By E-Mail
May 08,
2019
To
Sri Atul Srivastava,
The Director (P)
SAIL, New Delhi
Sub: Urgency requested in decision making on Cashless treatment and settling
Mediclaim Bills
Dear Sir,
Further to our request dated 23rd April 2019 in the
mail trail we are in receipt of a good number of queries from individuals as
also from our Member Associations as to what is SAIL doing for cashless service
and reimbursement of Medical Bills under SAIL Mediclaim Scheme once the Premium was paid by the
Members against a Circular from SAIL and UIIC has loudly refused to honour
the extension of the Scheme and pay the Bills.
In absence of a favourable
response from or complete silence of SAIL on this issue Retirees are not
only anxious but becoming desperate by the day esp because apart from regular treatment
there are some exigent situation where CABG, surgical intervention in head
injury, bone fracture / replacement etc may be emergently needed to protect
further damage, loss of limb or even to guard against fatality. We understand
that two urgent cases are pending - one Bye pass surgery of heart and
another knee replacement. Naturally this is expected to increase in the coming
days. In such eventuality, SAIL is legally and morally expected to come forward to take care of the
treatment fully in their listed hospitals if required as referral cases like
serving employees.
Sir, the Retirees have paid
their part of the medical premium and complied with such formalities as asked
for to avail the insurance coverage. If UIIC or TPA is disowning it is sheerly
due to incompetency or indolence of SAIL and it is their sole responsibility to
sort out the problem without further delay. In case of any loss/damage to vital
organs or loss of life one can sue SAIL in court and seek justice. One can also
approach IRDC. However, we would not like to advise or follow this route but
would certainly expect SAIL to follow its commitment and responsibilities and
help save the Retirees life.
In view of the above I request
you once again to kindly decide
with some urgency on taking care of the Healthcare of
the Members
of the Scheme by taking care of the treatment fully in SAIL's listed
hospitals if required as referral cases like serving employees using
SAIL's own resources.
With regards,
For and on
behalf of Federation of Retired SAIL Employees
(V.
N. Sharma)
Chairman
&&&&&&&&&&&&&&&&&&&&&&&&&&&&
By E-Mail
23/04/2019
To
Sri Atul Srivastava,
The Director (P)
SAIL, New Delhi
Sub: SAIL to take care of Mediclaim Scheme Members if UIIC disagree
with terms of extension of Mediclaim Scheme and refuses payment of Bills/
approve Cashless
Dear Sir,
Members of the SAIL Mediclaim Scheme, going
for regular / routine treatment like dialysis etc, are being refused approval
for Cashless treatment and have been told by the TPA that UIIC has issued
circular/ advisory not to honour the terms and conditions circulated by SAIL
dated 11th April 2019 for extension up to July 2019 even after the required amount
(https://drive.google.com/file/d/1-OgRTYEqypsze_SFyFqknEojI32jArm5/view)
(https://drive.google.com/file/d/1-OgRTYEqypsze_SFyFqknEojI32jArm5/view)
of
premium has been paid by the concerned and would pay for OPD/IPD Bills and
Cashless only if there is unspent amount left out in April 2018-March 2019.
Informal communication with TPA by some of our representatives confirm that
UIIC has issued such an advisory, copy endorsed to SAIL.
It is really shocking and surprising to know that the SAIL
circular was issued after month-long processing of Tender and deliberation and
negotiation with the Insurance companies and still UIIC refuses to honour the
terms of extension after the process of premium payment has gone more than
half-way. As it stands, it has put lots of retirees esp those in advanced
age-group to uncalled for difficulties.
In view of the above I request you to kindly take up the issue
with the appropriate authorities and get the moratorium by UIIC removed. I
further appeal that in case of unexpected delay in settlement with UIIC, SAIL Members
of the Scheme are paid / taken care of by SAIL's own resources to be recovered
from the Insurance co. later.
With regards,
For
and on behalf of Federation of Retired SAIL Employees
(V. N. Sharma)
Chairman
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