Grievances - Megha Health Insurance Scheme

INQUIRY/COMPLAINT/FEEDBACK Form

Grievance Redressal

Members Grievance Committee

Contacts

Grievance Redressal System

The success rate of any scheme depends on how it handles the complaints and grievances about the scheme. A process for handling the grievances can enhance outcome and give user the satisfaction that their complaints have been addressed, and there is a greater possibility that it would be resolved as per the policies.
Grievances under MHIS /PMJAY may be broadly related to issues concerned with Registration, Hospital empanelment, de-empanelment, delayed in claims settlement or payment of premium to the Insurance Company. In addition to this, some other type of grievances may also come. Complaints may come from any Stakeholders such as Beneficiary / Hospital / IC / TPA / NGO or any other party.

GRIEVANCE TYPES AND WHO CAN FILE GRIEVANCES

Grievances can be filed by any party directly or indirectly involved with the AB PMJAY or any stakeholder for this purpose, a stakeholder includes:

MHIS/AB PMJAY Beneficiary
Healthcare Provider
Insurer or its employees;
Implementation Support Agency (ISA) or its employees
State Health Agency (SHA) or its employees or nominated functionaries for implementation of the Scheme; and
Any other person having an interest or participating in the implementation of the Scheme.
Any person who may have observations, comments, feedback on any aspect of the Scheme may also file a complaint along with specific details. Vague comments/feedback which are not actionable shall not be entertained.

Grievance Redressal Committee members

	SGRC	DGRC
Chairperson	Secretary Health and Family Welfare Department, Govt. of Meghalaya/Chief Executive Officer MHIS	Deputy Commissioner
Convenor	Chief Executive Officer /Jt Chief Executive officer MHIS	District Medical & Health Officer
Members	DHS (MI) Director Finance State Manager Grievance Redressal Manager Monitoring and Control Officer Claims Officer Representatives Insurance company	District Key Manager, District Programme Manager District Accountant Representatives Insurance company

#	State	Contact Person	Email
1	Meghalaya	Mrs. Alda Passi – SGNO	grievance.mhis@mhis.org.in

#	District	Contact Person	Email
1	EAST GARO HILLS	Mr. Micky D Sangma – DGNO	dpm.egh@mhis.org.in
2	EAST JAINTIA HILLS	Mr.Rosebardtre Shadap – DGNO	dpm.ejh@mhis.org.in
3	EAST KHASI HILLS	Mr.Andrew Pyngrope – DGNO	dpm.ekh@mhis.org.in
4	NORTH GARO HILLS	Ms.Shienty Shira – DGNO	dpm.ngh@mhis.org.in
5	RI BHOI	Mr. Daniel F Marbaniang – DGNO	dpm.rb@mhis.org.in
6	SOUTH GARO HILLS	Mr. Anupam Ch Marak – DGNO	dpm.sgh@mhis.org.in
7	SOUTH WEST GARO HILLS	Mr. Sankar Hajong – DGNO	dpm.swgh@mhis.org.in
8	SOUTH WEST KHASI HILLS	Mrs. Prilyne Marwein – DGNO	dpm.swkh@mhis.org.in
9	WEST GARO HILLS	Ms. Vivian S Ch Marak – DGNO	dpm.wgh@mhis.org.in
10	WEST JAINTIA HILLS	Mr. Philemon Bamon – DGNO	dpm.wjh@mhis.org.in
11	WEST KHASI HILLS	Mr. Jason M Marbaniang – DGNO	dpm.wkh@mhis.org.in