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Monday, September 10, 2012

TNEB Pensioners' Health Fund Scheme - Financial assistance for treatment availed in Hospitals outside Tamil Nadu - Amendment


TAMIL NADU GENERATION AND DISTRIBUTION CORPORATION LIMITED
(ABSTRACT)

TANGEDCO – Tamil Nadu Electricity Board Pensioners' Health Fund Scheme - Financial assistance for treatment availed in Hospitals outside Tamil Nadu - Amendment - Proposal.
(SECRETARIAT BRANCH)

(Per) FB TANGEDCO Proceedings No.50              Dated the 5th September, 2012.
                                                                                                Aavani-20,
                                                                                                Thiruvalluvar Aandu 2043.

                                                                                                READ:

1. (Per) B.P.(FB) No.11 (SB), dated 06.03.2008.
            2. (Per) FB TANGEDCO Proceedings No.13 (SB), dt.18.12.2010.
            3. (Per) FB TANGEDCO Proceedings No.14 (SB), dt.18.12.2010.
            4. (Per) FB TANGEDCO Proceedings No.15 (SB), dt.18.12.2010.

*********
PROCEEDINGS:

            The Tamil Nadu Electricity Board Pensioners' Health Fund Scheme was introduced in TANGEDCO (erstwhile TNEB) based on the Tamil Nadu Pensioners' Health Fund Scheme and whenever the Government have made any amendment to the Tamil Nadu Pensioners' Health Fund Scheme, the TANGEDCO also made the amendments to the TNEB Pensioners' Health Fund Scheme, so as to extend the same benefits to the Pensioners/Family Pensioners of TANGEDCO. Previously, there was no specific guidelines given for taking treatment outside the State of Tamil Nadu. Hence, the pensioners were allowed reimbursement only for the treatments taken within the State of Tamil Nadu. During the year 2008, when a pensioner, who had undergone eye surgery in Aravind Eye Hospital/Pondicherry had represented to reimburse the cost of treatment incurred by him, though the treatment was taken outside the State. The case was placed before the Board for taking a decision. Even though there was no specific orders from the Government, the proposal was approved by the Board and it was resolved that in all such cases, 50% of the cost of treatments may be paid subject to the ceiling. Accordingly, necessary orders were issued in the Board's Proceedings first read above. Subsequently, the Government in G.O.Ms.No.477, Finance (Pension) Department, dated 30.09.2009 have issued orders that the claims for medical assistance from the pensioners in respect of ineligible treatments as well as eligible treatments taken in unaccredited institutions, both within the State as well as outside the State, shall also be eligible for sanction of assistance under the Tamil Nadu Pensioners' Health Fund Scheme. The said G.O. was adopted in TANGEDCO vide TANGEDCO Proceedings second read above.

            2. The ceiling limit on the claims from the Pensioners/Family Pensioners is fixed at the rate of 75% of the cost of treatments or Rs.1,00,000/- whichever is less, under the Tamil Nadu Electricity Board Pensioners' Health Fund Scheme vide (Per) (FB) TANGEDCO Proceedings No.13 and 14 (SB), dated 18.12.2010. The same ceiling limit is applicable on the orders issued in (Per) FB TANGEDCO Proceedings No.15 (SB), dated 18.12.2010 which provides pensioners to take treatments in the Hospitals within or outside the State. Hence, it has been proposed to cancel the earlier orders issued in (Per) B.P.(FB) No.11 (SB), dated 06.03.2008 and also to incorporate a condition on the maximum ceiling limit, in the TANGEDCO Proceedings fourth read above. The said proposals have been approved by the Board.

            3. Accordingly, the TANGEDCO hereby orders that

(i)        the earlier orders issued in (Per) B.P.(FB) No.11 (SB), dated 06.03.2008, be cancelled;
and

Contd..
..2..

(ii)        the following sentence may be added at the end of para-4 of (Per) (FB) TANGEDCO Proceedings No.15 (SB), dated 18.12.2010:

"subject to the maximum ceiling limit of Rs.1,00,000/- or 75% of the cost of treatments, whichever is less".

            4. The above orders shall come into effect from the date of issue of these orders.

            5. The receipt of these proceedings shall be acknowledged in the slip enclosed.

(BY ORDER OF THE BOARD)

                                                                                                                        A.S.PASUPATHI,
                                                                                                                           SECRETARY.

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