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               

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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              

Input for SAIL Mediclaim Scheme for coming years

By e-mail

FORSE/SAIL-C/ 0319

March 24, 2019  

To

Sri Anil Kumar Chaudhary,

Chairman,                                                                             

Steel Authority of India Ltd,

Ispat Bhavan, Lodhi Road, 

New Delhi – 110 003.

                 Re: Input for SAIL Mediclaim Scheme for coming years. 

Dear Sir,

It may kindly be recalled that enough discussions took place on inadequacies of present medical scheme of SAIL at our meeting at Ranchi on 29th Dec 2018 wherein we emphasised for a better scheme plugging all loopholes which really impedes fulfilment of avowed objectives for ensuring better protection and healthcare of the retirees of SAIL which nowhere come up to the level of other major PSUs. We are sure with some modifications even in existing parameters lot of sufferance can be minimised. That is the reason why we were inclined to get associated in formulation of the scheme in operative parameters keeping aside the price tag although by contributing around 20 - 22% towards total premium ipso facto we become beneficiaries and stake holders too.

Moreover, we feel that mediclaim wing is manned by junior level officers on short tenure basis and nitty gritty of the scheme along with major ramifications including major problems being faced by our members do not get assessed or appreciated to that extent although we do not have any doubt in their individual competence  All these points were kindly appreciated by you and it was kind of you to give a patient hearing. However, unfortunately no heed was paid to our request so far. In the meantime, as desired we made out a comprehensive note on Health Scheme (https://tinyurl.com/shp-sms) and sent to you vide our letter No. FORSE/SAIL-C/ 0219 dated March 15, 2019. 

Meanwhile it transpires that tenders for new contract have already been floated and are under finalisation stage. It also transpires that United India Insurance Co, the present Insurer may bag the contract. It is a welcome move as we always prefer a PSU company to get involved with SAIL in all their activities as personal gains anywhere are not on focus.

The present joint operation by UIIC with their TPA M/s MD India has been so far satisfactory by and large as per reports collected from other affiliated units with constant hammering except some areas like delayed payment, stray repudiation and use of confusing language in their Auto-replies to all correspondences leading to harassment to Members of the Scheme. But with a longer tenure of the scheme better understanding and accessibility have been established and it is not desirable to rupture this for general welfare at this point when we have demanded a long-term contract at least for 3 years with the same card.

We are also confident in pursuance with our discussions and in line with our comprehensive note already sent to you, our ceiling on OPD and IPD treatment will be increased along with improvements suggested in our note and no additional liability will be loaded further on our members making their life more miserable. As already appealed earlier, except for a token money full premium should be borne by SAIL till such time our treatment facilities are made at par with serving employees. The disparity between retirees of SAIL and RINL under the same Ministry in respect of medical scheme, especially in respect of contribution to Insurance premium by individual members, is also glaring.

It would not be out of place to mention that those who took VRS were not qualitatively inferior to those who superannuated, that their contribution to the Company’s performance was no less. In fact, they helped SAIL in various ways including in reduction in its expenses and in increasing Company’s profits by taking VRS. I am sure you will agree that such decisions taken long ago, in parts, and enforcing them now after dozens of years have passed, in an arbitrary manner, cannot be appreciated and justified and does not project SAIL as a well-meaning organisation. Therefore, medical facilities for different kinds of retires who took VRS, at different points of time, should be continued without differentiating with those who superannuated, as the healthcare needs are not different for them. I earnestly request you to kindly get such negatively oriented paragraphs deleted/ withdrawn forthwith and to continue with the existing practice of healthcare for VRS retirees.

As on date, what we need is a congenial environment with compassion and to assuage the feelings and ameliorate the conditions of distressed retirees instead of considering everything in water tight compartments.

Sir, we are having high expectations from you and we are sure these will not be belied.

With profound regards,
For and on behalf of Federation of Retired SAIL Employees
Yours faithfully,

(V. N. Sharma)

  Chairman

Copy to:

Director (P), SAIL

Director (F), SAIL    

EPS 95 Case Update

Please click on the link
 https://tinyurl.com/eps95case-update
to see the updates on our case for
Full Pension under EPS 95.

-- Dr V N Sharma, Chairman, FORSE &
Petitioner No. 1, WPC 1134/2018 in
Supreme Court

Appeal To Steel Minister re SAIL Pension Scheme 120219

SAIL Pension Scheme approved 110219

NCR Receipt and Certificate

FORSE delegates met SAIL Chairman 291218

Record Notes of discussion with SAIL Chairman at MTI Ranchi on 29/12/2018

Participants:

SAIL	FORSE
Sri Anil Kr Chaudhary, Chairman Sri D K Mohanty, ED (C. Sectt) Sri Amarendu Prakash, GM (C. Sectt.)  Sri Manas Rath, DGM (P&A), Ranchi Units	Dr V N Sharma (Chairman), Sri J S Nagabhushan (Vice Chairman) Sri M.P Singh (Bokaro) Sri Premanand Samal (Rourkela) Sri Arbinda Mitra (Burnpur)

       i.      Dr V N Sharma presented a bouquet to SAIL Chairman and welcomed him.

     ii.       At the outset SAIL Chairman gave an updated oral presentation of SAIL's performance both operationally and financially and informed that he had gone through the 'Comprehensive Charter ........' and would try his level best to do as much as possible to fulfil the aspirations and demands detailed in the Charter and the Agenda. Regarding SAIL Pension Scheme he informed that it's our commitment and it is under process to implement the same.

  iii.            The Meeting lasted for an hour and all the points in the attached Working Agenda were discussed thoroughly keeping the detailed explanation in the attached 'Comprehensive Charter ......' in the background.

   iv.            Dr Sharma requested SAIL Chairman to separate the Agenda items into those involving finances and those without that. Examples of the later are (a) granting Recognition to FORSE, (b) Allotment of Office Space to FORSE at Kolkata (space vacated by VISL in Kolkata) and to all FORSE affiliated Associations in the Townships as large number of houses are vacant and examine the feasibility.

