tag:blogger.com,1999:blog-887417032418581687.post5501851688345327075..comments2024-03-09T23:16:40.848+05:30Comments on Bank Pensioner: Clarifications on Domicilary Cover by United India Insurance CompanyChandrashkhar Belsarehttp://www.blogger.com/profile/09395877357361329261noreply@blogger.comBlogger5125tag:blogger.com,1999:blog-887417032418581687.post-51786403363780314732016-10-23T10:19:06.927+05:302016-10-23T10:19:06.927+05:30I have given the clarification in 3 parts since it...I have given the clarification in 3 parts since it is somewhat big and blog do not allow such big comments. Kindly pardon me.Anonymoushttps://www.blogger.com/profile/07496135351670059900noreply@blogger.comtag:blogger.com,1999:blog-887417032418581687.post-24008295266375191192016-10-23T10:18:06.587+05:302016-10-23T10:18:06.587+05:304
Whether the retired employees would be sanctione...4<br />Whether the retired employees would be sanctioned reimbursement for domiciliary treatment as per the list of 59 diseases circulated by the Bank, such as Diabetes, hypertension etc., on self certification or based on prescription of the general / family doctor or is it compulsory to obtain prescription from the hospital?<br />To Claim Domiciliary will need Doctor Consultation, prescription, Medicine bills/Investigation reports all in original.<br /><br />5<br />How often must the retiree get fresh certification from the doctor/hospital?<br />Valid upto 90 days i.e. 3 months and if the prescription says LIFE LONG TREATMENT the same will be valid for 180 days.<br /><br />6<br />Are those who retired from the Bank in the last year, entitled to Opt under this new Scheme?<br />Only who were covered in last year policy.<br /><br />7<br />An important advantage of the Scheme is the Cashless facility available for treatment in hospitals. But many hospitals are not covered by tie-up and hence employees are asked to pay for the treatment and then seek reimbursement. How can retires avoid such difficulties to avail cashless treatment facility?<br />We would request those retirees to check on the portal www.paramounttpa.com/iba <br />the Network list before getting hospitalized.<br /><br />8<br />The Settlement and the Scheme clearly provide that retirees would submit the Bills to the Banks and in turn the Banks to submit the Bills to the TPA to get the reimbursement. But in many some of the managements are asking the employees to submit the Bills directly to the TPA.<br />Should be submitted at your branch office from where you collect your pension.<br /><br />9<br />There are instances of death occurring during treatment in hospital and if it happens to be Sunday or holiday, the hospital/TPA does not come to the rescue and the family is facing problems in getting the body of the patient in time.<br />We are processing the Cashless on week days and on national holidays also so there is no question that TPA doesn’t help during crisis; only issue is there when the Sum Insured is exhausted.<br /><br />10<br />Treatments like Dialysis, etc. are disallowed by the TPA though covered by the Scheme and the employees are forced to pay the cost to the hospital. How can the scheme be implemented by the TPAs so that employees are not put into such hardship.<br />Day care list is already shared to all by Union Bank of India - Day Care List, and we have settled lot of Dialysis cases so where is the question of disallowing the same.<br /><br />11<br />In the case of Bills submitted to the Banks for domiciliary treatment, there are many complaints of undue delay by the TPAs and managements are not taking steps to liaise with them to expedite the claims. Special attention is required in this regard.<br />Last year there was no Domiciliary treatment so where the question of delay and delay is only happens when the documents are not proper or there is a deficiency. So we would request all to submit proper documents and in the given time frame.<br />÷÷÷÷÷÷÷÷÷÷÷÷÷÷÷÷÷÷÷÷÷÷÷÷÷÷÷÷÷÷÷÷÷÷÷÷÷Anonymoushttps://www.blogger.com/profile/07496135351670059900noreply@blogger.comtag:blogger.com,1999:blog-887417032418581687.post-16958334720288704892016-10-23T10:17:47.076+05:302016-10-23T10:17:47.076+05:30Reply of T.P.A.
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Why is the procedure for reimbu...Reply of T.P.A.<br /><br />1<br />Why is the procedure for reimbursement of domiciliary treatment not clearly outlined? It is being confused with the domiciliary conditional clause of individuals unable to be hospitalized or lack of space in hospitals?<br />It is a Domiciliary Treatment and not a Domiciliary Hospitalization.<br /><br /><br />2<br />Whether the rules and procedure followed/adopted in respect of in-service employees for sanction of reimbursement of domiciliary treatment is the same for retirees?<br />YES<br /><br />3<br />How frequently can the retired employee be permitted to claim the reimbursement for domiciliary treatment i.e. weekly, monthly, or quarterly?<br />Monthly<br />Anonymoushttps://www.blogger.com/profile/07496135351670059900noreply@blogger.comtag:blogger.com,1999:blog-887417032418581687.post-26955916020878640432016-10-23T10:17:11.846+05:302016-10-23T10:17:11.846+05:30Further, We have received clarifications by way of...Further, We have received clarifications by way of answers for the queries raised by AIURBF.<br /><br />Group Insurance Medical Policy: Reply of T.P.A.Paramount Inc.<br /><br />DOMICILIARY TREATMENT – CLARIFICATIONS<br /><br />We have in our earlier communication informed the members that the Federation has requested The Paramount Health Services Pvt. Ltd, the Third Party Administrator (TPA) of UIIC to clarify the rules and procedure for reimbursement of domiciliary treatment expenses to remove uncertainty.<br />We have received the reply from TPA which is appended here below for the information.<br />No.<br />AIUBRF’s query<br /><br />Anonymoushttps://www.blogger.com/profile/07496135351670059900noreply@blogger.comtag:blogger.com,1999:blog-887417032418581687.post-79994961886932709712016-10-19T05:57:48.235+05:302016-10-19T05:57:48.235+05:30Very good. There have been so many blogs/views on...Very good. There have been so many blogs/views on the<br />renewal of Mediclaim Policy by UIIC, and enough is enough because by now all the retirees, who need to be covered<br />under the Policy, must have got their accounts debited<br />by now with the renewed premium amount. It is time to<br />move on with all the remaining issues, particularly<br />those pertaining to the follow-up the Kolkatta High<br />Court judgement on the DA treatment to all the retirees<br />(including those retired prior to the year 2002),<br />maintaining that there should be no discrimination but<br />total uniformity and the pension to all the left-over<br />classes who are yet to any paisa as pension. Thanks for the understanding by all the Retirees' bodies who can<br />concentrate on more productive issues.S. Balasubramanianhttps://www.blogger.com/profile/10551821003625569033noreply@blogger.com