Shillong: The New India Assurance Co. Ltd has been issued a show cause notice by the Health Department, which had been receiving innumerable complaints regarding delays in reimbursement of medical bills to empanelled hospitals. The Health Department has issued a curt warning to New India Assurance Co to clear the clutter.An explanation has already been asked for by the Health department from the insurance group regarding the delay in reimbursements according to official sources.According to an official source the state government had signed up New India Assurance Co. for it had been the lowest bidder at the time of the implementation of the scheme. While reimbursement to hospitals was to be the insurance company's responsibility, the premium was to be paid by the state, according to the agreement.According to Shillong Times the disarrayed state of reimbursement took on a serious dimension when a Tura based hospital refused to accept the insurance company's health card stating that it already had its reimbursements worth Rs. 43 lakhs pending.The West Garo Hills Deputy Commissioner, Pravin Baskshi when contacted confirmed the pending 43 Lakh reimbursement figure.
Making its stand clear the New India Assurance Company stated, that it at no point in time had moved back on paying claims to hospitals since the inception of the scheme in August; quoting a figure of 8.11 crores as reimbursement payment, given by it hospitals.
Though the scheme is originally under Rahstriya Swasthya Bima Yojana (RSBY) as per 90:10 pattern in terms of expenditure to be borne by both the Centre and the state, Meghalaya has covered various illnesses which were not under RSBY and christened it as Megha Health Insurance Scheme . The features of RSBY are also included in MHIS.
A beneficiary has to pay only Rs 31 at the time of enrolment, while the MHIS covers hospitalization expenses up to Rs 1,60,000 for a family of five under the floater scheme. In other words the total amount can be used by one person or jointly with other members of the family. A single beneficiary can avail a maximum of about Rs 1 lakh at one time.