Q: Our contract states that the company should provide free medical cover to us. Recently, it purchased an insurance policy from Tawuniya, which charges all the workers 20 percent for consultation and 20 percent for medical and other services. We asked the company for the reimbursement of this 20 percent, but the company said it is the labor office's ruling that we bear the costs. I am the technical manager in the company and want to help all the poor workers, who do not possess knowledge of the rules. Please advise. A: As per the rules of the CCHI (Mandatory Medical Insurance), the minimum requirement is that the patient pays 20 percent of the cost of all out-patient treatments. However, the deductible should not apply to in-patient treatments. There are companies which provide zero deductible policies to their employees, but this is not legally binding on the company, it is a facility offered by the company to their employees. If your company has already taken a policy with 20 percent deductible, then they must have got a discount in the premium compared to a zero deductible policy. As per the contract that you have signed with your company, you are entitled to free medical insurance. You may convince them to reimburse the deductible paid by the workers to the hospital or a lump sum amount to each worker from the amount saved by your company in premium. This will not be a large expense. Giving anything beyond the minimum requirement prescribed by the CCHI is a prerogative of individual companies. Q: Seven days after the birth of my child, I took him to a hospital for his circumcision. Initially, the hospital informed me that the procedure is not covered under insurance, but later they asked for the child's card, which I have not yet received. This is our third child and as per my company's rules, I can have medical coverage for only two children. Please advise. A: It seems you have a mandatory insurance policy. If your wife's maternity benefit is covered under the policy, the cost of circumcision will also be covered by it, irrespective of the serial number of the child. The current CCHI policy does provide coverage for circumcision. Normally, if the operation takes place in the same hospital where the child was delivered, it is less difficult. But the same is a problem if you go to a different hospital. I suggest that you get the circumcision done in the same hospital as that of the child's birth. It will be easier to get the necessary approval. Otherwise, you will need to approach your insurer and get their approval for the procedure and proceed accordingly. Shujaath Ahmed Khan, an MBA, General Manager, Creative Associates is also a consultant and an expert in Insurance, Investments and Real Estate. He can be contacted at [email protected], website-www.creativeassociates.blogspot.com. __
