Railway Employees under the Medical Insurance Scheme for obtaining treatment in private hospitals - IRMS
Medical Insurance Scheme for Railway Employees
INDIAN RAILWAYS TECHNICAL SUPERVISORS ASSOCIATION
(Estd. 1965, Regd. No.1329, Website http://irtsa.net)
M. Shanmugam,
Central President, IRTSA
# 4, Sixth Street, TVS Nagar, Padi,
Chennai – 600050.
Email- cpirtsa@yahoo.com
Mob:09443140817
Harchandan Singh,
General Secretary, IRTSA,
C.Hq. 32, Phase 6, Mohali,
Chandigarh-160055.
Email gsirtsa@ yahoo.com
(Ph: 0172-2228306, 9316131598)
No: IRTSA/CHQ/Memo .2020-13
Date: 27.11.2020
DIRECTOR GENERAL (HR)
Railway Board
New Delhi
Sub: PROPOSAL OF MEDICAL INSURANCE SCHEME FOR RAILWAY EMPLOYEES.
Ref: 1) Railway Board letter No.E(W)2020/Misc/ Dashboard- GIS, dated 27.10.2020
2) Railway Board order No.ERB-1I/2020/23/30, dated 20.10.2020.
1) Ministry of Railways constituted a committee to examine and tender
their recommendations to bring all Railway Employees under the Medical
Insurance Scheme for obtaining treatment in private hospitals. IRTSA
submits the following for the kind consideration of Railway Board.
2) Indian Railways Medical Service (IRMS) is spread
across the length and breadth of the country. IRMS is having 125
hospitals and 586 dispensaries, manned by 33,300 medical staff catering
to approximately 66 lakh beneficiaries including 12.27 lakh serving
employees. In the year 2018-19 Railway Hospitals treated 2.01 crore OPD
patients, 5.08 lakh in-patients and performed 1.02 lakh major and
specialty surgeries.
7th
CPC Transport Allowance and DA granted for Indian Railway Medical
Service (IRMS) officers drawing Grade Pay of Rs.10,000/- under DACP
Scheme
3) Railway Hospitals performed pre-placement medical examination for
38,000 candidates and carried out periodical medical examination for
1.14 lakh employees. They also examined 12.51 lakh food and water
samples.
4) Indian Railways total medical services expenses for the year
2018-19 including cost of medical staff is Rs. 6888.34 crore. That makes
average medical expense per beneficiary as Rs.10,500.
5) No medical insurance company in India handles 66 lakh
beneficiaries. Medical Insurance doesn’t cover OPD. Since Railway is
catering 2.01 crore OPD patients in a year, it may not be possible to
include huge OPD beneficiaries in private managed medical insurance.
6) In existing Railway medical system all medical services like OPD,
diagnosing, medicines, Surgeries, in-patient care, major
treatment/surgeries carried out in referral private/ CGHS hospitals and
follow-up checking are part of employees’ welfare scheme offered to
employees and their dependents. It is a part of service condition. For
retired employees and their dependents who opted for RELHS on onetime
payment, same medical services are extended.
7) In the Railway Medical system, no cost ceiling is fixed for
entitlement of any required treatment. On the other hand, medical
insurance cover is basically extended to in-patient treatments and for
surgeries with a ceiling based on the premium paid.
8) For example, United India Insurance Company Limited offers Rs.10
lakh sum insured at premium rate per member Rs.12,386 in age group
41-45. If all 66 lakh Railway beneficiaries are covered under above
premium Rs.8370.78 crore will be paid as total premium. Whereas total
medical expense of Indian Railways for the year 2018-19 is Rs. 6888.34
crore which is for diverse services given in the Annexure.
9) In the same time there is a need for addition of more private
empanelled hospitals in Indian Railways Medical Services with seamless
cashless treatment, since large number of serving and retired health
care beneficiaries live in the newly developed suburbs of various cities
throughout India. It is pertinent to note that in case of emergency,
beneficiaries first require to approach Railway Hospital, then they are
referred to private hospitals and in many cases precious golden hours
are lost in mere formalities endangering the life.
10) Beneficiaries living in faraway places from Railway Hospitals
also find it difficult to get their regular treatments and minor
treatments occasionally, since they are required to travel long distance
to reach Railway Hospitals. These beneficiaries will be benefited if
cashless treatment is extended to them in the hospitals available near
their living place.
11) Hence it is requested that,
a. Existing Indian Railways Medical Service facilities may please be continued.
b. The proposal for Medical Insurance Scheme for Railway employees /
Pensioners and their depended may please be made as additionally
facility to the beneficiaries to get their regular treatments including
OPD & IPD in empaneled private hospitals, premium thereof may please
be borne by Railways.
Thanking You
Yours faithfully,
(Harchandan Singh),
General Secretary, IRTSA
Annexure
List of diverse services performed by Indian Railways Medical Service (IRMS)
1) Attending Railway accidents and similar incidents;
2) Emergency medical treatment for sick passengers;
3) Pre-employment medical examination for prospective employees;
4) Periodical medical examination for employees;
5) Medical boards and other medical certification for employees;
6) Safe water supply at Railway stations;
7) Safe food supply at Railway stations;
8) Running medical first-aid posts for IR factories under the Factories Act;
9) Certification of dead bodies;
10) Certification of perishable goods;
11) Curative healthcare; and
12) Preventive healthcare.