Citation Codes

Equivalent Citations

citation codes

Judges

Mr. Justice P. Jyothimani

Acts

rule 2 of the Tamil Nadu Government Employees Health Fund Rules 1991. 14. The Tamil Nadu Government Employees Health Fund Rules 1991
Nadu Government Employees Health Fund Scheme Rules 1991
Rule 2 of the Tamil Nadu Government Employees Health
Section 12(3) of the Industrial Disputes Act,
SECTION 29 INDUSTRIAL DISPUTES ACT
Section 9A of the Industrial Disputes Act
INDUSTRIAL DISPUTES ACT

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Smart Summary

Structured Summary of the Opinion

Factual and Procedural Background

The petitioner joined the respondent's service as an Assistant Tradesman on 15.11.1999 and was working at the Sivakasi Branch as a Junior Tradesman at the time of the proceedings. Under settlements entered into under Section 12(3) of the Industrial Disputes Act (settlement dated 13.02.1999 and an earlier settlement dated 28.09.1995), the Tamil Nadu Transport Corporation Employees Family Medical Assistance Scheme was implemented, providing up to Rs.1,00,000/- for specified treatments (including heart surgery). Employees paid Rs.5/- per month as subscription to the scheme.

The petitioner's father underwent open heart surgery on 13.12.2005 at Meenakshi Mission Hospital, Madurai. The petitioner paid substantial medical expenditure for that surgery—paying Rs.96,537/- to the hospital (the petition sought reimbursement of Rs.90,537/- with 12% p.a. interest from the Labour Welfare Fund). The petitioner made a representation to the respondent on 29.12.2005 with requisite certificates; that representation was not considered, and the respondent denied benefit under the scheme.

The petitioner filed this writ petition seeking a declaration that the denial was illegal, a direction to extend benefit under the scheme to him in respect of his father's surgery, and reimbursement of the stated medical expenses. The respondent filed a counter affidavit admitting the scheme but contending that the scheme's definition of "family" (as per G.O.Ms.No.194 dated 16.03.1993 and the Tamil Nadu Government Employees Health Fund Rules 1991) includes wife and children, and dependent parents only in the case of an unmarried government servant; since the petitioner is married, his father is said not to qualify. The respondent also contended that an alternative remedy under the Industrial Disputes Act is available.

Legal Issues Presented

Whether the petitioner's father's open heart surgery expense falls within the scope of the Tamil Nadu Transport Corporation Employees Family Medical Assistance Scheme (i.e., whether the father's treatment is covered under the scheme's definition of "family").
Whether denial of the petitioner's claim under the scheme is illegal and violative of Article 14 (as argued by the petitioner).
Whether the writ petition under Article 226 is maintainable when an alternative remedy exists under the Industrial Disputes Act for interpretation/enforcement of a settlement made under Section 12(3) of that Act.
Whether the earlier decision in W.P.No.6302 of 2003 (J. Annamalai) binds or controls the outcome in the present facts, i.e., whether the father's inclusion follows from that precedent.

Arguments of the Parties

Petitioner's Arguments

The petitioner relied on the settlement and the scheme which entitles employees to up to Rs.1,00,000/- for specified major treatments (including heart surgery); therefore he was entitled to reimbursement of the expenditure incurred for his father's surgery.
The petitioner argued that denial of benefit violates Article 14 and that refusal to implement the settlement may constitute an offence under Section 29 of the Industrial Disputes Act.
He relied on this Court's earlier order in W.P.No.6302 of 2003 (dated 04.08.2005) where the Court extended medical assistance to the father of a petitioner after considering a Medical Assistance Card and other benefits conferred by the Corporation; counsel submitted that the same point has been previously decided in his favour and that the respondent cannot now contend that "family" excludes the father.

