Jammu & Kashmir. The
Government is providing free health insurance cover to all the citizens of J&K for Rs 5 lakh per family per year on floater basis. The Government employees are also eligible for enrollment under the said insurance scheme.However, it has been observed that large number of medical reimbursement claims of employees are not being preferred under the insurance scheme being provided by the Government due to various reasons.
The issue has been examined in the Finance Department and it has been
decided that the claims for medical reimbursement of employees and their
dependent family members pertaining to the post launch period of SEHAT Scheme
shall invariably be preferred under the said scheme. The expenditure beyond the
insurance cover shall continue to be reimbursed by the Government as per the
provisions of the J&K Civil Services (Medical Attendance-cum-Allowance) Rules,1990.
The medical claims of the Government Servants and their dependents, who
are registered under the scheme shall be considered for reimbursement under
Medical Attendance Rules, only for the amount beyond the insurance cover being
provided under the SEHAT insurance scheme.The medical claims of the Government Servants, where beneficiaries have applied for registration under the scheme but have not been registered will be considered for reimbursement under Medical Attendance Rules, provided it is
established with documentary evidence that the application of the patient for
registration under the scheme has been submitted prior to the date of under taking
treatment.
The medical claims of the Government Servants and their dependents, who
have not applied for registration under the scheme, shall be considered for
reimbursement under Medical Attendance Rules, only for the expenditure incurred
beyond the admissible Insurance cover.
