Karnataka BOCW Medical Assistance Scheme (Karmika Arogya Bhagya)

What is Karmika Arogya Bhagya, the Karnataka BOCW medical assistance scheme?

Karnataka BOCW Medical Assistance Scheme, known as Karmika Arogya Bhagya, is a hospitalisation benefit run by the Karnataka Building and Other Construction Workers Welfare Board under the Karnataka Labour Department. The Board is financed by the 1% cess on construction cost collected under the Building and Other Construction Workers Welfare Cess Act, 1996, and spends it only on workers registered with it.

According to the Board's schemes page, medical assistance is granted under Rule 46 of the Karnataka Building and Other Construction Workers Rules. The benefit is Rs 300 per day of hospitalisation, subject to a maximum of Rs 20,000, payable where the registered worker or a dependent has been hospitalised for a minimum of 48 continuous hours. The claim is filed on the prescribed Form XXII-A within 6 months of the date hospitalisation began.

The design of the benefit matters. Karmika Arogya Bhagya is not a treatment package or an insurance cover that pays the hospital directly. It is a day-rate payment made to the worker after discharge, meant to offset the wages lost during an inpatient stay and the incidental costs a family bears, travel, attendant expenses, medicines bought outside. Because it is a flat day rate, the amount does not vary with the size of the hospital bill; a 10-day stay yields Rs 3,000 and a stay of 67 days or more reaches the Rs 20,000 ceiling.

A separate, larger benefit for serious illness. The Board also runs Karmika Chikitsa Bhagya under Rule 48, major-ailments assistance of up to Rs 2,00,000 for specified serious conditions. Workers facing a major illness should look at Rule 48 rather than assume Rs 20,000 is the limit of the Board's medical support. In addition, accident benefits under Rule 47 pay Rs 8 lakh on death, Rs 2 lakh for permanent total disablement and up to Rs 1 lakh for partial disablement where the accident occurs during employment.

Key features of Rule 46 medical assistance

• Rs 300 per day of hospitalisation.
• Rs 20,000 maximum per claim.
• Minimum 48 continuous hours of hospitalisation.
• Covers the registered worker and dependents.
• Filed on Form XXII-A within 6 months of admission.
• Paid by direct bank transfer after the Labour Officer's sanction.

Who is eligible for Karnataka BOCW medical assistance?

You can claim if:

• You are a registered beneficiary of the Karnataka BOCW Welfare Board with a live, renewed membership.
• You have worked as a construction worker for at least 90 days in the preceding year.
• You or a dependent, spouse, child or dependent parent — were hospitalised.
• The hospitalisation ran for 48 continuous hours or more.
• Treatment was taken at a government hospital, a private hospital listed under the Karnataka Government Servant's Medical Attendance Rules, 1963, or a hospital empanelled under a state-recognised insurance scheme.
• The claim is filed within 6 months of the date hospitalisation began.

You are not eligible if:

• You are not registered with the Karnataka BOCW Welfare Board, or your card has lapsed for want of renewal. There is no route into the scheme for an unregistered construction worker.
• The treatment was outpatient, day-care, or an inpatient stay shorter than 48 continuous hours.
• The hospital is not a government hospital and not on the recognised or empanelled lists, in which case the bills will not be accepted.
• You are filing more than 6 months after admission.
• The person treated is not a dependent of the registered worker.
• You work outside the building and construction trades. Agricultural, factory and domestic workers fall under other Karnataka welfare boards.

What documents are required for a medical assistance claim?

Ask the hospital to record the exact admission and discharge date and time on the discharge summary. The 48-hour condition is checked against those entries, so a summary that gives only dates and no times can hold up a short-stay claim.

How to apply for Karnataka BOCW medical assistance

1. Collect the discharge summary and the final itemised bill before leaving the hospital, making sure the admission and discharge dates and times are printed on them.
2. Check that your Board registration is live and clear any pending renewal at the Karmika Seva Kendra, because verification stops at a lapsed card.
3. Fill in Form XXII-A, the prescribed medical assistance claim form, with the patient's details, the hospital, the dates of stay and the number of days claimed.
4. Open karbwwb.karnataka.gov.in and go to the Schemes section, or log in to the Board's KB&OCWWB software with your registration number. Labour Department services also run through Seva Sindhu.
5. Select Medical Assistance (Rule 46) and upload Form XXII-A, the identity card, the employment certificate, the hospital bills, the discharge summary, the bank passbook and, where relevant, proof of dependency.
6. Submit the claim within 6 months of admission and save the acknowledgement number displayed on the screen.
7. Attend verification by the Senior Labour Inspector or Labour Inspector, who checks the hospital record and the days claimed.
8. Wait for the Labour Officer's sanction, after which the amount at Rs 300 per day, capped at Rs 20,000, is credited to your bank account.

How to apply offline at a Karmika Seva Kendra

1. Visit the Karmika Seva Kendra, taluk labour office or district labour office with the originals and one photocopy set.
2. Ask for Form XXII-A and complete it, or have the operator complete it for you from the discharge summary.
3. Submit the form with attested copies and collect a dated acknowledgement.
4. Follow up with the Labour Inspector for your circle if the file does not move within a month.

The Board's head office is Karmika Bhavan, Dairy Circle, Bengaluru 560029.

How do you check the status of a medical assistance claim?

Log in to the Board's software with your registration number and open the claim using the acknowledgement number. The screen shows whether the file is with the inspector, pending with the Labour Officer, sanctioned or rejected. Labour Department services also generate a Sakala acknowledgement number that can be tracked separately. If the record has not changed for several weeks, call 155214 quoting the acknowledgement number, or visit the district labour office holding the file.

Where the status reads sanctioned but the money has not arrived, the cause is usually the bank account: closed, dormant, in a different name, or not Aadhaar-seeded. Correct the account at the Karmika Seva Kendra rather than filing a fresh claim, which would be treated as a duplicate.

Why are medical assistance claims rejected?

• Stay shorter than 48 continuous hours, or a discharge summary that does not prove the duration.
• Registration lapsed or renewal unpaid on the date of the claim.
• Hospital not recognised, treatment at a facility outside the government, Medical Attendance Rules and empanelled lists.
• Claim filed after 6 months from the date of admission.
• Form XXII-A missing or incomplete.
• Bills without dates of admission and discharge, or without a breakdown of treatment.
• Employment certificate missing, so the 90-day condition fails.
• Dependency not proved where the patient is a family member.
• Duplicate claim for the same hospitalisation.

Before submitting, count the days between admission and discharge yourself and check that the figure on Form XXII-A matches the discharge summary. A mismatch is the most common reason a claim is reduced rather than rejected outright.

Where do you complain if the claim is stuck?

• Board helpline: 155214 for scheme and claim queries.
• District Labour Officer, the sanctioning authority for these claims.
• Deputy Labour Commissioner of the division, for an appeal against a rejection or a delay beyond the Sakala timeline.
• Karnataka BOCW Welfare Board head office, Karmika Bhavan, Dairy Circle, Bengaluru 560029, for written grievances.

Registration and every claim are free. No official, contractor or agent may charge a construction worker a fee to register with the Board or to file a medical assistance claim, and no one from the Board will ask for an OTP.