  SAIL Chairman agreed to take favourable decision on the above issues at the earliest.

     v.            Dr Sharma pointed out that there is no functioning channel of communication between SAIL and Retired Employees to resolve Retirees issues and explained that system of Nodal Officer set up two years ago has not worked. In view of this setting up an efficient and functioning communication channel and grievance procedure for Retirees is the need of the hour.

  SAIL Chairman agreed to pursue this matter and make this office more active so that Retirees problems are resolved easily through the Nodal Officers.   

   vi.            Dr Sharma also drew attention on the issue that policy making wrt the Retirees like Leasing/ licensing of Houses, Healthcare delivery and issuing Medicines and their implementation in all the Plants/ Units and for individuals is not uniformly applied which further causes Heart burning.

  SAIL Chairman agreed that he would try his best to make and implement uniform policy on all issues.

    On the issue of inefficient functioning of the TPA in relation to improper responses and delay in settling the Bills etc esp. in Eastern zone (Kolkata area) SAIL Chairman informed that based on messages from FORSE and others he has already called the TPA representative and sounded him to improve the functioning by adopting fast and efficient modus operandi for  Retirees issues as delays cannot be permitted in Healthcare matters.

    SAIL Chairman further informed that he had approved appointment of 100 doctors for SAIL Hospitals and purchase of new gadgets and furniture for Hospitals to improve Healthcare for both Retired and serving employees. He also assured that he would ask concerned departments/ hospitals to make all medicines available to all-retirees as well as serving employees.

    SAIL Chairman assured the FORSE delegates that enhancement in coverage amount for OPD and IPD is under serious review and gave positive hopes for the better.

vii.            On financial matters SAIL Chairman explained that financial involvement requires Govt approval and so becomes difficult. He agreed, however, to examine the points of Agenda involving finances and to do whatever and wherever possible. 

viii.            SAIL Chairman informed that Leasing of Houses has been restricted by the Govt. However, he agreed to continue the Licensing of houses and look into and remove the irritating issues related to Licensing of houses.

   ix.            SAIL Chairman further agreed to look into Auctioning of Houses by RSP as also 142+ cases of RSP retirees who are made to pay penalty rent of more that Rs 4000/- after 10 years of retirement.

     x.            On items in para V Issues from Plants/ Units SAIL Chairman informed that he would try to resolve the following issues after getting their details from the Units and Corporate Office. 

Ø Extending Mediclaim facility to the pre-April 2004 VISL Retirees will be looked into. 

Ø Uniform procedure for allotment of houses on licence basis will be adopted.

Ø The auctioning of houses in Rourkela is not acceptable. He assured that it will be looked into.

Ø Regarding HRA & Leave encashment he has given some hints.   

   xi.            On further query from SAIL Chairman

ü   Sri MP Singh explained non-availability of medicines at Bokaro General Hospital and also about 10% increase in the House Licensing fee as also payment/ adjustment of interest earned from the security money.

           SAIL Chairman agreed to ensure availability of medicines and look into interest part of security money.

ü   Sri J S Nagabhushan explained the Notice issued to House Licenced Holders to vacate the houses which has created restlessness in the Licensee’s mind.  

           SAIL Chairman informed that he would get it examined. However, such licensed holders may be allowed 11-months extension for the present.

ü   Premananda Samal explained the auction bidding of vacant houses to retirees of RSP in which they do not have sufficient financial resources. He requested to give licence among the applicants on seniority basis. He also brought up the issue of 142+ retirees who are forced to pay penal rent as their licences were not renewed. He requested to withdraw the eviction orders and renew their licences on the same terms and conditions.

           SAIL Chairman indicated ignorance about Auction bidding of houses. However, he agreed to look into it and do the needful. At the same time, he advised FORSE/ RSPREA to meet new ED (P&A), RSP and he hoped that it would be resolved.

ü   Sri Arabind Mitra informed that ISP does not lease or license houses and also that all Medicines are not available in ISP Hospitals.

                SAIL Chairman agreed to look into the house issue but assured that improvement in healthcare would become visible soon.

The Meeting ended with a vote of thanks to SAIL Chairman by FORSE delegates for providing this opportunity to present and explain the long pending Grievances and Demands of SAIL Retirees and for getting a favourable assurance from him.

0_____X _____X______0

EPS 95 Court Case Update

Note: Please click on the link https://tinyurl.com/eps95case to see the FORSE / Coalition Supreme Court Case Status Updates for full pension under EPS 95 pension:

Dear friends,
You all will be happy to know that much awaited Writ Petition of FORSE and others has been allotted Writ Petition WP(C) No. 1134 of 2018 (Regd. on 17.9.2018). We appreciate the meticulous and hard work done by the Legal Committee of the Coalition of EPS'95 Pensioners - NCR/NCOA case and the Advocate on Record Sri R. Vasudevan. Just to mention that it was filed on 12th Sept in the Supreme Court vide Diary Number 34267 of 2018. Copy of the relevant page from Supreme Court website is attached herewith for your quick and kind perusal.

May please note that it is a milestone case in SC filed directly under Art. 32 Hope it will bring about a landmark judgement.

Once the notice is issued, further details will be shared by the Legal Committee.
Let us all hope for the best.