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  • Speculative accusations aimed at undermining highly beneficial healthcare initiative 


SRINAGAR: Dispelling the qualms being created through social media about the robust Group Medical Insurance Scheme rolled out recently, the State Government today made it clear that the scheme is immensely advantageous for the employees across-the-board. “Ironically, disingenuous information being dished out about the scheme seems to be aimed at creating doubts in the minds of the employees and cross sections of the society, about the vastly beneficial advantages of the cashless healthcare initiative,” said a state government spokesman.


He said the scheme has been rolled out after following all required procedures in a fair and transparent manner. “The entire bidding process has been done in a competitive, clean and transparent manner in line with all Financial Rules and Regulations as well as CVC guidelines,” he said. Regarding the numbers quoted that Rs 1200 crore premium will be paid to the successful bidder, the spokesman clarified that only 3.5 lakh regular employees of the Government are expected to be covered under the scheme. “For all pensioners, All India Service Officers, Daily Wagers/Casual Labourers and those government employees who are already covered under a Health Insurance Scheme on their own, the scheme will be optional,” he said and added that the expected outgo of the premium would be approximately Rs 310 crore per annum.


Giving details, the spokesman said it is important to point out that more than four years ago when ICICI Lombard was awarded the contract, the premium wasRs6196 per annum. “However, coverage was much less than this time and was previously restricted to Gazetted employees only,” he said and added that although the earlier policy also covered employee plus 5 members of his family, the coverage was only for a sum up to Rs 5 lakh and between the age group of 3 months to 80 years.

He said the fresh scheme approved by the State Government for all employees, covers the employee plus 5 members of the family including new born babies and aged parents within the age group of zero to 100 years and that too for a coverage of Rs 6 lakh with a premium of Rs 8877 per annum. The spokesman said that on any criteria of coverage, number of hospitals where cashless service will be provided (more than 4700 hospitals across the country) and the prevalent market rates, the premium quoted by the successful bidder is extremely competitive and low. “It is also known that at the premium of Rs 6196 five years back the then Company suffered losses, as the total amount paid out by them for treatment was higher than the premium collected,” he said and added that ICICI Lombard with whom the State Government had its last contract has quoted Rs 17691.74 premium per annum under the fresh scheme.


The spokesman said that the entire bidding process was monitored by a team of senior-most officers, well versed with the Financial Rules and Regulations, conducted through a technical and financial evaluation. “When the first round of bidding was conducted, only one bid was submitted by a Public Sector Undertaking. In a nutshell, the first round of bidding concluded with poor response and, therefore, had to be terminated,” he said and added that thereafter, a pre-bid conference was organized where both private and PSU companies participated and the tender was reissued with minor changes in technical parameters on their suggestion.

The spokesman said that all PSUs as well as top private insurance companies were contacted to participate in the bidding process as a result of which in the second round, 9 Private and Public Sector Undertakings submitted their bids, out of which 5 qualified on technical evaluation criteria. The financial bid of 5 qualified companies were opened and the it emerged that Reliance General Insurance Company with a quoted premium of Rs 8776.84 was at L1, National Insurance Company Ltd with quoted premium of Rs 11918.00 at L2, ICICI Lombard with quoted premium of Rs 17691.74 at L3, Bajaj Allianz with quoted premium of Rs 23476.10 at L4 and United India Assurance Company with quoted premium of Rs 27225.00 at L5.

The spokesman said that the only PSU which participated in the first round and the bid of which was not opened due to poor response came second in the second round with a substantially higher premium quoted than L1.  “Further, the gap between L1 and other bidders was substantial and, therefore, there was no question of lack of competition,” he said.

The spokesman maintained that considering that OPD as well as surgical and other interventions are covered under the scheme, it was thought logical to discontinue the medical allowance of Rs 3600 annually being given to the employees keeping in view the huge benefit of the fresh scheme. “This has no consequence monetarily as even if the Government continues medical allowances then the employees will have to pay Rs 8877 as the premium while on discontinuance of medical allowances they are required to pay only Rs 5277 as the premium. “Therefore, this decision has no consequence so far as bidding process is concerned,” he said.

The spokesman also clarified that considering the large number of employees to be covered under the Scheme and Insurance Sector itself a complex matter, the settlement of claims and redressal of grievance was an extremely important issue. Therefore, services of a consultant were hired for support through the bidding process and also to act as the interface between the Government and the successful company to ensure settlement of cases in a timely manner through an effective grievance redressal mechanism. At the time, when the insurance was only for 20000 people, there used to be 15 to 20 complaints to be settled at any given point of time.

If the insurance is to be provided to a minimum 3.5 lakh estimated people there was a requirement of robust third-party Grievance Redressal mechanism. The Consultant will have Grievance Redressal Centres in all the 22 District Headquarters besides at the Civil Secretariat. However, the consultant will not charge anything from the Government for its services provided and the same will be borne by the successful company.

The spokesman also expressed dismay that the mention of the highest office of the State has been made in a factually incorrect and cavalier manner. “At no stage, the office of the then Governor stopped the bidding process. Instead, after the bidding process was concluded and having obtained the required approvals from the Finance Department and the concerned Advisor, the file was submitted to seek approval of the then Governor for submission to the SAC, which was approved by the then Governor,” he said and added that at each stage of the tendering process, the relevant competent authorities have approved the entire process which has been conducted in a transparent and professional manner.

