for the fifth respondent, who therefore prays for the dismissal of the writ petition.

5. I have given my anxious consideration to the submissions made on either side.

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

WP No. 20842 of 2022

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

WP No. 20842 of 2022

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).

10. In this regard, the learned counsel for the fifth respondent would submit that the rates prescribed under the relevant category range from Rs.6,500/- to Rs.8,500/- per day. Since the petitioner was admitted to the hospital for a period of 12 days, the reimbursement was calculated by applying the applicable rates, and a sum of Rs.1,10,260/- was accordingly settled.

11. Though the learned counsel for the petitioner would dispute the above calculation and rely upon the letter dated 01.02.2021 issued by the first respondent, a perusal of the said letter reveals that the fifth respondent was directed to settle the claim in accordance with the applicable eligibility criteria.

WP No. 20842 of 2022

Though the letter contains a reference to a sum of Rs.4,14,500/-, the same does not, by itself, establish that the said amount was finally determined as payable to the petitioner without reference to the applicable eligibility criteria.

12. In this regard, it is relevant to refer to paragraph 6 of the counter affidavit filed by the first respondent, wherein the following statement has been made: "6. In this regard, the United India Insurance Company, Chennai has processed the COVID-19 medical reimbursement claim of the writ petitioner and settled an amount of Rs.1,10,260/- to the writ petitioner Thiru.K.Thaniyarasu as eligible medical reimbursement for the treatment taken by him as per G.O.Ms.No.280, Finance (Salaries) Department, Dated 24.06.2020. Further, it is submitted that the eligible amount for COVID-19 treatment has been settled by insurance company as per G.O.Ms.No.280, Finance (Salaries) Department, Dated 24.06.2020."

13. According to the above stand taken by the first respondent, the amount eligible for reimbursement has already been settled, and the eligible amount payable to the petitioner was determined as Rs.1,10,260/-.

14. Therefore, though the petitioner places reliance upon the letter dated

WP No. 20842 of 2022

01.02.2021 issued by the first respondent, the said letter, when read as a whole, does not establish any further entitlement beyond the amount determined in accordance with the applicable eligibility criteria. On a consideration of the relevant provisions of G.O.Ms.No.280, Finance (Salaries) Department, dated 24.06.2020, this Court finds no reason to interfere with the stand taken by the respondents.

15. Accordingly, this Court finds no merit in the writ petition, and the same is dismissed. No costs 12-10-2026 Index: Yes Speaking order Neutral Citation: Yes JRS

WP No. 20842 of 2022

To

1. The Commissioner of Treasuries and Accounts Treasury and office of the Accounts Department, No.571, 3rd Floor, Integrated Judiciary Amma Complex, Anna Salai, Nanthanam, Chennai.

2. The District Collector, Pudukottai District.

3. The Joint Director, Medical and Rural Welfare, Pudukottai District.

4. The Treasury Accounts Officer District Treasury, Pudukottai District.

5. The Divisional Manager, United India Insurance Company, Divisional Office VI, 5th Floor, PLA Rathna Tower, 212, Anna Salai, Chennai-600 006.

6. The Public Prosecutor, High Court of Madras.

WP No. 20842 of 2022

WP No. 20842 of 2022

C.KUMARAPPAN J. JRS WP No. 20842 of 2022 12-10-2026