Judgment:
ORDER
N. Paul Vasanthakumar, J.
1. In this writ petition, petitioner seeks a direction to the first respondent to pay the sum of Rs.67,935/- to him forthwith, as per the sanction order dated 19.9.2005 of the second respondent along with interest at the rate of 18% per annum from the date of first sanction order dated 5.11.2003.
2. The brief facts of the case that are necessary for the disposal of the writ petition are as follows.
(a) Petitioner is working in the third respondent school, which is a fully aided school and getting 100% grant-in-aid from the Government of Tamil Nadu. He was initially appointed as Secondary Grade Teacher on 15.3.1973 and was later promoted as Tamil Pandit in the year 1995.
(b) The Government of Tamil Nadu framed a medical scheme called the 'Tamil Nadu Government Employees Health Fund Scheme' during the year 1992 with an object to provide financial assistance to the Government servants/employees of the Aided Educational Institutions, in case of major ailments either for themselves or for their family members. For that purpose, a Fund was created and each employee has to pay a sum of Rs.25/- per year as contribution towards the Fund. Later the rate of contribution was changed to Rs.10/- per month, from January, 1999. Petitioner made contributions to the said Fund till his retirement on 31.5.2005.
(c) While framing the scheme, the Government issued a list of ailments for which financial assistance can be availed and also issued a list of approved private hospitals from which the employees can take treatment or undergo surgery. The said lists of ailments and approved private hospitals were revised from time to time. The latest Government Order in this regard was issued in G.O.Ms.No.400 Finance (Salaries) Department, dated 29.8.2000. According to the petitioner, as per the said Government Order, every employee, who becomes a member to the Fund, is entitled to get advanced specialised treatment/surgery in any one of the accredited and approved hospitals for undergoing special treatment for themselves or for their family members. The diseases/ailments for which the advanced/specialised treatment/surgery can be undertaken by the employees are given in Annexure-I and the list of accredited and approved hospitals are given in Annexure-II to the said Government Order. As per the said Government Order, the employees can get financial assistance to the tune of 75% of the actual expenditure or Rs.1,00,000/-, whichever is less. The District/Regional Heads are empowered to sanction the financial assistance to the employees after verifying the nature of the treatment underwent and the hospital in which they got treatment.
(d) Petitioner states that his wife S.Kalaiselvi suffered a massive heart attack during April, 2003, and she was admitted into the G.Kuppusamy Naidu Memorial Hospital, Coimbatore. After clinical examinations and based on various medical reports, it was found that she was suffering from Congenital Heart Disease Class-II Dysphoea on exertion. She was admitted as inpatient on 21.4.2003 and discharged on 23.4.2003. The Doctors advised her to undergo immediate surgery to save her life. Hence petitioner's wife was again admitted into the same hospital on 27.4.2003 as inpatient and she was operated for the Congenital Heart Disease on 29.4.2003 and was discharged on 5.5.2003. Even after discharge, she was advised to take medical and follow-up treatment regularly and accordingly, she is taking medicines and going for periodical check-up till date.
(e) According to the petitioner, an amount of Rs.1,03,059.50 was spent towards surgery, treatment and medical expenses and the petitioner, being a Teacher of the Aided Educational Institution, is entitled to get the Family Benefit Fund and applied for the same on 7.5.2003 to the third respondent in the prescribed form with all medical reports and bills. The third respondent forwarded the application to the second respondent along with his letter of recommendation for the sanction of financial assistance. The second respondent by his letter dated --.9.2003 asked the third respondent to submit a certificate from the Doctor specifying as to what kind of operation was performed to the wife of the petitioner. The Doctor, who performed surgery to the petitioner's wife, issued a certificate certifying that the petitioner's wife was operated for Congenital Heart Disease, which was submitted to the second respondent through the third respondent. Pursuant to that, the second respondent, by his order dated 5.11.2003, sanctioned a sum of Rs.67,985/- being 75% of the actual expenditure and authorised the first respondent to issue a cheque/DD for the said amount, to the petitioner.
(f) It is further stated in the affidavit that after passing the sanction order dated 5.11.2003, the second respondent required the petitioner to submit a certificate specifically mentioning as to what kind of open heart surgery was performed to his wife as per G.O.No.400 and also to submit a certificate as to what was his son's occupational/professional status. Petitioner once again obtained a certificate dated 17.3.2004 from the Doctor to the effect that the open heart surgery was performed for correcting the congenital complex heart disease and submitted the same along with a certificate dated 17.3.2004 stating that his son was doing MBA through correspondence course and he had no source of income and that his wife was also not employed. Based on the said certificates, the second respondent passed a fresh sanction order dated 30.3.2004 (2nd sanction order) and forwarded the same to the first respondent for disbursement of the sanctioned amount to the petitioner.
(g) Further case of the petitioner is that in spite of the second sanction order dated 30.3.2004, the first respondent, instead of disbursing the sanctioned amount, by his proceedings dated 15.5.2004 returned the sanction order dated 30.3.2004 on the ground that the surgery, which the petitioner's wife underwent was not the one included in G.O.Ms.No.400, Finance (Salaries) dated 29.8.2000 and hence the claim of the petitioner could not be admitted. Hence, the second respondent referred the petitioner's wife to the Joint Director of Health Services, Coimbatore, to ascertain as to whether the surgery performed to the wife of the petitioner would come within the purview of the diseases/surgeries/special treatment, mentioned in G.O.No.400 dated 29.8.2000. Consequently, petitioner's wife appeared before the Medical Board, Government Head Quarters Hospital, Tiruppur on 28.7.2004 and based on the report of the Medical Board, the Joint Director of Health Services wrote a letter on 4.8.2004 to the second respondent certifying that the petitioner's wife had undergone Open Heart Surgery for Osticum Secundum Artrial Septal Defect at GKNM Hospital, Coimbatore, and the operation performed was a genuine one and it was absolutely necessary. It was also recommended that the claim of the petitioner for financial assistance could be admitted as per the Government rules. Based on the said report dated 4.8.2004 and in terms of G.O.Ms.No.400 dated 29.8.2000, the second respondent passed a fresh sanction order dated 25.10.2004 (3rd sanction order) and forwarded the same to the first respondent for disbursement to the petitioner.
