Sept 13, 2016
Dr. Nilu Mahapatra,
Director (Personnel), SAIL
New Delhi
Dear Sir,
Further to what I communicated in the mail trail inordinate and wilful delay in payment, repudiation of bills on flimsy grounds etc are resulting into more sufferance of the SAIL Retirees and leading to more and more queries by them - from TPA and their local offices, SAIL IRPs and us - as desperate attempt to find out why a resolution is not in sight even after our one-way regular and voluminous attempts to interact with all concerned incl. SAIL and clear the air wrt working of SAIL Mediclaim Scheme for over 5 months now-almost half the duration gone. Please remember that the terms of Agreement with the Insurance Co. and the TPA has no time frame for the
- release of payment of Bills,
- granting permission for Cashless treatment,
- release of payment to Hospital during patient's discharge (it has been taking 6-8 hours),
- correct and updated list of Hospitals,
- dispatch and delivery of I-cards and the Guidebook
We have prepared a list of suggestions incl the above issues for improvement which can be seen in the link http://tinyurl.com/sailme
Inability of all these agencies including SAIL and its IRPs in Plants and Units to explain the reason of such poor and inefficient working of the SAIL Mediclaim Scheme for so long and appropriate measures not taken to bring the Mediclaim Scheme back to rails is making the members believe more on reliable insiders' informal communication 'that this contract is not workable and whole operation may collapse within next few months. Also that OPD bills are held up just to slowdown the cash outflow of the IFFCO-TOKIO, the insurance company', that is causing panic in the minds of the Members of the Scheme.
We suggest that at this juncture when absence of communication and help to retirees by SAIL and absence of Action by Insurance Co. and the TPA is making the SAIL Retirees jittery by the day, SAIL must take some proactive action right now and correct the situation when this Mediclaim Insurance system appears to be failing completely. Instead of being a silent onlooker for so long SAIL may like to consider an alternative Plan to be ready to take care of Retirees health directly, at par with regular employees. It may please be noted that Retirees are contributing to the total premium paid by SAIL.
With warm regards,
Copy to: All Chief Executives, all SAIL IRPS and FORSE e-groups
--
Dr.V.N.Sharma, Chairman
For & on behalf of
Federation of Retired SAIL Employees (Regd)
<<<<<<<<<<<<<<<<<<
11/09/2016
Sept 13, 2016
Dr. Nilu Mahapatra,
Director (Personnel), SAIL
New Delhi
Dear Sir,
Further to what I communicated in the mail trail inordinate and wilful delay in payment, repudiation of bills on flimsy grounds etc are resulting into more sufferance of the SAIL Retirees and leading to more and more queries by them - from TPA and their local offices, SAIL IRPs and us - as desperate attempt to find out why a resolution is not in sight even after our one-way regular and voluminous attempts to interact with all concerned incl. SAIL and clear the air wrt working of SAIL Mediclaim Scheme for over 5 months now-almost half the duration gone. Please remember that the terms of Agreement with the Insurance Co. and the TPA has no time frame for the
- release of payment of Bills,
- granting permission for Cashless treatment,
- release of payment to Hospital during patient's discharge (it has been taking 6-8 hours),
- correct and updated list of Hospitals,
- dispatch and delivery of I-cards and the Guidebook
We have prepared a list of suggestions incl the above issues for improvement which can be seen in the link http://tinyurl.com/sailme
Inability of all these agencies including SAIL and its IRPs in Plants and Units to explain the reason of such poor and inefficient working of the SAIL Mediclaim Scheme for so long and appropriate measures not taken to bring the Mediclaim Scheme back to rails is making the members believe more on reliable insiders' informal communication 'that this contract is not workable and whole operation may collapse within next few months. Also that OPD bills are held up just to slowdown the cash outflow of the IFFCO-TOKIO, the insurance company', that is causing panic in the minds of the Members of the Scheme.
We suggest that at this juncture when absence of communication and help to retirees by SAIL and absence of Action by Insurance Co. and the TPA is making the SAIL Retirees jittery by the day, SAIL must take some proactive action right now and correct the situation when this Mediclaim Insurance system appears to be failing completely. Instead of being a silent onlooker for so long SAIL may like to consider an alternative Plan to be ready to take care of Retirees health directly, at par with regular employees. It may please be noted that Retirees are contributing to the total premium paid by SAIL.
