Madras High Court
WP/40798/2026 of P.Tamizarasi Vs THE STATE OF TAMIL NADU on 9 October 2026
IN THE HIGH COURT OF JUDICATURE AT MADRAS
DATED: 09-10-2026
CORAM
THE HON'BLE MS. JUSTICE P.T. ASHA
WP No. 40798 of 2026
CNR:{HCMA012300092026}
P.Tamizarasi
W/o. V.Baskaran,
No. 5/2 Kalathu Mettu street,
Peranamallur,
Vandavasi Taluk,
Thiruvannamalai district 604 503
..Petitioner(s)
Vs
1. The State Of Tamil Nadu
Rep. by its Principal Secretary to Government, Finance(Health Insurance) department, Secretariat, Chennai 09
2. The Chairman
The district Level Empowered committee,
New Health Insurance Scheme 2026
Thiruvannamalai district
3. The State Level Empowered committee
New Health Insurance Scheme 2026,
Office of the Commissioner/ Director of
Treasuries and Accounts,
Integrated office complex for Finance
department,
Veterinary Hospital campus , Anna Salai, Nandanam, Chennai 35
4. The assistant Elementary Educational officer Peranamallur Thiruvannamalai district
..Respondent(s)
Prayer:- Writ Petition filed under Article 226 of Constitution of India for the issuance of Writ of Mandamus directing the respondents to consider and dispose of the petitioners representation dated 28.08.2026 seeking reimbursement of the medical expenses incurred towards the treatment undergone from 5.07.2026 to 23.07.2026 by determining the eligible amount in accordance with G.O. Ms.No.122 Finance (Health Insurance) Department dated 24.06.2026 and the guidelines for implementation of the New Health Insurance scheme 2026 and consequently direct the respondents to release the eligible reimbursement amount out of Rs. 4,43,089/- paid by the petitioner within a time frame to be fixed by this Honble court.
For Petitioner(s):
M/s.M.Ravindhar
For Respondent(s):
M.Senthamizh Selvan A.G.P.For R1 To R4
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Order
This Writ Petition has been filed for the following reliefs:- “directing the respondents to consider and dispose of the petitioners representation dated 28.08.2026 seeking reimbursement of the medical expenses incurred towards the treatment undergone from 5.07.2026 to 23.07.2026 by determining the eligible amount in accordance with G.O. Ms.No.122 Finance (Health Insurance) Department dated 24.06.2026 and the guidelines for implementation of the New Health Insurance scheme 2026 and consequently direct the respondents to release the eligible reimbursement amount out of Rs. 4,43,089/- paid by the petitioner within a time frame to be fixed by this Honble court.
2. The Petitioner would submit that she is working as a Secondary Grade Teacher in the Tamil Nadu School Education Department and is a beneficiary under the New Health Insurance Scheme, 2026, introduced by the Government of Tamil Nadu vide G.O.Ms.No.122, Finance (Health Insurance) Department, dated 24.06.2026.
3. The Petitioner would submit that she sustained a bicondylar comminuted intra-articular fracture of the left proximal tibia and was admitted to Sri Ramachandra Medical Centre, Chennai, on 05.07.2026. She underwent treatment, including Left Knee Spanning External Fixator Application under Spinal Anaesthesia, and remained hospitalised till 23.07.2026.
4. The Petitioner would submit that the aforesaid treatment was undertaken during the currency of the NHIS-2026 and at a network hospital. However, despite the cashless facility envisaged under the Scheme, the Petitioner was compelled to meet a substantial portion of the hospital expenses from her own funds.
5. The Petitioner would further submit that the total hospital bill amounted to Rs.5,60,689/-, whereas the Insurance Company sanctioned only Rs.1,17,600/-, thereby compelling the Petitioner to bear the balance amount of Rs.4,43,089/- from her own funds.
6. The Petitioner would submit that Clause 16 of the NHIS-2026 Guidelines provides for reimbursement of payments made by a beneficiary to a network hospital towards eligible medical expenses. The said Guidelines also prescribe the procedure for submission and consideration of reimbursement claims by the Drawing and Disbursing Officer (DDO), the Grievance Redressal Officer and the District Level Empowered Committee.
7. The Petitioner would submit that she submitted a detailed representation dated 28.08.2026 before the District Level Empowered Committee, seeking reimbursement of the medical expenses incurred by her. However, despite the submission of the said representation, her claim has not been effectively considered or settled to date. Hence, the Petitioner is before this Court seeking the reliefs states supra.
8. Heard the learned counsel on either side and perused the records.
9. It is now submitted by the learned Additional Government Pleader that the Petitioner's representation is pending consideration before the 2nd Respondent. Therefore, considering the facts and circumstances of the case and the relief sought by the Petitioner, this Court, without expressing any opinion on the merits of the case, directs the 2nd Respondent to consider the Petitioner's representation dated 28.08.2026 seeking reimbursement of her medical expenses, in the light of G.O.Ms.No.122, Finance (Health Insurance) Department, dated 24.06.2026, and the Guidelines for implementation of the New Health Insurance Scheme, 2026, and pass appropriate orders on merits and in accordance with law, within a period of three weeks from the date of receipt of a copy of this order.
10. Accordingly, this writ petition is disposed of. No costs. 09-10-2026 Index: Yes/No Speaking/Non-speaking order Neutral Citation: Yes/No SHR
P.T.ASHA J. SHR To
1. The State Of Tamil Nadu Rep. by its Principal Secretary to Government, Finance(Health Insurance) department, Secretariat, Chennai 09
2. The Chairman The district Level Empowered committee, New Health Insurance Scheme 2026 Thiruvannamalai district
3. The State Level Empowered committee New Health Insurance Scheme 2026, Office of the Commissioner/ Director of Treasuries and Accounts, Integrated office complex for Finance department, Veterinary Hospital campus , Anna Salai, Nandanam, Chennai 35
4. The Assistant Elementary Educational officer Peranamallur Thiruvannamalai district
09-10-2026