2nd April 2015
Shri Anil Kumar Chaudhary
Director (Finance)
Steel Authority of India Limited,
New Delhi – 110003
Dear Sri Chaudhary,
Pl. find below our message to the CMD of United India Insurance Co. on fixing up of a more efficient and fast responding TPA. As you can see in the stream of messages in the link sailex.blogspot.in/2015/03/exchange-of-e-mails-with-sail-nic-and.html the services rendered by the TPA E-meditek was highly unsatisfactory in the expired term. We are not sure about the extent of contribution of the National Insurance Co. and that of the TPA in their malfunctioning but we request you to kindly take note of this and advise the newly contracted Insurance Co., the UIIC to take our request/ suggestions seriously and identify more efficient TPA.
With regards,
--
Dr.V.N.Sharma, Chairman
Federation of Retired SAIL Employees
Chairman
cum Managing Director,
United
India Insurance Co. Ltd.
CHENNAI.
Sub: issues related to Mediclaim Insurance of
SAIL Retirees
Ref: Our message dated 1st April 2015
Dear
Sri Kharat,
It
has formally come to our notice that SAIL has renewed the Mediclaim Insurance for its
Retirees for a period of one year
from 1st April, 2015 to 31st March, 2016 with your Co. - M/s. United India
Insurance Co. Ltd.
As we
understand the guiding principles of the Healthcare including mediclaim
insurance should be the following
and they should be accepted and enforced through the period of its effect by
the TPA contracted by you without any laxity.
Ø
Portal of the Govt. of India on Senior Citizens reads as “Senior
Citizens are a treasure to our society. They have worked hard all these years
for the development of the nation as well as the community. They possess a vast
experience in different walks of life. The youth of today can gain from the
experience of the senior citizens in taking the nation to greater heights. At this age of their life, they need to be taken care of and made
to feel special.”
Ø
“The
National Council for Senior Citizens formed under the Ministry of Social
Justice and Empowerment should take care of promotion of physical and financial
security, health and
independent and productive living and awareness generation and community
mobilization”.
Ø
“Healthcare
is directly related to life and death of a Citizen and leaves no chance for a
repeat performance. So the benefit of doubt should always be in favour of the
patient and there can be no room for laxity of any kind or slow action at any
time at either end of the network of SAIL, Insurance Co., the TPA and the
patient in cases of Medically Insured Senior Citizens who happen to be SAIL
Retirees in the instant case.”
As conveyed to you our
members remained distressed throughout the period of the coverage and no relief
came through even after a stream of complain looking messages were sent to all
and sundry. In view of this as you must have seen in
the link sailex.blogspot.in/2015/03/exchange-of-e-mails-with-sail-nic-and.html a tele discussion took place between us and
the representative of the TPA on 14th March 2015 on the basis of which blue
lettered Record Note of suggestions was posted to E-meditek, the TPA. However,
the TPA has not given its assent or dissent or comment on the suggestions made
to improve the service.
Since it was the fag end
of the duration of the Agreement not much was expected from either the
Insurance Co. and the TPA might have taken it for a pep talk.
Now that new term begins
with you as the Insurance Co. it would be better to present our suggestions as
follows afresh.
1. Fix up Hospitals of reasonable
and reliable quality in nearby locations for both OPD & IPD. All IPD
Hospitals must be permitted to entertain OPD cases, if possible.
2. Some Hospitals in the list given
by the E-meditek refuses to honour the list from day one of its implementation.
Number of mid-way withdrawals of service by a Hospital for Cashless Treatment etc
is very high almost half of the list for reasons best known to the previous
Insurance Co. and the TPA. We suggest that the Insurance Co. and the TPA
combine must ensure such mid-way withdrawals only after a month’s notice to the
SAIL Mediclaim members.
3. All
service activities of the TPA like
(a)
Preparation and delivery of Guidebook and ID cards etc. to the Members/ Spouse
(b) Decision making in all matters other than medical
(c)
Release of payment to Hospitals / reimbursement of OPD/ IPD Bills
etc must follow a time frame of a maximum of two weeks.
4. Permission
for Cashless / IPD Treatment and Settlement of Bills for the same must not
exceed Three hours from the time of receiving the message from the concerned
Hospital before treatment or to release the patient after Treatment.
5- For
every difference of opinion or interpretation on the terms of service TPA /
Insurance Co. should approach SAIL to circulate clarification/ clarified
version and made effective from a date sufficiently later than the issue of
such notification.
6. The
TPA and its staff must work more efficiently, if possible at least partly, with
missionary zeal and give a personal touch to the dealings.
7. TPA
must accept a member/ spouse as genuine if he/ she produces valid payment
receipt.
