GROUP MEDICLAIM SCHEME
Rev. Sh. R.B.Kishore and Dear Shri V. C. Jain & ALL PENSIONERS -
Through this mail I wish to point out one specific Clause 2.4 DOMICILIARY
HOSPITALISATION BENEFIT and Note thereto which is:
" When treatment such as Dialysis, Chemotherapy, Radiotherapy etc. is taken
in the Hospital/Nursing Home and the insured is discharged
on the same day, the treatment will be considered to be taken under
Hospitalisation Benefit Section.
But a rider has been added i.e.
LIABILITY OF THE COMPANY UNDER THIS CLAUSE IS RESTRICTED TO 20% OF THE TOTAL
S. A. PER PERSON.
The above has been brought to our notice by one of our members whose wife
is on dialysis. It is obvious that since number of such patients on dialysis
Radiotherapy is very small, the actual pinch has not been felt earlier
necessitating demanding review of the Clause restricting the liability to
a meagre 20% of the SA.
Patients under dialysis or Cancer patients have a shortened life and need
regular medication to survive. Their pain and agony, life oozing out bit by
bit; with family members
courageously putting up a support system knowing fully that the disease is
not curable but treatable only to some extent - we can only feel their pain.
The cost of treatment for diseases under these categories is exhorbitant.
Medical expenses for a patient on dialysis ( twice a week ) comes to almost
3000/-3500 per dialysis.
Whereas in the case of Chemotherapy, if the patient is advised 6 to 8 cycles
of the same, then the cost of medicines only is somewhere 8000/- to 10000/-
per cycle if he/she is
taking treatment from a Hospital like PGI. If we add the charges incurred in
a private hospital, we can well imagine the cost of treatment.
We fail to understand as to why this restrictionof 20% has been imposed.
I am sure you will please consider the issue dispassionately and take up the
same in a an appropriate way so
that in such traumatic cases atleast genuine financial medical assistance,
to the extent of total sum assured, is not denied under one pretext or the
I am forwarding a copy of this mail to Sh.P.N. Srivastava, Kanpur also
S. P. SOOD