GOVERNMENT OF INDIA
MINISTRY OF RAILWAYS
No. 2009/H / 6-4/Policy
All Indian Railways,
All Production Unit including RDSO
Dated: 09 .. 04.2015
Sub: Policy on reimbursement of medical expenses by Railways where part payment has been received by the beneficiary through medical insurance claim.
Ref: Railway Board’s letter no. 2009/H/6-4/Policy, dated 28.02.2013.
Railway Board has been receiving representations from various quarters for modifying the extant policy on reimbursement of medical expenses where part payment has been made through insurance claims. After due consideration, in supercession of the above referred letter, the following instructions are issued:-
Railway beneficiaries, both serving employees and retired employees (members of RELHS scheme) who have subscribed to Medical insuranace Policies, may be allowed to claim reimbursement both from the insurance company as well as Railways subject to the condition that the total amount of reimbursement from both the sources should not exceed the total expenditure incurred J:,y the beneficiary for the treatment. Tile beneficiary will mate the first
claim to the insurance company and thereafter to the Railway concerned, wherever necessary,
as per the procedure explained below.
1.. The medical claim ·against the original vouchers/bills would be raised by the beneficiary first to the insurance company, which would issue a certificate, addressed to the concerned CMS/MD indicating the amount reimbursed . The insurance company will retain the original vouchers/bills in such cases and issue photocopies of bills(vouchers duly certified in ink along with stamp of the insurance company.
2. The beneficiary would thereafter prefer his/her medical claim along with photocopies of vouchers/bills duly certified, in ink, along with stamp of the insurance company to the concerned MD/CMS through the Health Unit/Hospital where the Medical card is registered. ·
3. Medical Department shall scrutinize the claim as per the extant rules of Railway, Ignoring the amount already reimbursed by insurance company, and the amount
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