Ex-Servicemen Contributory Health Scheme (ECHS) — Harassment and undue deduction in medical claim by 68.5%

Address:

New Delhi, Delhi, 110047

My father sh. Sardar singh, ex-sergeant indian air force was taken in emergency to fortis hospital vasant vihar, new delhi on 04.03.2016 early morning due to cardiac arrest. The moment he was put on bed in hospital his heart beat stopped and blue alert was announced in the hospital. He was on ventilators for 6 hours and same day evening he was shifted to max hospital saket as the fortis was removed from echs empanellment.

This was duly reported to ms. Sunita echs polyclinic, afs tughlakabad in afternoon.

As fortis hospital was removed from the empanelled list of echs, we have paid the hospital bill of rs. 72, 779/- to fortis.

All required claim documents for the same was submitted duly on 14.03.2016 but despite of several visits and requests the claim was not processed till 04.04.2016 by echs polyclinic, afs tughlakabad. Even after issuing the claim no. On 04.04.2016, the dealing clerk took another 20 days to upload the documents causing undue delay. On 18.04.2016 i reported this delay to adjutant of the polyclinic.

Today on follow up, i was informed that the claim has been approved for only rs.23, 000/- having a deduction of almost rs.50, 000/- for no reasons explained.

My appeal is that the soldiers who put their lives on stake to protect us should not be harassed like this on what basis echs has deducted rs.50, 000? Fortis was under echs panel, we had no information about removal from list... Secondly, it was an emergency case not a normal or routine medical treatment.

If fortis would not have removed from the empanelled list, echs would have paid the hospital in full, then why not now in this emergency?

I humbly request you to kindly look into this matter and get the justice done to reimburse the entire amount of rs.72, 779/-

Claim no. Is 5025182 dated 04.04.2016.

Hope we will get justice.

Thanks and best regards

Jitender singh
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