Respondent's Arguments

The respondent admitted the existence of the Medical Assistance Scheme but relied on G.O.Ms.No.194 dated 16.03.1993 and related rules to show the term "family" (for scheme purposes) includes wife and children, and dependent parents only in the case of an unmarried government servant; since the petitioner is married, his father does not fall within the scheme's defined "family."
The respondent contended that the matter involves interpretation of a settlement entered under Section 12(3) of the Industrial Disputes Act and that an alternative remedy exists under the Act itself; therefore the writ petition is not maintainable.
The respondent relied on precedent (including a Supreme Court decision and Division Bench decisions of this Court) to support the proposition that factual questions concerning benefits under settlements should be raised before the appropriate industrial forum rather than by writ petition.

Table of Precedents Cited

Precedent	Rule or Principle Cited For	Application by the Court
W.P.No.6302 of 2003 (J. Annamalai Vs. Management of Metro Transport Corporation Limited) — Order dated 04.08.2005	Interpreted the scope of "family" for medical assistance by reference to actual conduct/benefits of the Corporation (Medical Assistance Card listing father and other benefits like free pass) and extended benefit to the father.	The petitioner relied on this decision. The Court distinguished it on the present facts because there is no record here showing that the respondent conferred other benefits to the petitioner's father; hence that judgment was held not to be applicable to this case.
Hindustan Steel Works Construction Ltd. & another Vs. Hindustan Steel Works Construction Ltd., Employees Union — 2005 (4) L.L.N. 15 (Supreme Court)	Held that matters involving essentially questions of fact (in that case concerning allowances under Section 9A of the Industrial Disputes Act) are matters for the appropriate tribunal and that an alternative remedy should be availed.	The respondent relied on this authority to argue that the present dispute involves questions of fact and therefore the proper remedy is to approach the Tribunal; the Court accepted that the principle supports the availability of an alternative remedy.
A. Annamalai Vs. General Manager, Tamil Nadu State Transport Corporation, Salem Division II Ltd., Dharmapuri — 2005 (1) L.L.N. 878 (Division Bench)	Reiterated that when an alternative remedy is available, a remedy under Article 226 is not necessarily appropriate as a matter of course.	The respondent relied on this Division Bench decision to support the objection to maintainability of the writ petition; the Court regarded this as weight in favor of directing the petitioner to the alternative remedy.
Reported authority — 2001 (98) FJR 269 (Division Bench)	Held that a settlement entered into under Section 12(3) of the Industrial Disputes Act does not create a public duty such that a writ would necessarily lie to enforce it.	The respondent cited this decision to support the proposition that enforcement of a settlement under Section 12(3) may not attract writ jurisdiction; the Court treated this as part of the authorities supporting the existence of an alternate remedy and the factual nature of the dispute.

Court's Reasoning and Analysis

The Court proceeded by examining the scheme, the governing Government Orders (in particular G.O.Ms.No.194 dated 16.03.1993), and the Tamil Nadu Government Employees Health Fund Rules 1991 (Rule 2). The Court noted:

Rule 2 and the G.O. identify who are "family members" for the purpose of the Health Fund scheme. The rule's text includes "wife and children" (or "husband and children" in the case of a female government servant) and specifies that in the case of an unmarried government servant the "dependent parents" are included.
The Court observed that the provision is drafted in inclusive terms and that, as earlier recognized by this Court, the word "family" is not exhaustively defined in the Rule; it is therefore a term susceptible to interpretation informed by context and the conduct of the respondent Corporation.
The petitioner's reliance on the earlier decision in W.P.No.6302/2003 was examined. In that earlier decision, the Court had relied on a Medical Assistance Card and other benefits (for example, travel free passes) that showed the Corporation had treated the father as entitled to benefits; on the basis of those facts that Court extended the medical reimbursement to the father.
In the present case, however, the Court found there is "absolutely nothing on record" to show that the respondent conferred any other benefits on the petitioner's father. Absent such factual evidence of the Corporation's conduct (which had been pivotal in the earlier decision), the Court could not extend that precedent to these facts.
Consequently, the question whether "family" should be interpreted in the broader manner used in W.P.No.6302/2003, or in accordance with the statutory/Government rule text, is a question of fact and mixed law that requires factual inquiry and evidence (for example, whether the Corporation has treated the father as a beneficiary in practice).
Because the dispute essentially raises factual issues about interpretation and implementation of a settlement entered under Section 12(3) of the Industrial Disputes Act (and related government orders), the Court accepted the respondent's contention that an alternative remedy under the Industrial Disputes Act is available. The Court relied on the principle (as stated in authorities cited by the respondent) that factual disputes concerning terms of settlements and allowances are ordinarily matters for the appropriate industrial forum or tribunal rather than immediate resolution by writ petition.
The Court also acknowledged that while beneficial schemes should be interpreted liberally, such an approach cannot be applied where the requisite factual basis (evidence of the employer's conduct or conferral of other benefits) is absent. The Court concluded that deciding entitlement here requires evidence and factual findings which are more appropriately determined by the alternative forum.