We would request you to
kindly identify and select an efficient and well intentioned TPA for executing
the above suggestions. We
are open to discussion even in a Skype meeting if and when desired by you. We
are also providing a list of Hospitals below in the Annexure to be included for
Cashless/ IPD/ OPD treatments in addition to the present list.
With regards,
Yours sincerely,
(V.N.Sharma)
Chairman
Annexure
LIST OF HOSPITALS TO BE INCLUDED AFRESH
|
1. Santevita Multispecilality Hospital,
1, HB Road, (Near Firayalal Chowk),Ranchi-834001, Ph:+91 651 301 1111, +91 651 222 5555, Web: http://www.santevitahospital.
E-mail: info@santevitahospital.com
2. Bhagwan Mahabir Medica Superspeciality Hospital, Ranchi
Ph. 06516606000,+917033093309
3. Orchid Medical Centre, HB Road, Ranchi-834001, Phone:0651 221 9501 http://www.orchidmedcentre.
4. MGM Eye Institute, Raipur
5. MMI Narayana Multispeciality Hospital,Raipur
6. Ramakrishna Hospital, Raipur
7. Chandulal Chandrakar Memorial Hospital,
Nehru Nagar Chowk, GE Road Bhilai, 07882294712, 2292683, 9993095039, info@ccmhbhilai.com
8. Apollo BSR hospital, junvani road, smriti nagar, Bhilai, 07882299999, 9981101111, info@apollobsr.com
9. "Combined Medical Institute Hospital (CMI), Haridwar Road, Dehradun"
10. Mother Hospital (P) Ltd, P.O. Pllazh, Olari, Thrissur 680012, Kerala State for cashless Treatment .
11. Chennai Meenakshi Multispeciality Hospital, 148, Luz Church Road, Mylapore, Chennai - 600 004 for OPD
12. Asian Instt of Medical Sciences ,Sector 21A.FARIDABAD for OPD also
13. Poyyanil Hospital, Poyyanil Juction,Kozhencherry P O Pathanamthitta Dist. KERALA PIN 689641 for OPD & IPD
14. Narayana Hrudayalaya, Shimoga
15. Nanjappa Hospital,Shimoga.
16. Hosmat - Hospital Pvt Ltd, 45, Magrath Road, off. Richmond Road, Bangalore - 560025
17. Columbia Asia Hospital, White field, Bangalore.
18. Brahm Shakti Hospital,U-178 Budh Vihar,Main Kanjhawala Road,New Delhi-110086 for OPD
19. Charnok Hospitals Pvt Ltd
(ISO-90001;2008 &ISO-14001:2004 Certified.NABL Accredited)
RGM-2013,Teghoria,
Tel:033-40-500-500.Fax:
E -Mail: info@charnokhospital.com
20. UMA Medical Related Institute Pvt Ltd,VIP Road, Teghoria, Kolkata-700157
(ISO 9001:2008) Phone:03367017711,
21. SJ Memorial Diabetic & Medical Speciality Centres Pvt Ltd
VIP Road, Teghoria, Raghunathpur,Kolkata-700059
Phone:033-25708428/
22. ORANGE CITY HOSPITAL
VASAN EYE CARE Nagpur
23. Sunetra Eye hospital, 1050/1, Eastern Metropolitan Bypass, Park Survey Santoshpur, Kolkata, West Bengal 700075. This is one of the renowned eye hospitals in Kolkata
24. BM Hospitals (044-22671182) –for OPD & Cashless
36, 5th Main Road, Thillaiganga Nagar, Chennai - 600061
25. DR Hariharan Diabetes & Heart Care Hospital (044-22345275)
24 / 26, "SWATHI", 29th Street, Nanganallur, Chennai - 600061
26. Hindu Mission Hospital (044-22262244) ) –for OPD & Cashless
103, Grand Southern Trunk Road
Tambaram West
Chennai - 600045
27. Hindu Mission Health Services, (044-22243026) ) –for OPD & Cashless
100 feet Road,
Hindu Colony
Nanganallur - 600061
28. Life Line Hospital) –for OPD & Cashless
No. 14/2, 2nd Cross Street,
Madipakkam,
Chennai - 600117
29. S.P Hospital, Address: 16, Karikalan E St, Adambakkam, Chennai, Tamil Nadu 600088
30. Sarathy Nursing Home (044-22456943), 28, 2nd Lane, Vellalar East Street, Adambakkam, Chennai – 600088
31. Parvathy Hospital, 241, GST Road, Chrompet. Chennai. 600044.
32. Prashanth Superspeciality Hospital,
No.36/37, Velachery Main Road, Velachery,
Chennai - 600042
33. SIMHAPURI HOSPITALS, NH-5, CHINTHAREDDYPALEM CROSSROAD,
NELLORE, ANDHRAPRADESH.