(h) Again the first respondent returned the sanction order dated 25.10.2004 by his letter dated 27.12.2004 by referring the letter dated 6.12.2004 and stating that the surgery performed to the wife of the petitioner was not one of the surgeries approved in the G.O.No.400 dated 29.8.2000. The third respondent once again forwarded the proposal along with the returned claims to the second respondent by letter dated 19.1.2005 and also enclosed a copy of G.O.Ms.No.400 dated 29.8.2000. Third respondent clearly pointed out that the surgery performed to the wife of the petitioner was correction of congenital complex heart disease, which is one of the open heart surgeries approved in para-1, Schedule-I of Annexure-I to the G.O.No.400 dated 29.8.2000 and therefore petitioner is entitled to get the financial assistance as per the said Government Order.
(i) The second respondent, after receipt of the renewed proposal from the third respondent, made a request to the Director of Medicine and Rural Health Services, Chennai-6, enclosing all the medical certificates, to ascertain as to whether the petitioner is eligible to get the financial assistance as per G.O.No.400 dated 29.8.2000. The Director of Medicine and Rural Health Services referred the matter to the Medical Board, Government General Hospital, Chennai-3 and obtained a report dated 2.6.2005 from the Medical Board. On the basis of the said report, the Director of Medicine and Rural Health Services wrote a letter on 27.6.2005 to the second respondent, wherein it is clearly certified that,
(i) the surgery performed was in emergency,
(ii) the treatment undergone by the wife of the petitioner is covered under G.O.No.400 dated 29.8.2000, and
(iii) the Hospital where petitioner's wife got treatment is also one of the hospitals approved in G.O.No.400 dated 29.8.2005.
Again the second respondent issued the sanction order dated 19.9.2005 (4th sanction order) for a sum of Rs.67,935/- as financial assistance towards the expenditure incurred by the petitioner for giving special treatment to the petitioner's wife. The said sanction order was forwarded to the first respondent along with a covering letter dated 19.9.2005 enclosing the resports/certificates issued by,
(a) the Doctor of GKNM Hospital,
(b) the letter sent by the Joint Director of Health Services,
Tiruppur,
(c) the medical report dated 25.6.2005 issued by the Medical Board, Government General Hospital, Chennai-3, and
(d) the letter dated 27.6.2005 from the Director of
Medicine and Rural Health Services, Chennai.
In spite of the said orders and reports, according to the petitioner, the first respondent has not disbursed the sanctioned financial assistance of Rs.67,935/- and therefore the petitioner has filed the present writ petition for the above referred prayer along with interest at the rate of 18% per annum from the date of first sanction order dated 5.11.2003 and also exemplery cost.
3. When the writ petition came up for admission on 6.12.2005, the learned Government Advocate took notice for respondents 1 and 2 and sought two weeks time for getting instructions. Hence the matter was directed to be posted after two weeks in the motion list. Again, when the matter was listed on 7.3.2006, at the request of learned Government Advocate, the case was adjourned to 13.3.2006, on which date, the learned Government Advocate appearing for the respondents submitted her arguments based on the available records.
4. The learned counsel for the petitioner reiterated the points urged in the affidavit and argued that G.O.Ms.No.400 dated 29.8.2000 clearly covers the disease for which the petitioner's wife underwent surgery and the hospital in which petitioner's wife underwent surgery is an accredited and approved hospital.
5. The learned Government Advocate, appearing for the respondents submitted that only because of the doubts with regard to the applicability of G.O.Ms.No.400 dated 29.8.2000 to the petitioner's case, repeated objections were raised by the first respondent.
6. I have considered the rival submissions of the respective counsels.
7. For proper appreciation of the issue involved, it is useful to extract the G.O.Ms.No.400 dated 29.8.2000, which reads as under,
GOVERNMENT OF TAMIL NADU
ABSTRACT
Tamil Nadu Government Employees Health Fund Scheme, 1991 - Streamlining and approval of registered private hospitals under the TNGEHFS - Classification of specialised advanced surgeries/treatment under the broad based groups - approved - orders issued.--------------------------------------------------------------FINANCE (SALARIES) DEPARTMENTG.O.Ms.No.400 Dated 29th August 2000,Aavani, 14 Vikkirama,Thiruvalluvar Aandu 2031Read:1. G.O.Ms.No.18, Finance (All) Department, dated 9.1.922. G.O.Ms.No.91 Finance (Sal) Department, dated 7.2.953. G.O.Ms.No.817 Finance (Sal) Department, dated 20.10.954. G.O.Ms.No.340 Finance (Sal) Department, dated 14.7.985. G.O.Ms.No.846 Finance (Sal) Department, dated 14.12.936. G.O.Ms.No.460 Finance (Sal) Department, dated 19.6.957. G.O.Ms.No.817 Finance (Sal) Department, dated 20.10.958. Government Letter No.6289 Finance (Sal) Department/96, dated 05.03.969. Government Letter No.52006 Finance (Sal) Department/95-7, dated 18.06.9910. Government Letter No.14186, Finance (Sal) Department/96-3, dated 29.09.9611. Government Letter No.25666 Finance (Sal) Department/99-1, dated 16.04.99.Read also:-12. G.O.Ms.No.532 Finance (Sal) Department, dated 10.12.99