Indian Express 19.08.2010
Mediclaim money proves elusive for KMC staff
Sreecheta Das Tags : KMC mediclaim, kolkata Posted: Thu Aug 19 2010, 02:45 hrs
Kolkata: A large section of Kolkata Municipal Corporation employees has complained that they have not been reimbursed their hospital bills by the company in charge of providing mediclaim.Since 2004 — when Subrata Mukherjee was the Mayor — the National Insurance Company Limited has been in charge of providing medical insurance to 19,000 employees of the corporation and the councillors. The policy of Rs 50,000 was increased to Rs 75,000 by the previous board.
The deal with TTK Healthcare Services Pvt Ltd, the Third Party Administrator (TPA) of the mediclaim policy, was that the company would provide cashless benefit at the 118 listed nursing homes. In case of admission in other nursing homes, the patients will be reimbursed their bill.
“But the company has refused to reimburse many patients on the ground that they have not been admitted in listed nursing homes,” said Dipankar Chakrobarty, the president of the Left-aligned KMC Clerks’ Union.
A large section of Kolkata Municipal Corporation employees has complained that they have not been reimbursed their hospital bills by the company in charge of providing mediclaim.
Since 2004 — when Subrata Mukherjee was the Mayor — the National Insurance Company Limited has been in charge of providing medical insurance to 19,000 employees of the corporation and the councillors. The policy of Rs 50,000 was increased to Rs 75,000 by the previous board.
The deal with TTK Healthcare Services Pvt Ltd, the Third Party Administrator (TPA) of the mediclaim policy, was that the company would provide cashless benefit at the 118 listed nursing homes. In case of admission in other nursing homes, the patients will be reimbursed their bill.
“But the company has refused to reimburse many patients on the ground that they have not been admitted in listed nursing homes,” said Dipankar Chakrobarty, the president of the Left-aligned KMC Clerks’ Union.
“I have produced all the required papers after I had to undergo an emergency surgery in August 2009,” said Bablu Das, a conservancy employee of the KMC. “Every time I am being rejected and I’m told that some papers are not ready. For me, Rs 11,000 is a huge amount and I have waited for one whole year. How much longer will I have to wait to get my dues?”
Biplab Bhattacharya, KMC Personnel Officer, has a similar story to tell. “I was admitted to Paramount Nursing Home in the middle of the night in November 2008, with a severe pain in the stomach due to an abscess in liver,” he said. “The hospital bill was Rs 40,000. I am constantly being refused money on the ground that the nursing home was not a listed one. But why should that be an issue when I did not avail of the cashless facility?”
But while ordinary employees are being harassed like this, senior KMC officials are getting their dues on time.
It is an evil nexus between TTK and a section of KMC bureaucrats,” Chakrobarty said. “Cases in point are of Sanjay Bhattacharya, the Deputy Manager of the Finance and Accounts Department and Partha Dasgupta, the Executive Engineer of Borough X, who were admitted to non-listed hospitals and their money was reimbursed within the stipulated time period.”
A meeting was held on July 31 in which all unions, irrespective of political colours, have demanded that there be a reimbursement for availing both cashless and non-cashless facilities and there should not be any sub-limit on any kind of treatment, which was there in the mediclaim policy.
“We are looking into the matter so the deserving people get back their money as soon as possible,” said KMC Commissioner Arnab Roy.
This year again the National Insurance Company has been given the charge of providing medical insurance to 1,84,000 BPL families of the city.
“It is a welcome move, but I hope there is enough infrastructure to carry out the project properly,” said Chakrobarty. “If educated employees of the KMC can be duped by the TPA, how will the illiterate BPL people manage to get their dues? But still, the initiative is a great one.”
