IN THE HIGH COURT OF JUDICATURE AT MADRAS DATED: 04.02.2008 CORAM: THE HONOURABLE MR.JUSTICE F.M.IBRAHIM KALIFULLA W.P.No.173 of 2008 and M.P.Nos.1 to 3 of 2008 V.Palaniammal .. Petitioner vs. 1.The Secretary to Government Finance (Salaries) Department, Fort St.George, Chennai-6. 2. The Director of School Education, DPI Compound, College Road, Chennai-6. 3.The District Elementary Education Officer, Namakkal, Namakkal District. .. Respondents Writ Petition filed under Article 226 of the Constitution of India, praying for issuance of a Writ of Mandamus, directing the respondents to disburse the fund from Tamilnadu Government Employees Health Fund to the petitioner for underwent Heart Operation as per G.O.Ms.No.400, Finance (Salaries) Department, dated 29.08.2000. For petitioner : Mr.C.Prakasam For respondents : Mr.V.R.Thangavelu, G.A. ORDER The petitioner seeks for the issuance of Writ of Mandamus to direct the respondents to disburse the fund from Tamilnadu Government Employees Health Fund to the petitioner for the treatment to her heart by applying G.O.Ms.No.400 Finance (Salaries) Department dated 29.08.2000. 2.The petitioner was working as School Teacher and she retired from the service in the year 2003 as Headmistress of Middle School. For her heart ailment, she took treatment in the Apollo Hospital at Chennai wherein she underwent angioplasty on 09.07.2002. The https://hcservices.ecourts.gov.in/hcservices/ expenses for undergoing the said treatment was stated to be Rs.2,04,359/-. When the petitioner made a claim for reimbursement based on G.O.Ms.No.400 dated 29.08.2000, the same was not considered. The petitioner, therefore, came forward with the present writ petition. Subsequent to the filing of the writ petition, an order came to be passed by the third respondent dated 10.06.2003, rejecting the petitioner's claim holding that the same does not found under the categorised treatment as per G.O.Ms.No.400 dated 29.08.2000. The petitioner therefore, filed M.P.No.2 of 2008 seeking for necessary amendment of her prayer challenging the subsequent order dated 10.06.2003 and consequetial, direction for disbursement of the fund from the Tamil Nadu Government Employees Health Fund by applying G.O.Ms.No.400 dated 29.08.2000. 3.Having regard to the facts as narrated above, the prayer of the petitioner for amendment as made in M.P.No.2 of 2008 merits consideration and the amendment is accordingly allowed. When the claim of the petitioner is considered, the subsequent G.O. in G.O.Ms.No.378 dated 13.10.2005 deserves to be considered. After referring to all other connected G.Os. including G.O.Ms.No.400 dated 29.08.2000, the State Government have now replaced the earlier Annexures by present Annexure I and II to G.O.Ms.No.378. Annexure I to the said G.O. has classified the various specialised advanced surgery/treatment for which assistance to the pensioners with effect from 01.04.2005 are allowed. In fact, the Hospital namely, Apollo Hospital at Chennai where the petitioner took treatment was stated to have already been approved in the list of approved Hospitals in the earlier G.Os. The claim of the petitioner was rejected on the sole ground that the treatment namely, angioplasty done to her heart did not fall under the category of open heart surgery and therefore, the assistance of reimbursement was not payable. 4.But the learned Government Advocate would contend that though in the present G.O.Ms.No.378 dated 13.10.2005 angioplasty and PTCA Stent have been specifically classified as treatments falling under the category of Cardiology and Cardio Thoracic Surgery, since the inclusion of such treatment came to be made as from 01.04.2005, the petitioner was not entitled to claim the said benefit. 