Holding and Implications

Holding: The writ petition is dismissed. The Court granted liberty to the petitioner to approach the appropriate forum under law (i.e., the remedies available under the Industrial Disputes Act). There is no order as to costs.

Implications:

The direct effect on the parties: the petitioner is not granted the declaratory relief or reimbursement in this writ petition and must pursue the question of entitlement (including the factual question whether his father was treated as a beneficiary) before the appropriate authority under the Industrial Disputes Act or other competent forum.
The Court expressly distinguished the earlier decision relied upon by the petitioner because that earlier decision turned on factual findings (existence of other benefits conferred on the father) which are not present on the record in this case.
No new precedent extending the scheme to the petitioner's father was created by this order; the Court made clear that the factual matrix is critical and that where factual issues predominate an alternative remedy must be pursued.

No additional facts, arguments or precedential interpretations beyond those contained in the provided opinion have been added in this summary.

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K.Sundararaj v. The Management Of

Heard the learned counsel appearing for the petitioner and the learned counsel for the respondent.

2. This writ petition is filed for a declaration that denying the petitioner's benefits payable under the Special Medical Assistance Scheme for the open heart surgery undergone by the petitioner's father on 13.12.2005 is illegal and also directed the respondent to extend the benefit under the scheme to the petitioner and reimburse the medical expenditure incurred by the petitioner by paying Rs.90,537/- with 12% interest per annum from the Labour Welfare Fund.

3. The case of the petitioner is that he has joined in the services of the respondent as Assistant Tradesman on 15.11.1999 and working at the Sivakasi Branch of the respondent Corporation as Junior Tradesman as on date. As per the settlement entered into between the trade unions of the employees and the management of the respondent under Section 12(3) of the Industrial Disputes Act on 13.02.1999, a special medical assistance scheme to the benefit of the workmen was introduced. It is called the Tamil Nadu Transport Corporation Employees Family Medical Assistance Scheme under which an employee is entitled for the maximum upto Rs.1,00,000/- for undergoing five types of medical treatments either by himself or by his family members. Accordingly, the petitioner and other workmen have been paying Rs.5/- per month from the monthly wages to the scheme as a subscription under clause 79(3) of the settlement. The medical assistance given in respect of (i) Heart surgery (ii) Kidney Transplantation

(iii) Ballooning heart operation (iv) Cancer surgery (v)Brain Tumor surgery. The petitioner's father has suffered a chest pain and he underwent an open heart surgery on 13.12.2005 in the Meenakshi Mission Hospital, Madurai. In respect of the said surgery of his father, the petitioner had to spent more than Rs.1,00,000/- and he has paid Rs.96,537/- to the hospital alone. Since, the scheme is made applicable, the petitioner is entitled for the said amount, he has made representation on 29.12.2005 to the respondent along with the necessary certificates and the same has not been considered.

4. In the circumstances, the petitioner has filed this writ petition containing inter alia that the denial of the right is violative of Article 14 and the the refusal to implement the settlement constitutes an offence under Section 29 of the Industrial Disputes Act and also the petitioner relied upon a judgment of this Court in W.P.No.6302 of 2003 dated 04.08.2005 under which this Court has extended the benefit of the scheme to the father of the petitioner therein who has undergone a special medical treatment.

