Thiruvananthapuram: The state government has given a week’s deadline to the Anil Ambani-owned Reliance General Insurance to complete the formalities, including the list of accredited hospitals coming under the Medical Insurance Scheme for Stae Employees and Pensioners (MEDISEP) scheme.
Finance Minister Thomas Isaac has expressed his displeasure over the lackadaisical attitude of the company. The minister admitted that hospitals with low standards had also been included in the scheme.
He asked the company to rectify the issue and said the premium amount will have to be increased if the government were to go for a fresh tender and cancel the contract with the Reliance Insurance.
There were reports that the government was planning to cancel the contract with Reliance General Insurance. It had accused the company of failing to enlist good quality hospitals under the scheme. The premium amount would be paid only if it rectified the problem at the earliest, the government said.
However, a final decision on the issue would be taken after discussions with the staff representatives. The government had earlier planned to call a fresh tender in view of the reluctance of some of the private hospitals to come on board.
Around 104 hospitals have been listed under the scheme. Most of the hospitals have problems with the rates fixed by the government and that’s one of the reasons why they are not coming on board. They have demanded a hike of 40 per cent in rates which were fixed by the government for the treatment of various ailments.
MEDISEP covers more than 11 lakh government employees and pensioners and their families.
The health coverage is provided for a term of three years. The beneficiaries include state government employees, including High Court staff, for whom Kerala Government Services Medical Attendant Rules are applicable, part- time contingency employees, teaching and non-teaching staff of aided education sector, part-time teachers, staff of local bodies and universities, members of personal staff, pensioners and family pension scheme members in all these categories.
As per rules, the dependants of these categories will also benefit from the insurance cover. The term of the current insurance scheme is for three years.
According to the finance department, the health insurance cover will be provided under three categories:
Basic insurance: Each family will get a health insurance cover of Rs 2 lakh annually during the insurance period.
Additional coverage: For organ transplantation, each family will get a maximum of Rs 6 lakh during the three-year period. This will be over and above the coverage of Rs 2 lakh per year for each family.
If Rs 6 lakh additional coverage is not sufficient for the treatment of serious ailments, then Rs 3 lakh each will be made available to the family during the period of the scheme.
A corpus fund Rs 25 crore will be constituted by the company for this purpose. The additional assistance to the beneficiaries would be provided from the corpus fund.
The Reliance General Insurance Company which quoted the lowest annual premium amount of Rs 2992.48, including GST, was selected for implementing MEDISEP.