With warm regards,
Copy to: All Chief Executives, all SAIL IRPS and FORSE e-groups
--
Dr.V.N.Sharma, Chairman
For & on behalf of
Federation of Retired SAIL Employees (Regd)
<<<<<<<<<<<<<<<<<<
11/09/2016
Dr. Nilu Mahapatra,
Director (Personnel), SAIL
New Delhi
Dear Sir,
Further to our e-mail dated 21st July I have to bring to your kind notice that Mediclaim services have not improved much beyond that date. On some pretext or the other the payment for OPD/ IPD Bills are delayed and not done in large number of cases. Printed plastic I-card and the Guidebook are yet to reach large number of the Members hands. Retirees settled in distant locations are the worst sufferers of this unruly dispatch and delivery systems. Writing to Raksha TPA does not fetch a reliable response. Dates / schedule given for action requested by the Retirees is lapsed by and large.
Reliable informal communications reveal that some actions were initiated from your end in the form of Video Conferencing with all concerned including SAIL IRPs and Insurance Co. and the TPA but these seem to have little impact. The business is going as usual and Members of the Scheme continue to live without respite.
I request you to please expedite the processes to make the operation of the SAIL Mediclaim Scheme more effective and efficient. We will appreciate if we are also kept in the loop of negotiation and communication.
With warm regards,
Copy to: All Chief Executives, all SAIL IRPS and FORSE e-groups
Dr. Nilu Mahapatra,
Director (Personnel), SAIL
New Delhi
Dear Sir,
Further to our e-mail dated 21st July I have to bring to your kind notice that Mediclaim services have not improved much beyond that date. On some pretext or the other the payment for OPD/ IPD Bills are delayed and not done in large number of cases. Printed plastic I-card and the Guidebook are yet to reach large number of the Members hands. Retirees settled in distant locations are the worst sufferers of this unruly dispatch and delivery systems. Writing to Raksha TPA does not fetch a reliable response. Dates / schedule given for action requested by the Retirees is lapsed by and large.
Reliable informal communications reveal that some actions were initiated from your end in the form of Video Conferencing with all concerned including SAIL IRPs and Insurance Co. and the TPA but these seem to have little impact. The business is going as usual and Members of the Scheme continue to live without respite.
I request you to please expedite the processes to make the operation of the SAIL Mediclaim Scheme more effective and efficient. We will appreciate if we are also kept in the loop of negotiation and communication.
With warm regards,
Copy to: All Chief Executives, all SAIL IRPS and FORSE e-groups
>>>>>>>>>>>>>>>>>>>>
21/07/2016
Sub:Extremely inefficient functioning of Raksha TPA
July 21, 2016
Dr. Nilu Mahapatra,
Director (Personnel), SAIL
New Delhi
Dear Sir,
This has reference to the tele-talk Sri Anutosh Maitra, the CEO of Bokaro Steel Plant, had with you yesterday. Further to that I would like to submit that the Raksha TPA appears to be totally non-functional in all area of its operation related to SAIL retirees.
- At the end of 3 months and 21 days the Plastic printed I-Card and the Guidebook are yet to be delivered to over 90% of SAIL Mediclaim Scheme members. (It may please be noted that large number of SAIL Retirees are not internet savvy and cannot download or refer to the website. Hence such advice is utopian and providing them the Hard copies are must-sooner the better)
- There does not appear to be a Nodal Officer in RakshaTPA. So there is no response to members queries. Its grievance office is not even visible in the form of a response. It has one way communication system.
- It has no system in place to acknowledge the receipt of Medical Bills submitted to its Branch offices with Ref No. or Case no.
- Payment procedure is non-existent. Like there is no time limit for release of payment of OPD or IPD Bills.
- List of Hospitals for Cashless Treatment is not updated.
- FORSE's recommendation on adding such Hospitals to IPD/OPD list, where SAIL retirees were taking treatment for couple of years with satisfaction, is also ignored.
- In cases endorsed to us it is observed that RakshaTPA either do not respond to the message sent by SAIL Mediclaim IRPs or their response is not followed up by action -similar to how they treat Retirees communications
This is based on direct complains received by us through phone, whats App or email trail or copies of email exchange between the individual retirees and SAIL Plant/ Unit IRPs or RakshaTPA's customercare from all locations in the country where our Retirees are settled.
Our request is that SAIL must do the needful to make Raksha TPA work efficiently and within a time-frame as the Healthcare issues can be deadly and killing if it is not attended to in time. It has happened in the past.
With warm regards,
--
Dr.V.N.Sharma, Chairman
For & on behalf of
Federation of Retired SAIL Employees (Regd)
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