Dual Claim

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Dual Claim

Claim from Private Insurance as well as from Department

Q8a. Claim submitted for Rs. 2,30,000/- The employee has also claimed from private insurance company which has sanctioned Rs. 1,40,000/-as per their admissibility for the procedure. Claim is for a medical management – the admissible amount for the same as CGHS rates is 1,50,000/- Now the amount admissible is: *

1 point

Rs. 150000/-

Rs. 90000/-

NIL – payments for room rent, medicines, investigations etc. cannot be made from two sources.

Q8b. Claim submitted for Rs. 430000/-, the employee has submitted the claim to office , the hospital bills indicate that the claim has been partially paid by the private insurance company – amount sanctioned is Rs. 3,00,000/- Claim is for a surgical procedure – the admissible amount for the same as per CGHS rates is 1,80,000/- The amount admissible is: *

1 point

Rs. 180000/-

Rs. 130000/-

Nil – claim for the surgery has been paid for by insurance company and claimant can’t receive payments from two sources for same procedure.

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