T.N.’s health infrastructure comes in for praise from SC

‘It was on show during second wave of COVID-19’

The Supreme Court on Wednesday said Tamil Nadu has one of the better health infrastructure systems in the country and it showed during the second wave of the COVID-19 pandemic.

“Tamil Nadu has one of the better infrastructure in the country,” Justice D.Y. Chandrachud orally remarked at a virtual hearing.

The Bench, also comprising Justice M.R. Shah, was hearing an appeal filed by United India Insurance Company Limited in a case concerning the implementation of the New Health Insurance Scheme of 2012 and 2014 for government employees and pensioners in the State. The State was represented by counsel Joseph Aristotle.

The scheme was based on an agreement between the company and the government. It is a cashless insurance scheme for specified diseases, treatment and surgeries. A network of nominated and approved hospitals comes under it.

United Insurance has challenged a single judge decision of the Madras High Court that it ought to pay the claims of patients who availed themselves of treatment and surgeries at hospitals outside the network. One of the respondent hospitals was represented by advocate Siva Balamurugan.

The single judge had said the company could recover the money from the government. The single judge invoked Article 21 (right to life) to justify the order. The company’s subsequent appeal to the Division Bench of the High Court failed.

The company contended that there was no provision for reimbursement. It reasoned that “a contract of insurance, like any other contract, is a commercial transaction, and parties are bound by the terms of the contract duly indicated in the cashless scheme for defined surgeries, diseases and treatment”. The company said the High Court had erroneously invoked Article 21.

The patients argued that it was a matter of their right to have the claims settled by the company. Mr. Aristotle said the claimants could also get reimbursed under the Tamil Nadu Medical Attendance Rules. On hearing this, Justice Chandrachud remarked approvingly about the State’s health infrastructure. The hearing would resume on Thursday.

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