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Show Cause Notice issued to New India Assurance Co.


Show Cause Notice issued to New India Assurance Co.
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.

 



Source: with inputs from The Shillong Times
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