Medical Claim Availed by Executives
9.0 Brief Introduction:
Vigilance department conducted a surprise check on Declaration of Dependent Family Members for availing Medical Benefits. As per the prevailing guide lines, the limit of income prescribed for medical dependent from all sources was Rs. 3,500/- per month (revised to Rs 9,000/- w.e.f. 30.09.2019).
During the investigation, it was revealed that some Executives have declared father and mother as dependent for the purpose of Medical benefit though the parents were in receipt of rental income which was more than the prescribed limit of income from all sources for the purpose of medical benefits.
From the investigation, it was also revealed that some executives are claiming Income tax rebate by submitting rent receipts obtained from their father and also they are availing medical benefits forhis/herfather/mother.
During the Investigation, the following irregularities were observed;
(a) Employees are submitting false medical declaration to gain unlawful benefit from the organization though the income of their parents is more than the prescribed limit of income as per prevailing guidelines.
(b) Employees are availing unlawful claims by submitting false dependent declaration form to HR department.
(c) There is no single window to verify the declaration of dependent forms summited by the employees and to verify the rent receipts submitted by executives for availing rebate on house rent.
Vigilance department recommended to recover the wrong medical claims submitted by the Executives to the tune of Rs. 5 lakhs.
Following systemic improvements were also suggested.
(i) HR department is the custodian of declarations of dependents forms submitted by the employees. However, the rent receipts for the purpose of income tax rebates are submitted to Pay Roll Dept. A suitable procedure/system be put in place so that HR dept. can access the details of above rent receipts to verify the declarations of dependents submitted by the employees.
(ii) Regular checks to be conducted by HR dept. to detect such wrong claims.
9.3 Impact and Benefits:
Due to Regular checks by HR department, wrong claims and false medical declaration can be minimized/nullified.