NIS must deal with exceptional cases that fall outside defined rules -Luncheon

Dr Roger Luncheon

The National Insurance Scheme (NIS) will have to find a way to deal with genuine cases that fall outside its legal framework where persons are unable to receive benefits because of the rigorous procedures the NIS must follow.

Chairman of the NIS board Dr Roger Luncheon admitted that there were several genuine cases of persons being denied benefits because of the scheme’s legal framework.

Dr Roger Luncheon
Dr Roger Luncheon

“To my mind NIS has to find a way to deal with exceptional cases… There must be a mechanism in place…,” Dr Luncheon, who is also head of the Presidential Secretariat, said on Thursday at a public meeting.

The meeting was held at the Paradise Primary School, East Coast Demerara and according to Luncheon such gatherings are being held in different parts of the country to provide an opportunity for the leadership of the scheme to interact with the general public. Acting General Manager, Doreen Nelson, and other senior staff members of the NIS were present at the meeting.
However, while no more than ten members of the public attended the meeting, those who did show up took the opportunity to raise a number of issues on behalf of themselves and others. In each case the persons faced severe difficulties receiving certain NIS benefits.

Over the years the NIS has come under severe criticism from members of the public. But according to Public Relations Officer Dianne Baxter-Lewis, often the utterances made are out of ignorance as people are not informed about the way the scheme operates.

The scheme has also been in the news because of the fraud that was discovered in its pension department last year and which resulted in several persons being sent home.
More recently, the NIS came under scrutiny when it was revealed that it had a huge investment in the now failed insurance company CLICO (Guyana).

Only one member of the public queried this issue, asking if the insurance company was unable to recoup the money it had invested and NIS in turn lost its investment, whether pensioners would also have to suffer losses. Luncheon sought to reassure the elderly woman, repeating President Bharrat Jagdeo’s promise that even if the NIS suffered losses from its CLICO investment pensioners would not be made to suffer. He also mentioned a recent motion on the issue that was passed in Parliament.

Asked if she was satisfied with the answer, the woman said she was quite aware of all Luncheon said but being a retired public servant for many years she had learned to take the words of President Jagdeo with “a pinch of salt”.

‘Little old lady’
Luncheon said he had personal knowledge of the exceptional cases he spoke about given the many letters written to him by disgruntled persons.
He shared the story of a “little old lady” who wrote him a letter informing that she was the common-law wife of a man for some 40 years and during that period the union produced four children. Upon his death the man in his will left everything for the woman stating that she should receive all benefits owed to him. The man was a pensioner and the woman approached the NIS in an effort to benefit from his pension. Unfortunately, the man had been married before he met her and he never divorced his wife so according to the NIS legal framework the man’s pension had to go to his legal wife.

He said that to date the woman had not been able to access the pension benefit and he saw her case as one that is genuine and which should be dealt with outside the legal framework. He said the time had come for the NIS to think outside the box.

However, he cautioned that even if the mechanism is introduced to deal with the exceptional cases someone would need to explain to the affected that their problems are not normal and that they would take some time to be solved. The persons must, however, be continually updated on the progress.

A woman at the meeting told of her plight where the doctor prescribed two pairs of spectacles for her but when she approached the NIS she was told that the scheme could only purchase one and she would have to foot the bill for the other one.

Nelson explained to the woman that the procedures of the scheme only allow for one pair of spectacles at a time per person. She said the woman’s problem was unique and not one they are faced with every day and suggested it was something they needed to look at to ascertain how many other such cases existed and then make representation to the board on their behalf.

The woman also raised the issue of someone she knows who is unable to receive a pension because of one contribution. Nelson pointed out that the NIS rules state that a person must make 750 contributions to benefit from the pension scheme and as such if someone is short of one or two contributions, according to the scheme’s rules, that person cannot receive a pension.

But she pointed out that the NIS attempts to help those persons including searching the records as sometimes contributions are inaccurately entered making it difficult for it to be established that they were made on behalf of the affected person. Sometimes employers would pay contributions for persons under names that are not on their birth certificates.

Other persons raised personal issues and were asked to give their names and telephone numbers for the NIS employees to investigate their cases and then call and report back to them.

‘Long history’
According to Luncheon most of the issues raised have a long history and one of his greatest regrets is that he may leave the board without them solving those problems. Luncheon has been chairman for 17 years.

He said he is “still disturbed” that after so many years the NIS still cannot say to people that they would not wait for long periods to receive benefits.
A woman raised the issue of a 94-year-old man who receives medication for his eyes as he is suffering from glaucoma. The new system introduced by the NIS, where each time a person needs assistance to purchase medications, even if it is for the same ailment, they must have a new prescription filled out by a doctor makes it difficult for him. The woman pointed out that not only is the man’s mobility an issue, but he also found it difficult to pay the doctor’s consultation fee every time he needed a prescription.

Luncheon said he was aware that the new system is creating problems as he was even told of it by a doctor he had to visit. He said the new system was introduced by management, but he has since asked management how the matter was dealt with before and it is an issue up for discussion at the next board meeting. He said he did not want to discuss the issue any further as he did not want to prejudice the upcoming board discussion.

However, he did note that nowhere in the world was a prescription recognised from a doctor who could not be found. He also said that if after some time the person no longer needed the medication, the person would not know this unless s/he was seen and examined by a doctor.

Constraints
When the question and answer session opened the first question was asked by Luncheon himself who said he was asking it on behalf of a resident of the East Coast.
He asked the manager of the Melanie Damishana office about ways in which the work carried out there could be improved and the manner in which the public receives information. He also asked how the head office contributed to improving the work of the local office.

In his response, the manager said his office worked under constraints but his staff still tried to effectively utilise the inadequate facilities they had to work with.
He said one of the problems they faced was frequent power outages and this affected the processing of claims as it is no longer done manually.

A major problem is the inadequate amount of computers, three of which currently need repairs, as this seriously hampered the work the office does.
The new computerised system introduced by the NIS where each office around the country is given a specific day to process vouchers, is creating its own problems as if there are frequent power outages on a given day or if the computers stopped working, then claims could not be processed until that same day the next week.

The issue about the computer system, which was raised in this newspaper before, where only a certain amount of users are allowed on at a time, also affects the smooth operation of the office. The office manager said that should there be a power outage, staff would be knocked off and then it would be very difficult for them to get back onto the system as another user would have logged on by the time power was restored.