Despite Maharashtra, Mumbai showing highest number of Covid deaths, few claim insurance benefits

MUMBAI: Mumbai and Maharashtra have seen the highest Covid infections and deaths in the country. Hence, they have also witnessed patients shelling the largest amounts of money on their medication. However, the insurance benefits passed on to them under a state-sponsored scheme seem to be comparatively minimal despite government paying huge premiums to insurance companies and an aid to government hospitals.

The demand for bringing treatment for Covid related infections, even in private hospitals, under the purview of state insurance scheme is now growing.

As on March 31, 2021, a total of 28,129,80 Covid cases were recorded in Maharashtra with 54,649 Covid deaths. However, Mahatma Jyotiba Phule Jan Arogya Yojana, government's prime insurance scheme, could benefit only 5,071,88 Covid patients between April 1, 2020 to and March 1, 2021, reveals the information obtained under RTI by activist Jeetendra Ghadge.

Considering the total number of infections and deaths of patients the number of 5 lakh beneficiaries appears a very small figure since the scheme covered 22,208,948 families across Maharashtra. The United India Insurance Company has been appointed as the insurer for this flagship health insurance scheme of the Maharashtra government, known as MJPJAY (Mahatma Jyotiba Phule Jan Arogya Yojana) since April 1, 2020, co-incidentally exactly when the pandemic began.

Surprisingly, though Mumbai had 4,23,419 infections and 11,708 deaths till 1st April 2021, only 29,664 claims were paid whereas 34,867 claims were paid in Ahmednagar against only 95,000 infections and 1221 deaths. Total 34,574 claims in Kolhapur and 34,045 in Pune were paid during the same one year period. However, Mumbai comes in fifth place when it comes to claims paid by the United India Insurance Company.

When thousands of people have paid lakhs of rupees through medical bills, such a small number of beneficiaries shows the non-serious and money-minting approach in safeguarding the economy of the common man, say activists. It demands for detailed scrutiny of the scheme, they add. After the second wave, now the total cases in the state have reached 61 lakh with casualties at 1.22 lakh. But the activists doubt if proportionately the beneficiaries have increased too.

Interestingly, a total of Rs 1,031 crores were paid to hospitals across Maharashtra under the scheme, but the United India insurance company refused to give the total amount of premiums paid by the Maharashtra government, revealed Ghadge through his RTI papers. The only positive side is that the rejection rate is only 4.4 % of the total 6,16,927 applications made, he pointed out.

Ghadge, also the founder of The Young Whistleblowers Foundation, said, "Government had declared that all types of ration cards will be eligible under this scheme but many families in Mumbai spent lakhs of rupees for Covid treatment. Hospitals that have forced citizens to pay hefty bills and avoided implementing the scheme should be brought to justice. A third-party audit should be made compulsory to check if hospitals have passed on the benefits of the scheme to the citizens judiciously. Private hospitals are reluctant to enroll in the scheme. Now, it should be made legally binding for them too to implement the scheme"

Source: The Times of India