Reimbursement of Medical Claims: CPWD's Instructions

No. 21/26/2013-EC-X

GOVERNMENT OF INDIA

DIRECTORTE GENERAL OF WORKS

CENTRAL PUBLIC WORKS DEPARTMENT

Nirman Bhawan, New Delhi 

Dated the 24th January, 2014

After repeated requests and making available of the required formalities for processing of reimbursement of medical claims, it has been observed that the medical reimbursement claims are still being received in this Directorate are forwarded/processed in a very casual manner resulting in delay in final settlement of claims of individuals and settling medical claims of different C.G.H.S. approved Hospitals.

To minimize the delay and to streamline the process of scrutinizing and submission of reimbursement of medical claims the stage wise steps required are appended below for action on the part of field units of this Directorate:-

1. The duly filled up Modified Check list for Reimbursement of Medical Claims and Medical Claims Form as per prescribed Performa.

2. The Copy of new CGHS card.

3. The Copy of Permission Letter from concerned office.

4. The Original Bills along with discharge/ Death summary from the Hospital.

5. Emergency Certificate in original from Hospital.

6. In case of death of CGHS Card Holder following documents as prescribed in modified checklist:

i.Affidavit on stamp paper by claimant.

ii.No objection from other Legal Heirs on stamp paper.

iii.Copy of Death Certificate.