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| ESIC fails to deliver, members wait clearance of medical bills | | |
Early Times Report
JAMMU, Aug 8 : Tall claims of providing hassle free services to its members by the Employees State Insurance Corporation (ESIC) seems to confined to its glossy advertisement only, as the insured persons (IPs) for 'Medical Services' reportedly are dissatisfied owing to the poor services rendered by it for the last two years. Sources revealed that there were many members waiting for the clearance of their medical bills which were lying pending for the last two years and towards which the ESIC officials not paying any attention.In his meek defence ESIC Regional Director Ravinder Kumar to these allegations briefly said delay in reimbursement of the medical bills was due to the non availability of the Administrative Medical Officer (AMO) (always a state government employee) from last few months whose job is to process the medical bills for clearance. He further said that though the AMO post was lying vacant but they were clearing the medical bills on the priority basis via Assistant Labour commissioner (ALC) so that critical patients won't suffer after analyzing their case while the matter for fulfilling the said post has already been taken up with the state government. However, the condition of the ESIC dispensaries is also very pathetic and lacking even the basic infrastructure ranging from sitting arrangement for the members to the computerization besides scarcity of the doctors and medical staff. If recalled here that the ESI Scheme was first implemented in the State on 1st October 1989 covering about 7000 workers in the centers at Jammu, Kathua and Srinagar adding Samba, Katra, Udhampur and Kandrorian centers till 2011. Apart from the other services the medical benefits are being provided in the state through an ESIC Model Hospital at Bari Brahmana, Jammu and eight Dispensaries, four each in Jammu and Kashmir Division besides further tie up arrangements for secondary care and super specialty treatment. Meanwhile Regional Director admitted that presently there was staff scarcity in the ESIC hospitals, dispensaries and even in the administration also but the doctors were working overtime and giving their best to the patients adding that an advertisement for the recruitment of doctors was published and soon the new recruitments will be made.On the computerization issue, he informed that owning to the electricity snag the computerization of the ESIC hospitals and dispensaries got failed in Jammu for which a written letter has been forwarded to the PDD. Dr. Monika Kotwal IMO Digiana Dispensary said "There is an immense work load on the doctors due to the shortfall as one single doctor has to look after the 10,000 IPs along with their families. The non reimbursement of medical bills is due to the objections leveled by the concerned authorities on the incomplete forms". "Medical Bills up to Rs 4000 are to be cleared from Bakshi Nagar Dispensary office and there is no pendency of bills below Rs 4000 while the bills above this amount are to be cleared by Labour Commissioner which might be taking some time owing to certain formalities. Rest there is acute shortage of doctors in the ESIC hospitals as in Bari Brahmana only one doctor is doing the job of three", said Dr Vandana Bakshi IMO Bakshi Nagar Dispensary.Dr. Kumail Murtaza IMO Bari Brahmana dispensary said "No bill below Rs 4000 is pending with ESIC but the bills exceeding Rs 4000/-, Rs 15,000/- and above 50,000/- are to be cleared by AMO, Labour Commissioner and Concerned Commissioner Secretary which might be pending owing to some objections in documents submitted by the IPs. "As per ESIC norms five doctors are to be deployed for 15,000/- IPs but presently only one doctor is available working under huge work load and pressure while the infrastructure is also very pitiable with no computerization due to casual approach of concerned authorities towards it".An aggrieved Romesh Kumar, Insurance no. 1901057735 pending bill Rs 1.65 Lakh said "I have lost my son in a tragic road accident last year in the month of April. "The medical expenditure incurred on his treatment was paid by me by borrowing money on interest but till date the ESIC has not cleared the said bills owing to which the amount borrowed by me has almost doubled". Another aggrieved Amit Thappa, Insurance no. 1901006470 pending amount 2.15 Lakh said "my medical bill of Rs 2.15 Lakh is pending from last more than one and a half year and the sum borrowed by me for the treatment of my mother at PGI Chandigarh still stands outstanding at ESIC due to the reason best known to ESIC officials. |
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