5. The respondent has filed counter affidavit while admitting that the Employees Medical Assistance Scheme was introduced under Section 12(3) of the Industrial Disputes Act and the employees are entitled to get upto Rs.1,00,000/- for the employee's family which was as per the settlement dated 28.09.1995, subsequently, by another settlement dated 13.02.1999, it was agreed to extend the scheme by applying the Tamil Nadu Government Employees Health Fund Scheme to the employees of the State Transport Corporations. As per the G.O.194 dated 16.03.1993 by which the Government has already amended the Rule 2 of the Tamil Nadu Government Employees Health Fund Scheme wherein while defining the 'family' it is stated to include wife and children of the Government servant and in the case of unmarried Government servant it would include the dependant parents. According to the petitioner, he is a married man and therefore, as per the definition of the 'family' the petitioner is not entitled for the amount spent for his father's treatment as per the scheme.

6. Mr.Hariparathanman, learned counsel appearing for the petitioner would submit that this Court while interpreting the definition of the 'family' as per the G.O.Ms.No.194 dated 16.03.1993 in the order of this Court dated 04.08.2005 passed in writ petition W.P.No.6302 of 2003 has held that as per the clause 2 of the scheme eventhough the word 'family' was used for the purpose of giving medical reimbursement the said word admittedly not defined and it was in those circumstances, this Court has held that the term 'family' has to be understood with the attended circumstances and benefits granted to the employees. This Court has relied upon a Medical Assistance Card given by the respondent to its employees in which S.No.5 contemplates the name of the father for the purpose of medical assistance. Further, this Court considering the fact that certain other benefits like free pass for travelling purpose in the Transport Corporation bus have been given to the father of the petitioner and in such circumstances, this Court has rejected the similar contentions raised by the respondent that the father of the petitioner cannot be included to the benefit under the scheme. It was in those circumstances, and also for other reasons stated therein, this Court has allowed the writ petition directing the respondents to reimburse the medical expenditure incurred by the petitioner therein in respect of his father's treatment.

7. Relying upon the said judgment, the learned counsel for the petitioner would submit that the exact point which has been raised presently was already dealt with by this Court and therefore, the contentions of the respondent that the word 'family' does not include the father is no more available to the respondent.

8. On the other hand, Mr.R.Sivamanogaran, learned counsel appearing for the State Transport Corporation would submit that the matter involves the interpretation of the settlement entered into under Section 12(3) of the Industrial Disputes Act and there is an alternative remedy available under the Industrial Disputes Act itself. In the presence of such alternative remedy available under the Industrial Disputes Act this Writ petition cannot be entertained.

9. The learned counsel in support of the said contention has placed reliance on the judgment of the Supreme Court rendered in Hindustan Steel Works Construction, Limited and another Vs.Hindustan Steel Works Construction Ltd., Employees Union reported in 2005(4) L.L.N.15 where the Apex Court, while dealing with Section 9A of the Industrial Disputes Act in respect of the allowance to the employees working at the projects, has held that the matter involves essentially a question of fact and therefore, the proper remedy is to approach the Tribunal.

10. He has also relied upon another judgment of the Division Bench of this Court in A.Annamalai Vs. General Manager, Tamil Nadu State Transport Corporation, Salem Division II Ltd., Dharmapuri reported in 2005 (1) L.L.N.878 for the same proposition that when an alternative remedy is available, remedy under Article 226 cannot be a matter of course. He has also relied upon another judgment of the Division Bench of this Court reported in 2001 (98) FJR 269 to show that the settlement entered into between the parties under Section 12(3) of the Industrial Disputes Act, does not create a public duty and no writ will lie. According to him, the matter involves a question of fact and therefore, the writ petition should be dismissed.

11. I have heard the learned counsel for the petitioner as well as the learned counsel for the respondents and perused the entire records.

12. The main contention raised on behalf of the respondent while admitting that the Medical Assistance Scheme was introduced and implemented as per the Government order by referring to a G.O.Ms.No.194 dated 16.03.1993 and the G.O.Ms.No.100 dated 19.05.1998, is that the term 'family' as per the Rule 2 is stated to include the wife and children of the Government servant and in the case of unmarried Government servant it would include the dependent parents alone. In this case, inasmuch as the petitioner is married, father cannot be treated as a dependent parent and therefore, it will not be covered within the word 'family'.

