Group Medi-claim Insurance for Bank Employees

Group Medi-claim Insurance for Bank Employees

CIRCULAR LETTER NO. 28/24/2017/25

13-7-2017

TO ALL OFFICE BEARERS/STATE FEDERATIONS/ALL INDIA BANKWISE ORGANISATIONS / ALL UNITS

Dear Comrades,

Reg: Group Medi-claim Insurance Policy

Under 10th Bipartite Settlement, medical/hospitalisation expenses are reimbursed/settled under the Group Medi-claim Insurance Policy. The policy for the in-service employees/officers began from 1-10-2015 and for retirees from 1-11-2015. The policies have been renewed from 1-10-16 and 1-11-16 respectively.

We wish to share the following details for the information of our unions.

Banks covered under the Policy            :    33 (for 2016-17)

Employees covered                                  :    326,600

Officers covered                                        :    295,400

Total staff covered                                    :    622,000

Total lives/family members covered    :    19.25 lacs

Total Premium paid                                 :    Rs. 762 cr + Tax

Claims settled so far/under process

As of end of June, 2017                           :    Rs. 515 cr

(Last year i.e. 2015-16 : 39 Banks – 7.10 lac employees/officers covered – Premium paid Rs. 390 crores – Claims settled Rs. 775 crores)

RETIREES (2016-17) From Nov. 2016 upto June, 2017

  WITH DOMICILIARY WITHOUT DOMICILIARY TOTAL
RETIRED EMPLOYEES/OFFICERS COVERED 89,300 1,00,400 1,89,700
TOTAL LIVES COVERED 1,74,600 1,92,400 3,67,400
PREMIUM PAID 148 CR 129 CR 277 CR
CLAIMS PAID/UNDER PROCESS UPTO END OF JUNE 2017 195 CR 109 CR 304 CR

2016 -17 – IN SERVICE EMPLOYEES/OFFICERS – UPTO END OF JUNE, 2017

CLAIMS PAID UNDER PROCESS TOTAL
BY CASHLESS 210 CR 70 CR 280 CR
BY REIMBURSEMENT 112 CR 51 CR 163 CR
UNDER DOMICILIARY 61 CR 11 CR 72 CR
TOTAL 383 CR 132 CR 515 CR

2016-17 – RETIREES – UPTO END OF JUNE, 2017 (WITH DOMICILIARY)

CLAIMS PAID UNDER PROCESS TOTAL
BY CASHLESS 76 CR 23 CR 99 CR
BY REIMBURSEMENT 29 CR 11 CR 40 CR
UNDER DOMICILIARY 47 CR 9 CR 56 CR
TOTAL 152 CR 43 CR 195 CR

2016-17 – RETIREES – UPTO END OF JUNE, 2017 (WITHOUT DOMICILIARY)

CLAIMS PAID UNDER PROCESS TOTAL
BY CASHLESS 61 CR 20 CR 81 CR
BY REIMBURSEMENT 20 CR 8 CR 28 CR
TOTAL 81 CR 28 CR 109 CR

Thus, we find that the scheme is benefiting large number of employees. However, there are many grievances and complaints about the undue delay in settlement of claims, problems in cashless treatment in hospitals, problems being created by TPAs, unilateral rejection of claims, delay at Bank-level in forwarding the claims to TPA, etc. In order to take up these issues with the IBA for plugging the loop-holes in the scheme and to ensure effective implementation of the scheme in favour of the employees, we request our units to inform us the important problems faced by the employees at the grass-root level for being taken up with IBA.

Since this is one of the important issues in the current 11th Bipartite charter of demands, we seek the co-operation of our units to furnish the above details at the earliest.

With greetings,

Yours comradely,

C.H.VENKATACHALAN

GENERAL SECRETARY

Source: AIBEA.in

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