: Criticising government officials for refusing to reimburse treatment charges incurred by a school teacher for treating dengue fever suffered by her daughter, the Madras High Court Bench here has held that diseases listed under insurance and health fund schemes should be considered illustrative and not exhaustive.
Allowing a writ petition filed by the teacher, Justice K. Ravichandra Baabu said: “It is an undisputed fact that so many people have lost their life due to dengue fever. Therefore, if these sort of technical objections are raised to deny the benefit of the scheme, it would only defeat the object sought to be achieved rather than ensuring that the benefit reaches the needy without any hindrance.”
He went on to state: “A beneficial scheme aimed at the common man’s interest and welfare should always be made and applied as viable and practicable as far as possible. If practical approach is not made and the authorities are sticking on to their pedantic views based on the terms of the scheme, then this court can always lift the veil and find out as to what is the real object which is sought to be achieved.”
In the instant case, the petitioner, N. Suseela, a secondary grade teacher in Tirunelveli district, stated that she was a subscriber of Family Health Fund Scheme. In 2012, the petitioner reportedly incurred Rs.4.16 lakh to save her daughter from dengue fever and applied to the government for reimbursement.
However, her plea was rejected on the ground that dengue was not a listed disease.
Disapproving of such rejection, Mr. Justice Baabu said: “No one knows as to what ailment or physical sufferance he or she has to undergo or what course of treatment one has to take for such ailment or sufferance. Equally, the framers of the scheme also cannot guarantee that no one will suffer from diseases other than those listed out in the scheme.”
He quashed an order passed by the Sub-Treasury Officer at Ambasamudram on February 11, 2013 refusing to reimburse the treatment cost and directed the officer to reimburse the petitioner to the extent permissible under the rules after ascertaining the payments made by her to the hospital.
"List of diseases in insurance schemes can only be illustrative"