C.PARTHIBAN vs THE STATE OF TAMILNADU

WP No. 26752 of 2023
IN THE HIGH COURT OF JUDICATURE AT MADRAS
DATED: 13-10-2026
CORAM
THE HON'BLE MR.JUSTICE C.KUMARAPPAN
WP No. 26752 of 2023
CNR: {HCMA011622832023}
C.Parthiban
..Petitioner(s)
Vs
1. The State Of Tamilnadu
Rep. By Its Principal Secretary To Government,
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.
..Respondent(s)
This Writ Petition is filed under Article 226 of the Constitution of
India, seeking direction to the respondents to pay to 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.
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WP No. 26752 of 2023
For Petitioner(s): Mr.R.Prem Narayan
For Respondent(s): Mr.S.Ilamvaludhi,
Special Government Pleader,
For R1 To R3.
M/s.V. Pushpa, For R4
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
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WP No. 26752 of 2023
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:
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WP No. 26752 of 2023
“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.
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WP No. 26752 of 2023
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.
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WP No. 26752 of 2023
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
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WP No. 26752 of 2023
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
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WP No. 26752 of 2023
C.KUMARAPPAN, J.
PVS
WP No. 26752 of 2023
13-10-2026
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