Policemen opting out of health insurance plan

Point out several lacunae in its implementation

Last week, a Special Sub-Inspector of Police wrote to the Director-General of Police, seeking to opt out of the New Health Insurance Scheme, 2016, and requested that the deduction of ₹180 from his salary towards monthly premium be stopped with immediate effect.

S. Allaudeen, working as an SSI in Chennai, went though an ordeal of having to shell out ₹1.09 lakh to a private hospital for his son’s treatment despite having a cashless health insurance cover for self and family members. Since he was not given the health insurance card, the hospital refused to provide treatment under the scheme.

He got no assistance from the Tamil Nadu Police Benefit Fund, Mr. Allaudeen said. He did not even get income tax relief for the premium paid towards the cost of health insurance. A Head Constable wrote to the Police Commissioner on Monday requesting that his health cover be terminated since it was of no use. On two occasions when he and his wife were admitted to hospitals, the insurance company refused to pay, saying the ailments were not covered under the policy. According to police sources, there have been dozens of such cases where police personnel or their family members who got admitted to network hospitals for various ailments were not provided cashless facility as promised in the scheme.

The State government in June 2016 passed an order announcing health care assistance to the employees of Government Departments, State Public Sector Undertakings, Statutory Boards, Local Bodies, State Government Universities and their eligible family members.

Health coverage

The New Health Insurance Scheme, 2016, was given to the United India Insurance Company Limited for implementation and enrolment was made compulsory for lakhs of employees and their eligible family members. They were told that they would get a health cover of up to ₹4 lakh in a block of four years commencing from July 1, 2016 and the assistance would be increased to ₹7 lakh for treatment of cancer, major heart problem requiring surgery etc.

“There have been issues with the scheme right from the inception. Despite being a cashless model, police personnel have been complaining that network hospitals insisted on payment of advance money for commencing the treatment. In many cases, the insurance provider refused to approve the treatment stating that the ailment was not covered under the policy. We have received a large number of complaints from the rank and file in this regard,” a senior police officer told The Hindu on Monday.

The officer said that no data was available on the list of police personnel and their family members who got the benefit of the health insurance scheme.

In Madurai, the Commissioner of Police introduced a model where information on hospitalisation of employee or his/her family is reported on a daily basis. An official in the rank of Inspector of Police is deputed to the hospital to liaise with the insurance company.