Jahangeer Ganaie
Srinagar, Oct 14: Secretary Health and Medical Education Bhupinder Kumar on Saturday termed the allegation of Rs 500 Cr loss to the exchequer regarding PMJAY SEHAT Scheme as baseless and far from the reality.
Addressing a press conference in Jammu, Kumar said that there is an allegation of losses to the exchequer to the tune of Rs 500 crores but a total of premium that was paid to the Bajaj Allianz during the whole policy period that began on April 26l 2020 and continued till March 2022 including the interim period of 79 days on stop loss basis, was Rs 304 crores.
“Total premium that was paid to Bajaj was Rs 304 crores and during same period of one year and 79 days the claims pay out to both private and public by the insurance company was Rs 398.41 crores,” he said. “Based on these figures, the allegation of scam of Rs 500 crore is baseless. The fact is that the company instead of earning profit has on the contrary incurred monetary loss of Rs 93.2 crores.”
The Secretary health added that there has also been an attempt to build a false narrative on the baseless and wrong facts reported in some media outlets about the termination clause.
“It has also been alleged that the review of the renewal of contract was to be done after two years, however, it is being clarified that as per the contract between Bajaj allianz and State Health Agency J&K was allotted to Bajaj after competitive bidding process using the model tender document issued by the National Health Authority,” he said.
He said: “The maximum term of the contract was fixed three years which was to be renewed after every 12 months. The revision of clauses 9 and 27 of the contract make it clear that the continuation of the contract beyond the first year was to be on the basis of mutual agreement of both the parties.”
Kumar said that the insurance company as per the terms and conditions of the contract served the notice expressing unwillingness to continue the contract beyond the completion of one year in view of the losses incurred by it.
He said that every effort was made by the department at that time for ensuring continuing of the contract and services but the company chosed to exercise the option of exiting after the expiry of one year term.
“To prevent service interruptions, State Health Agency J&K entered into an agreement with Bajaj alliance to continue services on stop loss basis until the selection of new insurance company is finalised,” he said, adding that it has also been misquoted that the number of eligible families covered under the scheme was increased by 10 lakhs to benefit the company during the interim period of 79 days but it is clarified that number of families during the policy period from 26th of January 2020 to 25th of December 2021 and the interim period of 79 days remained same as 21.24 lakhs.
He said that this model hasn’t only strengthened the health care systems within J&K but has also significantly reduced out of pocket expenses preventing catastrophic payments and poverty for families in need of hospitalization.
“However, it is worth mentioning that there have been attempts to discredit the scheme through misinformation. Such allegations are intended to disrupt the services and are totally baseless and false besides meant to malign the image of government and are vehemently denied,” he said.