The spokesman said that the Group Medical Insurance Scheme with a very reasonable premium alongwith the coverage it provides, number of hospitals including all top hospitals of the country being empaneled, shall be extremely beneficial for the employees and the misleading information being spread is only aimed at creating doubts in the minds of the people.

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JAMMU: District Magistrate Ramesh Kumar, also the Chairman District Disaster Management Authority today reviewed the District Disaster Management Plan and response preparedness here at a meeting of   Central/ State Government agencies. The meeting also took review of available Medicare facilities and preventive measures for spread of dengue. The meeting was attended by SSP Traffic Joginder Singh, SP (Hqr) R C Kotwal, Additional Deputy Commissioner, Kanta Devi, Commandant SDRF, 2nd Battalion, Dy Director Information, Secretary JMC , ACD  , SDMs, CMO, Dy M S GMC ,Deputy Controller Civil Defence Jammu, Engineers of PHE, Irrigation & Flood Control, PDD, PWD(R&B), PMGSY,   Deputy Director Fire and Emergency Services besides senior functionaries of concerned departments.


Detailed discussion was held on issues like procurement of rescue equipments, conduct of workshops on Disaster preparedness, Publicity  of disaster related awareness programme in print and social media, conduct of capacity building trainings on Disaster preparedness, data preparation  of total number of volunteers with Civil Defense, SDRF & Red Cross, community based disaster management, besides financial aspects and other vital issues.

The DM directed Disaster Managers to keep their men and machinery ready with tents, boats, sand bags, life jackets and other rescue equipments. He asked them to make available sand bags and dewatering pumps at vulnerable locations as precautionary measures. He further directed to take immediate action to fill up any identified additional gaps to avert/ tackle arising incidents during heavy rainfall and   flood like situation in future.


He directed the concerned departments to prepare a module of disaster management and organize awareness camps to train the people including students with special focus on first-aid and other rescue techniques to minimize losses during any disaster. He called for maintaining close coordination among different departments and agencies to safeguard precious lives in case of any eventuality during the rainy season.


The JMC and R&B Deptt was asked to ensure clearance of all drains in advance to avoid water logging during rains. PDD was asked to take measures for preventing  power supply disruption and keep  alternate power lines ready in case of failure of main Line. The DM also reviewed the medicine stock position in hospitals and asked the health department to issue advisories with respect to any epidemic and health issues.


The FCS&CA was asked to keep adequate ration in stores to meet emergent requirements. He directed officers to stay alert for meeting any eventuality. He also directed rescue teams to be ready for quick response. Meanwhile, the DM also discussed measures for prevention of spread of dengue fever in the district. He stressed for creating awareness among the masses about control and prevention of spread of Dengue. He directed the concerned department to ensure fogging and spray in a routine way to control the disease. The DM directed DDMA to aware public about Do’s and Don’ts at the time of eventuality through print, electronic and social media.

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SRINAGAR: The failure of the health authorities to settle the appointment issue of an employee has left hundreds of employees including doctors and Para-medics working at different healthcare facilities in medical block Qazigund without salaries for last four months.  While the authorities maintain that the appointee has got the salary account of the entire medical block seized through a court order, employees say that the authorities have made all the employees of the medical block hostage by failing to settle the issue with the court. 


Sources in the Medical Block said that a person Bilal Ahmad was appointed in the department in 2006 by the then BMO. Later in 2012 when the fake recruitment scam in the health department involving top officials for exposed and scores of such appointees were shown door and the officers involved were suspended , the then DDO stopped his salary. Since the matter was under investigation none of the DDOs posted in the block since then agreed to release his salary. Though the authorities later cleared the cases of many of such appointees but kept many of them pending. Those whose cases were not cleared had alleged that the authorities resorted to pick and choose in clearing the cases of the alleged fake appointees. 


Sources said that the appointee after being denied the salary since 2012 moved the court seeking release of his wages. The court in response to his plea ordered the seizure of the salary account of the BMO Qazigund four months ago till the pending wages in favour of the said appointee are not released.  A delegation of employees including doctors and para-medics told that the authorities have made over two hundred employees working in different healthcare facilities of the block suffer for their no fault. 


"The authorities have failed to settle the issue of one employee in the court. If the appointment of the employee is genuine let the authorities convince the court and release his salary as directed by the court. But instead of settling the issue they are making us suffer. We are without salaries from last nearly four months. Even on the occasion of two Eids we were not given our salaries," said a para-medic who was part of the delegation. 

He said that there are some poor sweepers working in the block who were virtually weeping on the occasion of Eid for salaries.  "How come authorities are so callous and hold hundreds of employees as hostages," he said. Block Medical Officer, Qazigund, Dr Zahoor , admitted that hundreds of employees are suffering due to the salary issue of one employee.  "This is injustice with the employees but we are helpless as the court has seized the salary account of the entire block. Now the court has asked the director to appear personally next week and I am hopeful the issue will be resolved that day," BMO said. 


Asked why they are not releasing the salary of the particular appointee, Dr Zahoor said that he had some service break which led to the stoppage of his salaries since 2012.  "I am here for last one year only but his salary is pending for last several years as no DDO has released his salary keeping in view the nature of his appointment," BMO said.