Maharashtra: Dispute over unspent funds of state health insurance scheme set for resolution soon

  • | Thursday | 18th October, 2018

“Funds to that effect are yet to be finalised,” said Dr Sudhakar Shinde, Chief Operating Officer at MJPJAY Society. MJPJAY then wrote to the state government claiming that funds paid for IEC activities had been under-utilised. When the company refused, MJPJAY paid the premium for June after reducing Rs 63 crore to adjust the IEC funds. Officials from the MJPJAY Society, however, said that in the last two years the funds directed to NIC were not utilised. Officials claim that in the last two years, while the society continued to provide funds, the insurance company did not utilise the funds for IEC work.

The insurance provider added, “Moreover, now that we have reduced the premium by two per cent in lieu of IEC expenses, NIC would not be required to spend any amounts on IEC activities henceforth.” (Representational Image) The insurance provider added, “Moreover, now that we have reduced the premium by two per cent in lieu of IEC expenses, NIC would not be required to spend any amounts on IEC activities henceforth.” (Representational Image) A dispute between public sector insurer National Insurance Company (NIC) and the Mahatma Jyotiba Phule Jan Arogya Yojana (MJPJAY) Society over unspent funds of the state health insurance scheme is drawing to a close after three months with the former agreeing to refund a sum of Rs 80 crore to the state government. In return, the state government has now assured to pay NIC pending premiums, totalling Rs 376 crore. In a letter to the MJPJAY Society on Monday, the NIC agreed to refund the unused Information, Education and Communication (IEC) funds in instalments though the third and fourth quarters of 2018, by way of deducting this from the premium amount the state government owes the NIC. The insurance provider added, “Moreover, now that we have reduced the premium by two per cent in lieu of IEC expenses, NIC would not be required to spend any amounts on IEC activities henceforth.” The state government will now fund awareness about the existing insurance scheme and the newly-launched Pradhan Mantri Jan Arogya Yojana (PMJAY). A personalised letter from Prime Minister Narendra Modi will be distributed at the Zilla Parishad level to sensitise people about the health insurance schemes. “Funds to that effect are yet to be finalised,” said Dr Sudhakar Shinde, Chief Operating Officer at MJPJAY Society. In 2012, when the MJPJAY was launched (then named Rajiv Gandhi Jeevandayee Arogya Yojana), the state government had agreed in a Memorandum of Understanding to pay two per cent of the premium cost to NIC for IEC activities. Officials claim that in the last two years, while the society continued to provide funds, the insurance company did not utilise the funds for IEC work. “We did IEC when and where required on direction of the MJPJAY Society. The CEO of MJPJAY finalises and approves the awareness program. In the last two years there have been few IEC activities,” said S Rajagopalan, NIC regional manager and project in-charge of MJPJAY for the insurer. Officials from the MJPJAY Society, however, said that in the last two years the funds directed to NIC were not utilised. In July, MJPJAY CEO Shinde wrote to the insurance company to refund the unused amount. When the company refused, MJPJAY paid the premium for June after reducing Rs 63 crore to adjust the IEC funds. “NIC threatened to stop providing insurance coverage under Section 64 VB of the Insurance Act,” an official from MJPJAY said. MJPJAY then wrote to the state government claiming that funds paid for IEC activities had been under-utilised. Subsequently, MJPJAY Society withheld premiums since July. On October 8, MJPJAY officials met the NIC board following which the latter agreed to refund the IEC funds of Rs 80 crore. MJPJAY has now assured that it will pay the pending premiums totalling Rs 376 crore. The newly-launched PMJAY, that provides medical cover of Rs 5 lakh, has over 1,100 hospitals waitlisted for enrollment in state. Maharashtra government is set to issue fresh tender in December 2018 after the current tender with NIC ends. For all the latest Mumbai News, download Indian Express App

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