We have received reports that TPA Medi Assist is subjecting retirees-(MAF) member patients- to uncalled-for investigations while the patients are undergoing treatment/procedures at the approved hospitals. The investigations have been conducted at the residence of the patient after the discharge from the hospital and, in some cases, at the Hospital concerned prior to the discharge. The members undergoing treatment/procedure have also been photographed through a mobile by the Investigator.
The investigations are being conducted through companies who are not parties to the agreement that Bank entered into with United India Insurance Company Ltd.,
In a recent case, representative of the investigative company - Hoaxicide Healthcare Pvt Ltd. Ghaziabad – visited the residence of a retiree patient after his discharge from the Hospital. The representative sought to photograph the retiree as also wanted the patient to disclose other personal details about him and his family within few hours of the cataract operation undergone by the patient member of MAF.
Incidentally, Hoaxicide Healthcare Pvt., Ltd. Ghaziabad is being run from a House in INDIRAPURAM, GHAZIABAD - having only two directors, one of whom appears to be nominee of a Doctor employed with TPA. The so called investigator was thoroughly ignorant of the medical know-how and asked questions such as why you chose this hospital?, is there no other hospital near your residence? Under the scheme circulated by the Bank treatment can be had anywhere in India in an hospital provided in the booklet issued by the TPA.
RBI New Delhi OERS optees & Pensioners Welfare Association by their letter dated 16th July 2015 have referred the matter to central office, although an undated apology letter has been received from the TPA that ducks the issues raised by the concerned member in his letter dated 14th May 2015.
Such investigations give rise to various issues of impropriety by the TPA and are given below :
1) Such investigations are not the part of the features of the scheme as circulated by the bank. and amounts to a breach of contract. They hint more towards a nexus between the investigating company and some professionals in the TPA.
2) these investigations invade the privacy of the patient concerned at a time when he needs rest and peace of mind most to recuperate. Are such investigations not a threat to his security in the prevailing law and order situation in the Metros.?
3) Whether taking the photograph of the member of MAF by a private unknown person at the residence of the retiree or at the approved hospital prior to discharge/after discharge is proper when the Bank had already provided photographs to TPA.
An application under RTI act has also been filed with the Bank and the latest position in the matter will be communicated in due course.