बुधवार, 15 मई 2019

Mediclaim Issues with SAIL & UIIC

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
 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              

कोई टिप्पणी नहीं: