Group Mediclaim Insurance Policy for Bank Employees

Group Mediclaim Insurance Policy 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 Medicliam Insurance Policy

Under 10th Bipartite Settlement, medical/hospitalisation expenses are reimbursed/settled under the Group Mediclaim 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)

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

 
WITH DOMICILIARTY
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 benefitting large number of employees. However, there are many grievances and complaints about the undue delay in settlement of claims, prblems 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

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