Team Herald
PANJIM: The government’s ambitious Deen Dayal Swasthya Seva Yojna (DDSSY) has provided much-needed relief to about 12,936 Goans from expensive health treatments by way of insurance cover, but interestingly, it proved to be major boon to the insurance company, United India Insurance Company Limited (UIIC).
While the government spent Rs 64.52 crore (another Rs 18.29 crore is in process) in form of premium to the insurance company till August 31, the claims made by the hospitals – government and private – amount to only 56 percent of the total premium paid. The total claims paid to the hospitals amount to Rs 36.59 crore, which includes Rs 23.80 crore to private hospitals and Rs 12.78 crore to government hospitals.
However, Chief Minister Manohar Parrikar said the government is working towards getting a refund of the excess amount. “There are several claims left to be cleared once that is done we will see how to get back the refund from the insurance company,” Parrikar said on Wednesday.
Further, as per figures provided, pre-authorisation has been given to 12,936 cases amounting to Rs 47.13 crore. Also an amount of Rs 63.99 lakh has been spent on medicines for chronic illnesses.
The scheme was launched on May 30, 2016, while the first policy period began from September 1, 2016. A premium of Rs 2800 plus service tax and now GST per family has been paid to the insurance company. A family of up to three members is provided an insurance cover of Rs 2.5 lakh, while a family of four or more members is provided a cover of Rs 4 lakh.
Of the 447 procedures mentioned in the scheme, the highest utilisation of financial assistance is in cardiology which is almost 26.53 percent of the total claims made, followed by orthopaedic surgery and procedures, which is 12.10 percent.
The other procedures that patients opted for include nephrology, cardiac and cardiothoracic surgery, general surgery, genitourinary system, critical care, neurosurgery, gynaecology, medical oncology, surgical oncology, etc.
