KARACHI: The critical condition of a Karachi Water and Sewerage Corporation (KW&SC) employee has raised serious questions over whether the health insurance coverage available under the TPL Insurance arrangement is adequate to meet the costs of life-saving emergency treatment.
Atiq Ahmed, a naib qasid posted at New Karachi Tax, suffered a brain haemorrhage on Wednesday night and was taken to Saifee Hospital in North Nazimabad, which his family says is on the relevant insurance panel. He remains on a ventilator.
Speaking to Health Matters Media, Atiq's brother Muhammad Iqbal said the family was informed that Rs247,000 was available for treatment under the insurance coverage, while the hospital was seeking approximately Rs700,000 for treatment and surgery.
The amounts have been provided by the patient's family and have not been independently confirmed by TPL Insurance or the hospital.
Iqbal questioned how a critically ill employee could receive timely life-saving treatment when the available insurance coverage was substantially below the amount being sought by the hospital.
He alleged that the family approached both KW&SC and the insurance company for assistance but initially did not receive the level of support they believed was required considering Atiq's critical condition.
The case raises a wider public-interest question: if the cost of emergency surgery, intensive care and ventilator support exceeds an employee's insurance limit, what mechanism ensures that treatment continues without potentially dangerous delays over payment?
Following Health Matters Media's contact with KW&SC regarding Atiq Ahmed's case, Director Medical Services Faisal Qureshi provided the corporation's position.
Qureshi said the health and wellbeing of KW&SC officers and employees was among the corporation's top priorities and that negligence or delay in an employee's treatment would not be tolerated.
He said KW&SC employees receive medical treatment under the agreed health insurance policy and that prescribed health coverage limits apply to employees.
According to Qureshi, KW&SC has approved an additional Rs250,000 from its medical pool for Atiq Ahmed, over and above his prescribed insurance coverage. He said further payment could also be made depending on the patient's medical requirements.
Qureshi said the hospital administration had been informed through email and instructed that there should be no deficiency or negligence in Atiq Ahmed's treatment.
He added that KWSC officials were monitoring the patient's condition and maintained that every possible medical facility would be provided to him.
The case nevertheless raises questions about the adequacy of the insurance coverage available for employees requiring high-cost emergency and critical care, and about how quickly additional financial support can be made available when treatment costs exceed the prescribed limit.
TPL Insurance's version regarding the coverage available in Atiq Ahmed's case was not available at the time of publication. Health Matters Media remains open to incorporating the company's response or clarification whenever received.
