Mir Farhat
SRINAGAR, Mar 6: The State Government employees have demanded rollback of the mediclaim insurance policy after it has failed to fulfill their medical needs because of its limited utility and rigid implementation.
The employees said that the policy did not yield the benefits as they had expected from it after it was made compulsory by the Government.
Introduced in 2014 for three years for all the State Government gazetted employees, the Group Mediclaim Insurance Policy is implemented through ICICI Lombard General Insurance Company Ltd at an annual premium of Rs 6,081.
The employees said that the empanelled hospitals in the State where the policy benefits can be availed are limited and a number of them don’t fulfill their desired health needs.
Muneer Ahmad, an employee, has for the past eight months taken her pregnant wife for regular checkups to a senior gynecologist at a private hospital. He said that he wanted his wife to deliver under the same doctor’s watch.
“But the hospital is not enlisted among those hospitals where I can avail the policy benefits. I think the hospitals where I can avail it are not well equipped and don’t have the senior doctors. So the policy does not make any sense for me,” Meer said.
Muneer said that he does not want to risk her wife’s life by taking her to a hospital which was not upto mark. “Though the government deducts premium from my salary, but I am not able to avail its benefits. I want its rollback,” he said.
As per the list, eight hospitals in Jammu, 11 in Kashmir and 112 in other parts of the country have been enlisted where a beneficiary can avail treatment under the insurance cover of Rs 5 lakhs on floater basis for each year.
Thousands of gazetted employees of the State fall under the medical insurance cover, and most of them are disappointed with the shortcomings of the scheme.
Another employee, Ajaz Ahmad, said that he had to undergo an ear surgery few months ago and he could not take the policy benefits, for the hospital where he wanted to undergo the surgery has not been listed by the insurance company.
“I went to a Government hospital for the surgery. But I had to wait three months for my turn because of the huge rush of patients there. So, for me the policy is useless,” he complained.
They said that no employee would risk to get admitted at any of these listed hospitals that lack modern health facilities and efficient doctors.
Under the policy, the employee and his five dependents within the age group of 3 months to 80 years are covered.
“There is no provision of reimbursement of the medical expenses if we seek treatment in an institution of our choice,” they said, explaining the shortcomings of the policy.
An official of the ICICI Lombard GIC Ltd said that the policy has “proved” beneficial for the employees.
“There is no binding on us to empanel a particular hospital and exclude any. We can increase the list of the hospitals in the policy,” he told Excelsior, but didn’t want to be named as he is not authorized to talk to media.
Finance Minister Haseeb Drabu was not available for comments as his phone was switched off.
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