Mahadevi Dhanaji Paul experiences Inclusiveness of Uplift Biradaree
Mahadevi Dhanaji Paul, has been living with her husband and three school going children in the Azadnagar, Thane for the last 18 years. Her husband an autorickshaw driver is the sole earner in the family with an income of INR 10,000 (USD 153) per month. She joined Uplift in June 2017.
Mahadevi had attended the health camp organized by Uplift along with her children. Her son was diagnosed with a gum problem and Dr Swati Shinde, the medical officer at Uplift advised her to see a dentist. Mahadevi narrates her experience, “I took my son to the dentist and he was diagnosed with a dental cyst and advised surgery. I went back to Dr Swati to ask her advice. She looked at the reports and seconded the dentist’s diagnosis. We incurred an expense of INR 4,000 for the surgery, I filed for a claim and was reimbursed INR 3,400. This was a first for us, within a month of becoming an Uplift member not only did I receive valuable advice but also got back the money spent in hospitalization. I have complete faith in the Uplift system.”
However, while Mahadevi takes care of her family, her own health is neglected. Although in her 30s, she suffers from diabetes and hypertension. She has had to discontinue her treatment due to lack of money. She explains, “My medicines cost INR 40 per day and given our economic condition, I need to concentrate on my children first. I can live without the medication”. In the coming months, the Uplift staff will work with her to ensure that she begins her medication
What is important to note here is that Mahadevi’s claim for the dental cyst was technically rejected as the diagnosis of the disease was before her policy start date though the surgery was done after the policy start date. The pre-existing clause was applicable for her application. She had paid her premium on the 10th of June but the policy was to start from July 1, 2017. Her son was diagnosed around 20th of June.
However, the member claims committee took a decision to pay her the claim. Shakila Bhanu Sheikh, one of the member benefit council member talks about this case, “It was only by 10 days that the case fell in the pre-existing diseases category. Since the case was diagnosed in our health camp and by our own doctor, we knew it was a genuine case and decided to pay her the claim. Why should we punish our member who had followed all rules and responsibilities?”
