A meeting was held by New India Assurance Co. Ltd. with HITPA on 19 th December 2018
14 th January 2019
Shri Ranjit Gangadharan,
General Manager,
New India Assurance Co. Ltd.,
87, M. G. road, Fort,
Mumbai-400001.
Sir,
A meeting was held by New India Assurance Co. Ltd. with HITPA on 19 th December 2018 wherein our
organization was advised to join as we have several issues of pensioners on mediclaim.
G. M. Shri Gangadharan initiated stating that due to lots of grievances of pensioners/active employees &
Pensioner Association it has become necessary to have this meeting. Dy. G. M. Shri Kumaria , Chief Manger
Shri Khandelwal narrated issues. Shri Samant was requested to give pensioners experience on mediclaim.
He stated that we are here to understand the working of the mediclaim settlement in which lot of
difficulties is experienced by pensioners. 1) Pensioners are tossed between GIPSA & HITPA. It is irritating. 2)
limited number of cash less hospitals,3) huge deposits are demanded, 4) delay in authorization as well as
discharge payments, 5) ID cards etc.
General Manger shri Gangadharan assured the Federation that New India is committed to provide better
services to its active as well as retired employees on staff mediclaim & hence such meeting is decided.
He then enquired on TURN around time.
Dy. CEO shri Pawan Choube of HITPA stated that earlier it was about a month because suddenly
HITPA was suddenly asked to take over GIPSA mediclaim. However now HITPA turnaround time is fifteen
days & same will come down to seven days by January fifteen. He further informed of acquiring of premises as
also appointments of three Doctors in Mumbai to provide quick service.
On Association’s objection for shifting this office to new Mumbai TPA assured that sterling cinema
office will continue to provide service.
Dr. Choube said that during one year TPA is ensuring that overcharging by Hospitals, inflated bills etc is
controlled resulting in ICR coming down. It hopes to further control ICR in near future.
On float HITPA stated that claims are scrutinized & float is sent to companies for releasing payment.
New India management pointed out that such floats are not sent by TPA but pensioners are wrongfully
directed to the company leading to irritation of pensioners. Also TPA is not available to co`s officials on phone.
In some cases discharge is delayed for hours together in spite of company pursuing with TPA. There is problem
of remittances to hospitals as UTR numbers are given differently for one Hospital. Authorization is also delayed
for cashless.
Pensioners requested TPA to send the clearance without waiting for a float of 25 or fifty files together
and/or weekly as is presently done. This will curtail the delay to an extent.
HITPA submitted that UTR no are allotted to each Hospitals and remittances are done according to such
UTR no. Hospitals receive the payment but they are not able to account for against each patient hence her is
disputs of nearly 9000 cases of this nature.
HITPA agreed to provide separate number to New India for contact.
On the question of delay in clearance & discharge under cashless arrangement TPA stated it takes 45
minutes to 1houor. Both co and Federation disagreed with this contention. TPA assured to monitor such
hospitals but urged the patients to find out the time of discharge reported by the Doctor from which position
will be clear.
On expanding cashless arrangements it was assured that TPA is entering in to MOU with Major Hospital
like Hiduja. Already nearly 6000 hospitals are on list of priffered net work hospitals.
As far deposits demanded by cashless hospitals TPA assured to take up with Hospitals as & when
informed to it.
On deduction of certain items both NIA & TPA maintained that such exclusions are on IRDA`s
direction. They are minor.
HITPA assured to uploaded in its website disallowed items & inform to the insured. TPA expressed
helplessness in mobile intimation as many have changed their service provider to JIO & not intimated to TPA.
On raising querries in piecemeal by TPA it was submitted that insured are requested to provide all
particulars even report in original only once. TPA is obliged to adhere to IRDA & audit norms.
On ID card it is assured that R.O wise cards are given & corrections will be done speedily.
TPA emphasized that in cashless cases insured should take due care in verifying the bills . This is
ultimately resulting in loading of the premium.
Thanking you.
Yours Sincerely,
U Banerjee
General Secretary
