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/hospitalization 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 up to 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 REIMBUSEMENT | 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 REIMBUSEMENT | 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 REIMBUSEMENT | 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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