BPL health insurance fails in Kalahandi

Expressbuzz, May 21, 2011
BHAWANIPATNA: The benefits under the Rashtriya Suraksha Bima Yojana (RSBY) have failed to trickle down to the beneficiaries the Below Poverty Line (BPL) families.


Though launched as a pilot project in Kalahandi in November 2009, poor management and lack of awareness among the BPL beneficiaries have marred the cashless treatment provision.

Out of the surveyed 2,24,859 BPL families, 1,03,083 families were enrolled in 20092010.

Ironically, in the first year, only 1,513 persons could avail of the benefits and against it only Rs 35,44,770 was paid by the insurance company, New India Insurance, towards claims to different hospitals and health institutions empanelled.

Interestingly, during the year, the insurance company collected Rs 5.14 crore towards premium.

The main reasons for the dismal performance are inadequate training in the use of Smart Card, delays and reductions in the payments due from the insurance company to hospitals, and imposition of noncontracted upper limits on treatment duration and cost.

Awareness drive taken up initially by the insurance company and the Rural Health Mission was allegedly ineffective as it could not reach out to the beneficiaries, either illiterate or semi-literate, who do not know the details of using the Smart Card.

Under the scheme, the total sum insured is Rs 30,000 per BPL family for a maximum of five members and the family would have to pay a token annual premium of Rs 30 to avail of cashless services from the empanelled government hospitals and health institutions.

The Government has been paying Rs 750 to the insurance company towards annual premium per head, but only 2.5 per cent of the beneficiaries have availed of the services.

To add to the woes, the annual premium which expired in November 2010 is yet to be renewed due to a legal dispute.

Deputy Labour Commissioner, Bhubaneswar, NK Samantrai said that for the second term United India Insurance Company has been given the tender for the scheme against the bidder New India Insurance Company.

Meanwhile, the New India Insurance Company has obtained stay order from the High Court and hence the scheme could not be renewed.

Steps will be taken for early renewal of the scheme soon after the ruling by the High Court, he added.