PMC health cover to help insurance firms, not the poor: Dhende

The ex-deputy mayor claims that the civic body’s plan to provide cover to only two lakh citizens of the 31 lakh population would deprive many poor people of the health cover benefits

Former deputy mayor and RPI (A) leader Siddarth Dhende on Friday urged the civic administration not to go ahead with its plan to engage insurance companies and brokers to implement health cover schemes of the Pune Municipal Corporation (PMC) for the urban poor. He said such an initiative would serve the interest of insurance companies and brokers more than the needy.

In a written communication to municipal commissioner Vikram Kumar, Dhende said that the urban poor are getting health cover from various schemes of the Union government, state government and the PMC.

“The plan to implement the PMC health cover schemes through insurance companies, along with appointing an insurance broker as consultant, would cause financial loss to the civic body. The move would also create problems for the urban poor in availing of the health cover benefit,” he said.

The PMC has sought proposals from insurance companies to implement its health cover scheme for the urban poor and has also decided to appoint an insurance broker as consultant.

The PMC provides medical treatment to residents at its civic hospitals at nominal rates. The health cover scheme for the urban poor is implemented with financial assistance of Rs 1 lakh for treatment in private hospital for cases of serious ailments. The existing and retired civic employees, along with their family members, sitting and former corporators along with their family members, are provided free treatment in private hospitals.

Also, 35,000 families are provided health cover of Rs 5 lakh under the Ayushman Bharat scheme and Rs 2 lakh cover under the state government scheme. The needy get financial assistance from the Mayor’s Fund for expensive treatment. Also, the PMC has an agreement with private organisations to offer medical treatment at cheap rate using civic health infrastructure.

Dhende said the PMC has planned to replace its scheme for the urban poor with health cover of Rs two lakh for two lakh citizens through insurance companies. “There is no such policy decision taken either by the standing committee or the general body to implement health cover scheme through insurance company,” he said.

Also, the plan to rope in an insurance broker as consultant to implement the health cover scheme with payment by insurance company and no cost to the civic body means the consultant would work in the interest of the company and not the PMC, he added.

The former deputy mayor said no insurance company pays fees to consultant as per the Insurance Regulatory Development Authority (IRDA) rules and instead the brokers are paid charges based on the selling of insurance policy to citizens. “It is necessary for the PMC to follow the IRDA guidelines and the existing plan is completely wrong,” he said. Dhende added that the PMC would appoint insurance brokers as consultants who are already working as agents for various insurance companies and it would lead to conflict of interest.

He said that 42 percent of the city’s population lives in slums, while the PMC is planning to provide cover to only two lakh citizens of the 31 lakh population, depriving many poor people of the health cover benefits. “The PMC has an annual expenditure of Rs 60 crore under the health cover scheme for the urban poor. The civic body pays the medical bills directly to the private hospitals. However, the new plan would mean the amount would go to the insurance company as premium and also benefit the consultant,” he added.

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