WP/32264/2022 of R.S.Manimaran Vs The Chairman - cum- Managing director on 15 September 2026

ORDER

The present writ petition has been filed for Certiorarified Mandamus directing the respondents to settle a sum of Rs.5,00,600/- by way of reimbursement on account of the treatment taken by the petitioner from Kauvery Hospital.

2. The learned counsel appearing for the petitioner would submit that the respondents denied the benefit of reimbursement vide their rejection order dated 16.02.2022.

3. When the matter was taken up for hearing on 25.08.2026, this Court passed the following order: “The learned counsel for the petitioner would submit that the petitioner has undergone by-pass surgery and he has got triple vessel decease of more than 70% to 80% and upto 99% stenosis. Immediately after the angiogram on 04.08.2021, the petitioner was admitted on 06.08.2021 for by-pass surgery and CABG was done on 06.08.2021 and he was discharged on 11.08.2021.

2. On perusal of the discharge summary, the same clearly says that the petitioner suffers severe triple vessel decease.

3. However, the stand of the respondents is that this is not an emergency situation and that they have already obtained report from the Experts qua Doctors.

4. In view of the same, the respondents are directed to produce the report before this Court by 31.08.2026.

5. Post the matter on 31.08.2026.”

4. Today, the learned counsel appearing for the respondents has submitted the Committee report.

5. In the case in hand, the facts are not in serious dispute. Therefore there is no necessity to go into the nature of treatment and the amount to which the petitioner has spent. However, the one disputed issue between the petitioner and the respondent is that according to the petitioner, this is an emergency treatment, however, the respondents would contend that this is not an emergency treatment. In this regard as per the direction of this Court dated 25.08.2026, the respondent has submitted the Committee report. The same is extracted hereunder: “The Committee examined the medical reimbursement claim of Shri Manimaran R S, CPF No.31910, Sr. Foreman, Mine I for and the details as under are submitted. Shri Manimaran went for treatment on his own at M/s Kauvery Hospital, Chennai on 04.08.2022 without any referral from NLC Hospital. He got admitted on 04.08.2021 with stable hemodynamics (as per discharge summary – copy enclosed). He was advised to continue the medication as per chart and to get CABG done later. The same was also communicated by M/s Kauvery Hospital Chennai through mail on 05.08.2021 In spite of the above, he got admitted on his own on 06.08.2021 and got CABG done. He was discharged on 11.08.2021. The individual has submitted the medical claim for reimbursement and the same was received at NLC Hospital on 04.09.2021. Emergency Certificate was also not enclosed along with the reimbursement claim (Medical Benefit Rule _ 37.11.1.5 – copy enclosed). The Medical Officer scrutinized the medical claim and informed that the treatment underwent is not an emergency one. The same was also communicated to the individual vide ref.2 cited.

Shri Manimaran resubmitted a representation on 29.03.2022 requesting for reimbursement for the medical treatment expenditure. The same was forwarded to NLC Hospital through e-office. On rescrutinizing the bill claim, it has been noted that Shri Manimaran has enclosed an emergency certificate (which is contradictory to the mail sent from M/s Kauvery Hospital Chennai vide ref.3 cited) without any authenticated date (the same was not enclosed in the earlier bill claim). Based on the discharge summary issued by the treating doctor of M/s Kauvery Hospital, Chennai, the treatment underwent is not an emergency one. On 23-05-2022, the O/oGs/Medical has submitted report after scrutiny of the medical bills that the treatment underwent is not an emergency one (copy of the letter enclosed vide ref.5). Again on 06-07-2022, the individual re- submitted a request which has been forwarded from the O/oCMD. The committee constituted for screening of emergency bills once again rescrutinised the bill claim and confirmed that the treatment underwent is not an emergency one.”

6. According to the above report, the reason for not considering the treatment undergone by the petitioner as emergent is on trivial reason that the petitioner did not submit the emergency certificate issued by the Hospital.

7. At this juncture, the learned counsel appearing for the petitioner invited the attention of this Court to the certificate given by the Kauveri Hospital Doctor, Dr.R.Anantharaman. He in his certificate stated that CAS done on 04.08.2021 showed severe triple vessel disease, for which he had undergone emergency CABG surgery 3 grafts on 06.08.2021. With regard to the above certificate, the respondents counsel would submit that the said certificate has no date. At this juncture, this Court put a pertinent question, as to whether they verified their referral Hospital qua Kauvery Hospital regarding the veracity of the certificate. The learned counsel replied that they did not verify the veracity of the certificate. Therefore the certificate submitted by the petitioner before the respondents cannot be termed as fabricated one. According to the above certificate, there is clear reference that the petitioner has undergone emergency CABG surgery.

8. The learned counsel appearing for the respondents would invite the attention of this Court to the NLCIL Medical Benefit Rules and would submit that according to the procedures of reimbursement, the petitioner ought to have submitted emergency certificate for reimbursement. But the emergency certificate was not submitted.

9. No doubt that the petitioner did not submit the emergency certificate. But later he submitted the emergency certificate. Since it has no date, the respondents did not consider the same. This according to this Court is nothing but exhibition of scornfulness against their employee’s health and their sufferings. Further this being Triple Vessel Disease having Distal LAD – Diffuse disease 70 – 80% stenosis and Proximal LAD – 99% stenosis, by applying the doctrine of res ipsa loquitur, the emergency can be demonstrated. Furthermore, the certificate submitted by the petitioner also vindicates the emergency. Here the expert opinion relied by the respondent only reflect the effort put by the Committee to prove that they are emperor in expression, but failed to express their common touch and practical approach to the realities.

10. Therefore this Court is of the view that the denial of reimbursement is hypertechnical and demonstrate the pedantic approach of the respondent. In a health issue that too when a person is suffering serious stenosis in his heart, it may be easy for others to give confidence, but we must see what the treating Doctors says to him. Here we must consider the bold decision of the petitioner to undergo such surgery, this by itself according to me is sufficient to explain emergency. In such view of the circumstances this Court is inclined to interfere with the order dated 16.02.2022.

11. Accordingly the order of the second respondent dated 16.02.2022, is hereby set aside. The respondent is directed to reimburse the amount of Rs.5,00,600/- to the petitioner, within a period of eight weeks from the date of receipt of a copy of this order. If the respondent fails to settle the amount within the above stipulated period, the petitioner is entitled to have interest at the rate of 6% p.a. for the default period. However, after payment of the interest by the respondents, the respondents are at liberty to recover the same from the concerned Officers those who are responsible for such delay.

12. Accordingly the writ petition is allowed on the above terms. No costs. 15-09-2026 Index: Yes/No Speaking/Non-speaking order Neutral Citation: Yes/No pri To

1. The Chairman – Cum – Managing Director Neyveli Lignite Corporation Limited, Block 1, Neyveli, Cuddalore District, Tamil Nadu 607 801.

2. The Addl. Chief Manager (HR) / EB/ Mine -1 NLC India Limited, Office of the Chief General Manager / Mine 1, HR Department/ Main 1, Neyveli, Cuddalore District, Tamil Nadu 607 801.

C.KUMARAPPAN, J. pri WP No. 32264 of 2022 15-09-2026