Cashless insurance not trouble free for ESI beneficiaries

Manmeet Singh Gill

Tribune News Service

Amritsar, April 20

While there are a number of government-run insurance schemes for various categories, but technical flaws in most of them and absence of zeal to streamline the system often results in trouble for the insured and their families.

Even as the employees of various government and private organisations are beneficiaries of the Employees State Insurance Scheme in the city, they, too, find it difficult to get cashless treatment if they are suffering from any orthopaedic problem.

The ESI Hospital, Majitha Road, does not have an orthopaedic specialist for the past more than seven months. It also does not have any local private hospital which can treat orthopaedic patients on its list of empanelled private hospitals.

A local resident, Amanpreet Singh, said, “In case of an orthopaedic emergency, the ESI beneficiary cannot get treatment in the city.” He said even the Civil Hospital is reluctant to admit ESI beneficiaries.

The hospital had last operated an ESI beneficiary around six months ago. The reasons of the alleged ‘reluctance’ could be that the treatment expenses incurred by the hospital have not yet been paid by ESI Corporation to the Civil Hospital.

The Civil Hospital’s Senior Medical Officer, Dr Hardeep Singh Ghai, however, denied any ‘reluctance’ on their part. “We do not refuse any patient. We cannot do so,” he said. However, he admitted that the bills of the treatment are yet to be paid. The hospital has reportedly around Rs 20,000 pending against the treatment it had given to a patient around six months ago

Dr Ghai said they are not worried about the bills, as the Civil Hospital like the ESI is a government body.

However, a delay of around six months in delivering the benefits of the cashless health scheme to the treating hospital could be a good enough reason for the private hospitals to deny treatment to the beneficiaries of the government-run cashless health schemes.

Meanwhile, ESI Hospital’s Senior Medical Officer Dr Balbir Singh Dhillon admitted that a certain amount is pending. He said they have forwarded the case to senior ESI officials and it would be cleared as soon as the bill is cleared by the treasury.