34 Max Hospital
Malsi, Mussoorie Diversion Road, Dehradun (Uttarakhand)
It is a multi-speciality hospital.
35. CMI Hospital
Haridwar Road, Dehradun - 248001 (Uttarakhand)
(This is also a multi-speciality hospital.)
36. The Apollo Clinic
8/4-1, near Kishan Nagar Chowk, Dehradun - 248001 (Uttarakhand)
37. Medica Superspecialty
Mukundapur, 127, Eastern Metropolitan Bypass, Kolkata, West Bengal-700099
38. Vision Care Hospital-Mukundapur
E.M. Bypass, Mukundapur. Landmark: Behind Metro Cash & Carry Near Medica Hospital, Kolkata
39. Sankara Nethralaya
147 Mukundapur, EM bypass, Near Purba Jadavpur Thana,
40. Narayna Hrudayalaya Pvt. Ltd.
Plot No. 3 & 4, Sadaramangala Industrial Area, Whitefield Main Road, Mahadevapura Post, Bangalore 560 048
Tel: 080 71112555
WWW.narayanahealth.org
Tel: 080 71112555
WWW.narayanahealth.org
41. Karnataka Institute of Diabetology
Bannerghatta Road, 9th Block Jaynagar, Bangalore 560 069
Phone: +91 80 2297 7698/99
WWW.kidbangalore.in
Bannerghatta Road, 9th Block Jaynagar, Bangalore 560 069
Phone: +91 80 2297 7698/99
WWW.kidbangalore.in
42. Max Super Speciality Hospital
Malsi, Mussoorie Diversion Road
Dehradun - 248 001
43. CMI Hospital
Haridwar Road
Dehradun - 248 001
44. CHODANKAR NURSING HOME
H-17, PORVORIM,
BARDEZ, GOA-403521,
PHONE 0832 2417778
45. Ramkrishna Care Hospital :
Aurobindo Enclave, Pachpedi Naka, Dhmtari Road, NH-43, RAIPUR – 492001,
Ph.No. 0771-2419193/194: e-mail:
46 . MMI Narayana Multispeciality Hospital : Dhamtari Road, Lalpur, Raipur,
Aurobindo Enclave, Pachpedi Naka, Dhmtari Road, NH-43, RAIPUR – 492001,
Ph.No. 0771-2419193/194: e-mail:
46 . MMI Narayana Multispeciality Hospital : Dhamtari Road, Lalpur, Raipur,
Chhattisgarh 492001.
Phone:0771- 42 12761
47. Satya Sai Sanjeevani Hospital : Sector 2, Naya Raipur, Chhattisgarh 492101
Ph:094242 07140
48. MGM Eye Institute: 5th Mile, Vidhansabha Road, Raipur -493111, Chhattisgarh,
Phone:0771 - 29 70670
47. Satya Sai Sanjeevani Hospital : Sector 2, Naya Raipur, Chhattisgarh 492101
Ph:094242 07140
48. MGM Eye Institute: 5th Mile, Vidhansabha Road, Raipur -493111, Chhattisgarh,
Phone:0771 - 29 70670
49. Institute of Liver and Biliary Sciences
Address: D-1, Vasant Kunj, New Delhi, Delhi 110010
Phone:011 4630 0000
50. Sahyadri Speciality Hospital Deccan Gymkhana
Plot no.30 – C, Erandwane, Deccan Gymkhana,
Pune 411004, Maharashtra, India
Telephone: 020-6721 3000 (30 lines) / 25403000 / 25403040
Fax No.: 020-25459315
51. Brahm Shakti Hospital, Pooth Kalan,
Rohini, New Delhi, Delhi 110086
52. Ashwini Hospital, Cuttack (Odisha),
53. Aurobindo Eye Hospital, Raipur
--
Dr.V.N.Sharma, Chairman
2015-04-01 19:41 GMT+05:30 Federation of Retired SAIL Employees <forsesail@gmail.com>:
Dear Sri Kharat,
Your Co. has been selected to implement SAIL Mediclaim Policy for SAIL Retirees. Our experience with the current Indsurance Co. + the TPA was extremely unsatisfactory. Pl. read the contents of our dissatisfaction in the linksailex.blogspot.in/2015/03/exchange-of-e-mails-with-sail- nic-and.html and take decision to appoint a TPA in consultation with us. Hoping to hear from you soon before things are finalised.
--Dr.V.N.Sharma, Chairman
Federation of Retired SAIL Employees
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