Assistance of major ailments

A) “Major ailments” means any heart operation, Kidney transformation [ eye operation, treatment of paralysis, orthopedics operation, uterus operation, treatment of asthama disease, maternity miscarriage cases, treatment of gall bladder related ailments, removal of kidney stone, treatment of brain hemorrhage, treatment of ulcer, cancer [dialysis, kidney related surgery, ENT treatment and surgery, neurosurgery, vascular surgery, esophagus treatment and surgery, gastrointestinal surgery, breast related treatment surgery, hernia surgery, appendicitis, surgery, treatment of fracture/dislocation, general surgery] or such other ailments as in the opinion of the Board be considered as major ailmonts].

B) “Eligibility” Every registered construction worker, who hs major ailments specified in sub-rule(1) is eligible for medical expenses.

C) Claim.

  1. Every registered construction worker who is eligible for assistance of medical expenses under sub-rule (1) shall apply to the Board in Form XXII:
  2. [Provided that a construction worker, who is eligible for assistance of medical expenses under sub-rule (1) shall produce to the Board a certificate in Form XXII –A by an Assistant Surgeon of a Government Hospital or the concerned Surgeon or Doctor who has treated the registered construction worker or Head of the Private Hospital specified in the Schedule I of the Karnataka Government Servants’ (Medical Attendance) Rules, 1963 or the RSBY recognized hospitals.]
  3. The Board shall examine every application for medical expenses in accordance with the provisions of this rule and may accept or reject the claim. The decision of the Board shall be final:
  4. Provided that the Board shall, before rejecting a claim for medical expenses, give the applicant a reasonable opportunity of the making the representation.

D) Amount of assistance medical expenses: The Board shall grant an amount upto Rs. 2,00,000/- (Rupees two lakhs only) subjects to the rates of every application or an estimate of treatment / operation provided the applicant fulfills all the conditions. This doesn’t bar the applicant from claiming medical expenses under any other statute.

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