5.Having heard Mr.C.Prakasm, learned counsel for the petitioner as well as Mr.V.R.Thangavelu, learned Government Advocate, I am of the view such a stand taken by the respondents cannot be accepted. Once the Hospital which gave treatment to the petitioner has certified that coronary angioplasty with stenting done on the petitioner on 09.07.2002 is equivalent to bypass surgery in order to provide fresh blood supply to the areas, which is supplied by the blocked artery due to advanced technologies it https://hcservices.ecourts.gov.in/hcservices/ will have to be held that the same would fall well within the classified treatments under the erstwhile G.Os. themselves. The revised detailed classification of the treatments mentioned in G.O.Ms.No.378 dated 13.10.2005 by way of clarification can only be construed as classification of the treatment of open heart surgery in different forms. In fact, Annexure I to G.O.Ms.No.378 dated 13.10.2005 the Cardiology and Cardio Thoracic Surgery falling under I category is stated as under: "I CARDIOLOGY AND CARDIO THORACIC SURGERY 1.Open heart surgery including (a)Caronary By-pass surgery (CABG) (b)Valve replacement. (c)Correction of Congenital complex heart diseases (d)Angioplasty and PTCA Stent (e)Baloon Valvulo Plasty (f)Permanent Pacemaker (g)Peripheral artery embolism (Embolectories) By pass surgeries (Aneurysm repair)" 6.Such a detailed reference to different kinds of treatment falling under open heart surgery only shows that while all the above treatments falling under Clause a to g came within the common category of open heart surgery which was the treatment already provided for in the earlier Government Orders including G.O.Ms.No.400 dated 29.08.2000, the present expanded classification of the said open heart surgery cannot be construed as an inclusion of new treatment in order to state that for such a treatment the eligibility would arise only after the issuance of the present G.O.Ms.No.378 dated 13.10.2005. Similarly such a view has been expressed by Justice D.Murugesan in the decision reported in 2007 Writ L.R. 1073 E.Ramalingam V. The Director of Collegiate Education College Road, Chennai-6 and another, paragraph 7 and 8 are relevant which reads as under: "7.In matters like this, the Government Orders should not be strictly construed as on the date when the Government Order was issued, the treatment viz., PTCA Stent could not have been invented or introduced. In recent days, the concept of treating ailments, has advanced so much, thanks not only to the Speciality Hospitals, Doctors specialised in the modern/advance treatments, but also the advanced techniques in method of treatment with use of sophisticated equipments. It is acceptable to common sense, that ultimate decision as to how a patient should be treated vests only with the Doctor, who is well versed and expertised both on academic qualifications and experience gained. Very little scope is left to the patient or his relative to https://hcservices.ecourts.gov.in/hcservices/ decide as to manner in which the ailment should be treated. 8...... The real test must be the factum of treatment. Before any medical claim is honoured, the authorities are bound to ensure as to whether the claimant had actually taken treatment and the factum of treatment is supported by records duly certified by Doctors/Hospitals concerned. Once, it is established, the claim cannot be denied on technical grounds as found in the impugned order. Having regard to the above lacunae in the earlier Government Order and issuance of subsequent Government Order including not only the treatment but also the hospital, I am of the view that the petitioner is entitled to claim reimbursement". 7.Having regard to my above conclusions, the impugned order of the third respondent dated 10.06.2003 cannot be sustained. While setting aside the same, the respondents are directed to pass orders for disbursement of the fund to the petitioner for having underwent angioplasty operation underwent by her on 09.07.2002 and pay the permissible amount within two months from the date of receipt of a copy of this order. 8.With the above direction, this Writ Petition stands allowed. No costs. Consequently, connected miscellaneous petitions are closed. Sd/- Asst. Registrar. /true copy/ Sub Asst. Registrar. sgl To 1.The Secretary to Government Finance (Salaries) Department, Fort St.George, Chennai-6. 2.The District Elementary Education Officer, Namakkal, Namakkal District. https://hcservices.ecourts.gov.in/hcservices/ 3. The Director of School Education, DPI Compound, College Road, Chennai.6 1 cc to Mr.C. Prakasam, Sr. 5255 1 cc to Government Pleader, High Court, Madras. SR. 5588 W.P.No.173 of 2008 KS (CO) kk 13/2 https://hcservices.ecourts.gov.in/hcservices/