"Achyutha,Anantha,Govinda namocharana beshajath nasyanti sakala rohath ,Satyam satyam vadhamyaham"

 

FEDERATION OF RETIRED LIC CLASS I OFFICERS' ASSOCIATIONS   

Acting President :    Shri P.P.Dhamija R-6/104, Raj Nagar, GHAZIABAD – 201002. Tel: 0120-4107104 / 9810186067 Email Id – premdhamija38@gmail.com

General Secretary :    D Krishnan No.6/1, Sreshta Riverside Apartments, Wood Creek Road, Nandambakkam, Chennai - 600089 Tel : 9176635967 / 044 42850049. Email Id - dkrishnan1@gmail.com

 E circular No.DK/54                                        8--03-2021

Friends,

Reg:  Bridging a long gap in time …

 There has been a fairly long gap in time since we last communicated anything to you. Just to break the monotony of silence, I thought a message should go out now from here.

One happy piece of information is that we have been able to secure a PAN No and PAN Card for the Federation, at long last! Yes, this was made possible through sharing of information from Sri T K Ravindran of Bengaluru Association, who had been able to get a PAN Card for his Assn. through an intermediary agency called ‘Integrated Enterprises’, who are essentially in the area of facilitating Investments for individuals. We followed the same route and managed to get our Federation PAN Card in just a week’s time. It was earlier presumed that unless ours is a registered body, the PAN No would not be allotted.  Actually, all they need for PAN No to be allotted is the date of Incorporation of the body. So, it turned out much simpler than we had imagined. What this would mean to the Federation is the possibility of Filing Returns and getting Refunds where due. Hitherto we have lost out on some opportunities to get such refunds, all because we did not have a PAN No. I must express my sincere thanks to Sri Ravindran of Bengaluru Assn. for making this possible now. 

The other thing we have to report is about a letter sent to the EDs OS and Personnel of LIC Central Office, regarding changes that we would suggest in the contractual deal with the New India for Mediclaim scheme for 2021-22. The letter sent out is being reproduced here for your benefit:

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FEDERATION OF RETIRED LIC CLASS I OFFICERS' ASSOCIATIONS     

Acting President :   P.P.DHAMIJA R-6/104, Raj Nagar, GHAZIABAD – 201002. Tel: 0120-4107104 / 9810186067 Email Id – premdhamija38@gmail.com

General Secretary :    D Krishnan No.6/1, Sreshta Riverside Apartments, Wood Creek Road, Nandambakkam, Chennai - 600089 Tel : 9176635967 / 044 42850049. Email Id - dkrishnan1@gmail.com

18-02-2021

Dear Sri Nadkarni sab,  

Reg:  MEDICLAIM CONTRACT FOR 2021-22

 The  purpose of this message is to request you to take into consideration the following points before you conclude the deal with the Insurer on Mediclaim  for the coming year (2021-22):

             The system of availing Cash-less facility is beset with a lot of practical problems. The Pre-approval by TPA, and further, the stage by stage  approvals, do not go along with the smooth procedure of treatment in the Hospital.  Waiting is involved at every stage and the final part of TPA approval, before Discharge, is the most painful, when the TPA disallows part of the claim, and the aged patient, in his weakened state, is in no position to fight it out.          The Discharge itself gets held up due to the impasse, and the patient is forced to search for resources at the last minute, in order to pay-up the full Hospital Bill!  Technical grounds of rules, rather than the medical expediency, on lines of treatment decided by the Doctors in the Hospital, is the order that now obtains. I feel precedence should be accorded to the decision taken by Doctors in the Hospital instead of applying the rule strictly to deny the claim on certain aspects of the Treatment.  It will be appreciated, that even if some part of the claim is disallowed by the TPA/Insurer,  that part of the Hospital Bill will have to be necessarily paid out by the patient in any case.   So it becomes a genuine expense not reimbursed!

I may quote for example a COVID  case where the Doctor had to put the patient in the ICU, because Oxygen supply connection, and 24 hour attention, was available in that Hospital,  only in the ICU. The TPA approval on this questioned the ICU charges and denied the amount claimed thereof, saying ICU treatment was unnecessary. Here, in view of the peculiar situation in the Hospital concerned, the Doctor’s decision to put the patient in ICU should have been respected, and the claim on that item allowed. The patient can’t be fighting with the TPA, nor expected to argue with the Hospital, on domain decisions taken by the Doctor in charge.

            So while on paper the scheme looks benign, as you at the CO sign the contract, with the Insurer, the aged pensioners, while actually going through the experience of Hospitalization, find difficulty due to the hard/wooden attitude of the TPA/Insurer, in getting genuine claims granted.  This needs to be sorted out with the Insurer before the contract is concluded.  Otherwise what is deemed a facility becomes a Hassle.    The Cash-less Scheme tends to be a Less-cash Scheme, as it works out!

However there are also certain other areas where definite improvements are very much needed, especially after the COVID 19 scenario, which has resulted in all Hospitals hiking every aspect of the Charges. Consultation Fees have virtually doubled, Hospital Room charges have been hiked up. The line of distinction between major Cities and lesser Towns, have almost disappeared, because Private/corporate Hospitals all over tend to charge similarly, especially on Room Rent. In the light of these changes, please consider the points noted below:

1.     Kindly offer one more chance for individuals to raise their Sum Assured level. 

2.     Room Rent levels to be raised to just two slabs of 12500/- and 15000/- per day. (This is so in the Schemes of the GIC companies who administer the Mediclaim on a mutual basis – A-class Cities 15000/-, and other places 12500/- Pl see Attachments).

 3.     Some form of Dental Treatment being brought on the Scheme. 

4.     Medical Check-up every alternate year up to, say, a maximum of 5000/- limit. This can help bring down claims too, because diseases could be forewarned and preventive steps taken. 

Thanking you and with Regards 

D.Krishnan.

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We have been trying to get across to the FM through sources that are close to her, on our three major pending matters – Revision of Pensions, Family Pension review, and 5 yearly rises of pension for those over 80 years of age.  These attempts have not fructified till now because of logistical factors. We have made out a draft of the letter in just one page highlighting the very compelling factors justifying these improvements. Once we are able to send it across through channels that are close to the FM we shall let you know the details. 

We are waiting to know when the SC starts Hearing cases in the Court as was done before the Covid Pandemic changed the practice into the virtual mode of Hearing. Once that position is known it will be our endeavor to try and get a Date for our Case without further delay. 

It is now the season of Vaccinations, and most of us would have already gone through the event because, as senior citizens, we happen to be in the priority group. The prick, by itself, very harmless and smooth as the experience goes, does lead one into some small issues of minimal reactions in the next two days. But eventually, it does offer that life-protection, so important to be free from the dreaded virus.

Wishing all of you good health and happiness. 

D.Krishnan

General Secretary