CGHS Delhi has been organizing CLAIM ADALAT for the last three years on zonal basis. This is a novel and unique method in the health sector to reach out to its beneficiaries to settle on spot any dispute arising out of the claims related to medical bills reimbursement. These beneficiaries are mostly the pensions of the Government of India who submit their claims with CGHS.
CGHS North Zone is going to organize a claim Adalat on 27th February, Saturday, 2010 at the premises of the office of the Addl. Director CGHS North Zone situated at Shankar Road, New Razinder Nagar. This would be the third occasion when this Zone is going to hear the disputes/grievances about payments of medical bills.
Beneficiaries are informed through Newspaper publications/information at the CGHS dispensary level to apply to the Addl. Director in case they have any problem so far as their bills are settled. However, claims which are already been examined and rejected will not be discussed in such across the table settlements. Applications received by post and by hand are documented and concerned files are opened to re-scrutinize the claims on the merit case to case basis under the ambit of CGHS rules and regulations. Cases are readied from before hand to enable the parties to settle the matter amicably to the satisfaction of the beneficiary.
Most of the beneficiaries although had long been associated with the central government, are not acquainted with CGHS MRC rules and regulations.
Misunderstanding and grievances thus crop up. Despite of all genuine and sincere efforts it is also not unlikely that some delay in disposal of the huge number of claims does occur. In such cases, these Adalat are ideal forum to settle on spot instead of long and cumbersome procedure of correspondence and files. Observers from Ministry are present to oversee the procedure to make it transparent and overboard.
In this Adalat, officers who will represent CGHS are Addl. Director, OSD (reimbursement), PAO and Administrative officer while the Ministry would be represented by the Deputy Secretary, CGHS, Ministry of H&FW.
This type of claim Adalat is in the principle of fast track decisions followed in judicial system and is usually done to clear the long pending cases for good. Main theme of these exercises is to make the officialdom transparent and rid of long pending cases. Unnecessary litigations may also be avoided by virtue of this type of out of the settlements.