Exclusion of claim on Domiciliary treatment of retirees under new Mediclaim scheme

General Secretary ,All India Bank Retirees Federation has, taken up the matter with Chairman ,IBA,on exclusion of claim on Domiciliary treatment by retirees, under new Medi Claim Insurance Scheme vide letter dated 16.11.2015.
Copy of the above letter is furnished here under for information Quote  
 To
The Chairman Indian Bank Association ( IBA )
Mumbai
 
Dear Sir,
Re: IBA approved medical scheme for bank retirees
Re: Reimbursement of Domiciliary Expenses
 
 We are getting very disturbing and shocking information from TPA as well as from some individual banks who are responsible for implementation of the IBA approved medical scheme for the retirees under 10th wage settlement that facility of reimbursement of domiciliary expenses will not be available to the bank retirees and their spouses under group insurance policy.

2. On careful scrutiny of various clauses of the scheme which is a part of the bipartite settlement as applicable to the retirees, it is no where directly or indirectly mentioned in the scheme that facility of reimbursement of domiciliary expenses for eligible ailments will not be available to the retirees and their spouses. In fact the bank retirees were induced and encouraged to opt for this group medi claim policy based on this attractive feature.

3. Now when bank retirees in large number have already exercised option to buy this policy , their accounts have been debited for payment of premiums and policy has come in to force from 1.11.2015 , to advise them at this stage by TPA / bank managements that domiciliary facility will not be available to retirees is nothing but gross and blatant violation of the clause of the scheme , suppression of the vital clause of the policy and non discloser of vital information from the customer.

4. We request IBA to immediately clarify the position and prevail upon Insurance Company, Insurance Broking firm, TPA and bank managements to strictly follow terms and condition of the scheme as sanctioned under the settlement and withdraw their communications issued by them in this regard in recent past to avoid any litigation in this regard.


With Regards,
Yours Sincerely
Sd/-
(S.C.JAIN)
GENERAL SECRETARY "

Unquote 
Source: AIBRF Website

 

IBA Clarification on Mediclaim Scheme to retirees

IBA has clarified on points raised by some of the member banks, on Medi Claim Insurance Scheme vide their HR & INDUSTRIAL RELATIONS No. CIR/HR&IR/2015-16/XBPS/J/1593 dated,October 31, 2015,communicated to Chief Executives of Member Banks which are parties to the Bipartite Discussions,which read as follows:

Dear Sir/Madam, 
                                                 Implementation of Medical Insurance Scheme to Retirees as agreed Vide Bipartite Settlement/Joint Note dated 25.5.2015 
We refer to our Circular No.CIR/HR&IR/2015-16/XBPS/J/1413 dated 1.10.2015 advising member banks to obtain consent of retirees expeditiously and provide details to United India Insurance Company Ltd., (UIICL) and to make Group Medical Insurance Policy operational, preferably w.e.f. 1.11.2015. We are informed that as on date, 13 banks have sent details of retirees and have either paid the premium or are in the process of remitting the premium and joined the Scheme w.e.f. 1.11.2015. 
                                              We have been receiving queries from banks, as to whether surviving spouse of the deceased employee (widow/widower) are eligible to join the Scheme. We are to state that since insurance premium is to be paid by the retirees/surviving spouses of the deceased employees and UIICL has agreed to include spouse of the deceased employee, Banks may include the spouse of deceased retired employee under the Group Medical Insurance Scheme. Further, Bank will not incur any additional cost by doing so as Insurance Premium would be borne by the retiree/spouse. 
IBA received letters from few Banks to request the UIICL to start the Group Medical Insurance Policy for retirees from 1.12.15 (instead of 1.11.2015) and permit them to pay pro rata premium, as banks have not completed the process of collecting details/premiums from the retirees. On reference to Insurance Companies, we are advised as under: 
“In all our workshops we have been mentioning that there would be no pro rata premium for the retirees.This is so, because in case of the retirees the coverage and the premium is very competitive and is not available anywhere else. They also being covered under the policy without any medical examination and coverage for preexisting ailments is also available to them. They may join at a later date on pro rata and could delay hospitalisation which may have been needed in November to December or January. In this manner, though they may pay a reduced pro rata premium, the claims would be 100% and this would upset the actuarial balance of the policy.” 
                                             In view of the foregoing, for retirees, the Policy will commence uniformly w.e.f. 1.11.2015 and they have to pay full year premium. Banks which are yet to submit details of retired employees/remittance of premium, are requested to do so at the earliest, so as to cover the retirees from the date of payment of premium, lest they will be deprived of the benefit of coverage from 1.11.2015 till the date of payment of premium. 
Yours faithfully,

 (Sd.) 

K UNNIKRISHNAN 

DEPUTY CHIEF EXECUTIVE

Source: Bankpensioner google group