Written by: Ananya Banerjee
3 min readMumbaiDec 15, 2011 12:30 AM IST
First published on: Dec 15, 2011 at 12:30 AM IST
Almost one-and-a-half years after ‘Project Connect’,the insurance scheme for HIV positive persons,was introduced in Mumbai,only 10 persons have been registered as benficiaries. Moreover,those who have been insured,have been complaining of delay in reimbursements.
“The medicine prescription that was given to me did not specify dosages. There was some discrepancy in the costs of the medicines too. I had to go back to the doctor and then to the pharmacy to get the correct documents,” said a Chembur resident,who has been visiting a Ghatkopar hospital for treatment.
Introduced last year in Mumbai-Thane,the scheme is supported by the United States Agency for International Development (USAID) and the insurance is being provided by Star Health and Allied Insurance.
As per the scheme,the client will initially get a health cover of Rs 30,000 for which a premium of Rs 1,511 will have to be paid to the insurance company. The policy holder is entitled to pay only Rs 750 and the rest is subsidised by NGO Population Services of India (PSI). Half of the amount can be claimed at the onset of AIDS,and the rest for the treatment of other problems,like co-infections associated with HIV.
Officials say the delay in reimbursement is a result of inaccurate documents issued by hospitals. “The insurance company sends back the claims wherever they find inadequate proof and claimants then have to run back to the doctors to clarify details,” said a PSI officer. He added that often finer details of the procedure are ignored,as a result of which only around 10 persons from Mumbai have been registered as beneficiaries as part of the scheme.
Incidentally,sources have said that PSI’s tie up with the project has ended which has added to the delay in reimbursements. “PSI was a facilitator in the initiation of the scheme. Our project period ended in September and other NGOs will continue to be a medium between the insurance company and the claimant,” said project director of PSI,Dr Shekhar Waikar.
According to the Maharashtra State AIDS Control Society (MSACS),Raigad,Pune and Latur don’t have even a single person registered as a beneficiary.
“The scheme was introduced in 25 districts of the state,excluding Mumbai and Thane. The districts in charge are responsible for helping the claimants to get their insurance. However,due to lack of manpower,many districts don’t have an official in charge,as a result of which the scheme hasn’t been able to reach out to many districts yet,” said an MSACS official.
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