13. A reference to the Rule 2 would show as it is seen in G.O.No.194 dated 16.03.1993 in the following terms:

The benefit under the scheme be extended to the family members of Government employees specified in rule 2 of the Tamil Nadu Government Employees Health Fund Rules 1991.

14. The Tamil Nadu Government Employees Health Fund Rules 1991 has amended the existing Rule 2 states as follows:

These rules shall extent to the whole of the State of Tamil Nadu. These rules shall apply to all categories of full time regular (Time-Scale) Government Employees of the Government of Tamil Nadu and their family members and to All India Service Officers serving in the State and to their family members.

15. Therefore, a reading of the rule would show that the benefit is applicable to the employees of the family members. However, while enumerating the term 'family' the said rule further states as follows:

"Family" for the purpose of this scheme will include, 'wife and children' of the Government servant. In case of female Government servant 'Husband and Children' and in the case of unmarried Government servant the dependent parents".

16. A reference to the said paragraph shows that the term 'family' is not actually defined as pointed out by this Court earlier in the Writ Petition in W.P.No.6302 of 2003 and the term is stated as only inclusive. Therefore, the term 'family' for the purpose of extension of benefits of the scheme has to be considered based on the conduct of the respondent Corporation. However, in the said judgment relied upon by the petitioner which is in J.Annamalai Vs. Management of Metro Transport Corporation Limited, rep. by its Managing Director, Pallavan House, Anna Salai, Chennai-2. The petitioner has relied upon the medical assistance card and other benefits like free pass for travelling purpose for the family members and on the said fact this Court has come to the conclusion that such benefits have been conferred to the father of the petitioner therein. It was in those circumstances, this Court having considered that when other benefits have been extended to the father of a married employee of the State Transport Corporation, there was no reason to deny such benefit in respect of the medical reimbursement scheme also. However, in the present case, there is absolutely nothing on record or even in the affidavit filed by the petitioner stating that any other benefits has been conferred to the father of the petitioner.

17. Therefore, I am of the considered view that the judgment relied upon by the petitioner in the said writ petition is not applicable to the facts and circumstances of the case. As I stated earlier in that case relied upon by the petitioner, on fact certain other benefits have been conferred to the father, and therefore, the Court has come to a conclusion that denying the same for the medical reimbursement scheme will be discriminatory.

18. I am unable to come to such a conclusion since there is absolutely no record to show that such benefits have been conferred on the father of the petitioner from the respondent Corporation. Moreover, the respondent Corporation in the present circumstance, is different from the Transport Corporation in that case.

19. In view of such circumstances, I am of the considered view that as correctly pointed out by the learned counsel for the respondents that the matter involves a question of fact as to whether the term 'family' has to be interpreted in the manner which is stated to the Tamil Nadu Government Employees Health Fund Scheme Rules 1991 or as interpreted by this Court in W.P.No.6302 of 2003 based on other available materials.

20. There is one other circumstance namely that the petitioner is certainly entitled to have an alternative remedy available under the Industrial Disputes Act, since, the matter relates to a question of fact for the purpose of deciding the term 'family' either by statue or arrived at under Section 12(3) of the Industrial Disputes Act or as per the Government order in G.O.Ms.No.194 (Finance Department)) dated 16.03.1993.

21. Eventhough, the beneficial scheme has to be interpreted in a more liberal manner this Court is unable to come to such a conclusion in the present case for want of actual particulars and also for a decision on factual issues which involves the evidence and interpretation of various words under the settlement as also the Government order.

22. In view of the same, giving liberty to the petitioner to approach the appropriate forum under law, this Writ petition stands dismissed. There is no order as to costs.

sms To The Management of Tamil Nadu State Transport Corporation (Madurai)Ltd., Rep.by its Managing Director, Bye-pass Road, Madurai.

K.Sundararaj v. The Management Of

Structured Summary of the Opinion

Factual and Procedural Background

Legal Issues Presented

Arguments of the Parties

Petitioner's Arguments

Respondent's Arguments

Table of Precedents Cited

Court's Reasoning and Analysis

Holding and Implications

K.Sundararaj v. The Management Of

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