Demand for revision in medical ex-gratia

NOINO has demanded for modification/revision in the high-cost-treatment scheme. A letter has been written to Shri Thomas Mathew T, Managing Director in this regard. The letter is reproduced below. A similar letter has also been submitted to Shri B Manivannan, ED(P).

27.3.2012.

Shri Thomas Mathew T.,

Managing Director,

L.I.C. of India.

Dear Sir,

Re: Modification in scheme of ex-gratia re-imbursement in medical expenses in cases of High Cost/protracted treatment

        The scheme of ex-gratia re-imbursement in medical expenses in cases of High Cost/protracted treatment needs to be revised in various respects including the limits of re-imbursement & other conditions. Our demands/suggestions are as under:-

1. Revision in limits of re-imbursement: --- Looking into the spiraling medical costs over the years, the limits should be revised immediately. We demand that the limit should be revised to at least 10 lakhs each time, i.e. total at least 20 lakhs. Another point is that those who have opted for a higher sum assured in the mediclaim scheme are sort of put to loss as the limit of ex-gratia re-imbursement is the same for all irrespective of the sum assured in the mediclaim scheme.
   
   
2. Removal of condition of a fixed percentage of re-imbursement instead of full re-imbursement:--- At present, 90% of the claim is payable after deduction of mediclaim re-imbursement(for expenses up to 3,33,333) & 70 % of the claim for expenses in excess of Rs. 3,33,333. We demand that full re-imbursement to the extent of the ex-gratia amount should be allowed.

3. Removal of condition of time restriction of 180 days :- At present, there is a time restriction of 180 days for claiming post-hospitalization expenses except for Cancer & liver transplant. We demand that this limit of 180 days should be removed for all diseases/illnesses& the re-imbursement should be made till the full amount of ex-gratia is exhausted.

              We request you to please consider the above demands at the earliest & provide relief to the employees who unfortunately have to undergo the trauma & agony.

Sd/-

Dr. S B Sharan

WP, NOINO