WBHS Death Claim: No More Delays! WBHS Introduces DCARC for Death Claims – What You Need to Know

WBHS Death Claim: The Government of West Bengal has introduced a significant reform to the process of settling medical bills under the West Bengal Health Scheme (WBHS) following the death of an enrolled government employee or pensioner during in-patient (IPD) treatment. A notification dated June 30, 2025, outlines a new, streamlined procedure designed to eliminate previous delays and simplify the settlement process for grieving families.

The Problems with the Old System

Previously, when a WBHS beneficiary passed away during IPD treatment at an empanelled Health Care Organisation (HCO), the settlement process was often lengthy and complex. The government identified several key factors causing these delays:

• Manual Processing: Files were manually transferred from the Medical Cell to administrative departments, and internal processing was often time-consuming.
• Billing Complications: Administrative departments frequently faced difficulties in obtaining separate sets of bills when payments had to be made to both the hospital and the legal heirs of the deceased.
• Lack of Information: Departments often did not have ready access to the bank account details of empanelled HCOs, which contributed to further processing delays.

The New, Streamlined Procedure

To address these issues, the government has revised the entire process to ensure faster and more efficient settlement of death claims. The new procedure is as follows:

1. Direct Payment to Hospitals

Under the new rules, the empanelled hospital will forward the outstanding treatment bills directly to the Finance Department’s Medical Cell. The Medical Cell will then process these bills according to existing WBHS guidelines and—most importantly—make the payment directly to the hospital through a cashless payment mechanism. This eliminates the need for the claim file to be sent to the administrative department for the hospital’s portion of the payment.

2. Simplified Reimbursement for Families

To simplify the reimbursement process for the legal heirs of the deceased, a new certificate has been introduced.

• The DCARC Certificate: The Medical Cell will now issue a “Death Case Admissibility-cum-Reimbursement Certificate” (DCARC).
• Clearance for Payment: This certificate will formally confirm the admissibility of the claim and will be sent to the deceased’s respective Administrative Department, Head of Office (HoO), or Pension Sanctioning Authority (PSA).
• Faster Reimbursement: Based on the reference documents provided by the Medical Cell, including the DCARC, the administrative department can then process the payment due to the legal heir(s) in accordance with existing rules.

This new order supersedes all previous orders on this matter and takes immediate effect. The change is expected to bring significant relief to families by making the claim process faster, more transparent, and less cumbersome during a difficult time.