Clarifications on Domicilary Cover by United India Insurance Company

The United India Insurance Company has clarified that "The Domiciliary Cover of Rs.40000 or Rs.30000 reimbursement is within overall sum insured. The retiree / claimant has to use the same within the overall sum insured he is entitled for. With Domiciliary Expenses and Hospitalisation claim the sum insured should not exceed Rs.40000 and Rs. 30000 respectively."

The insurance company has sent the list of 59 ailments covered under domiciliary treatment, which is given below. 

 Domiciliary Hospitalization / Domiciliary Treatment
Sr.
No.  Treatments
1  Cancer
2  Leukemia
3  Thalassemia
4  Tuberculosis
5  Paralysis
6  Cardiac Ailments
7  Pleurisy
8  Leprosy
9  Kidney Ailment
10 All Seizure disorders
11  Parkinson’s diseases
12  Psychiatric disorder including schizophrenia and psychotherapy
13  Diabetes and its complications
14  Hypertension
15  Hepatitis –B
16  Hepatitis - C
17  Hemophilia
18  Myasthenia gravis
19  Wilson’s disease
20  Ulcerative Colitis
21  Epidermolysis bullosa
22  Venous Thrombosis(not caused by smoking) Aplastic Anaemia
23  Psoriasis
24  Third Degree burns
25  Arthritis
26  Hypothyroidism
27  Hyperthyroidism expenses incurred on radiotherapy and chemotherapy in the treatment of cancer and leukemia
28  Glaucoma
29  Tumor
30  Diptheria
31  Malaria
32  Non-Alcoholic Cirrhosis of Liver
33  Purpura
34  Typhoid
35  Accidents of Serious Nature
36  Cerebral Palsy
37  Polio
38  All Strokes Leading to Paralysis
39  Haemorrhages caused by accidents
40  All animal/reptile/insect bite or sting
41  Chronic pancreatitis
42  Immuno suppressants
43  Multiple sclerosis / motorneuron disease
44  Status asthamaticus
45  Sequalea of meningitis
46  Osteoporosis
47  Muscular dystrophies
48  Sleep apnea syndrome(not related to obesity)
49  Any organ related (chronic) condition
50  Sickle cell disease
51  Systemic lupus erythematous (SLE)
52  Any connective tissue disorder
53  Varicose veins
54  Thrombo embolism venous thrombosis/venous thrombo embolism (VTE)]
55  Growth disorders
56  Graves’ disease
57  Chronic Pulmonary Disease
58  Chronic Bronchitis
59  Physiotherapy and swine flu shall be considered for reimbursement under domiciliary treatment.

Source: Circular by Bank of India

Clarification on procedure to be followed for lodging claims under domiciliary as given by United India Insurance Co Ltd

We reproduce below the circular issued by AIBRF on the above subject.

Issue	Our query	UIIC clarification
Modalities of domiciliary expenses .	What will be the modalities of reimbursing the claim under domiciliary expenses to retirees ?	It can be send to TPA directly or to the nearest Bank office from where it has to be forwarded to zonal office enabling the TPA officer to collect it.
Format for claiming domiciliary  expenses.	Whether you have introduced any prescribed format for claiming domiciliary expenses for retirees ? If yes, please provide us a copy of the same.	Same claim form as being  used for hospitalization. Please advise the retiree to write on the top "For domiciliary treatment".
Nature of expenses admissible.	Please clarify what type/nature of expenses are covered for the treatment of identified 59 ailments.	Same as applicable to employee policy.
Extension of domiciliary treatment to such retirees, who are not the member at present.	Since the  UIICL has introduced option for domiciliary expenses  now, whether such retirees who have not become member of the Scheme so far,  can join the Medical Insurance Scheme now ?	Only present retirees who are covered in the current policy are allowed to join the renewal policy.
Switching over from domiciliary expenses benefit to normal renewal (without domiciliary cover) or vice versa.	Please clarify whether a  retiree who opts for domiciliary expenses benefit (Option II) now, be allowed  to  switch over to normal renewal next  year or Vice-versa	The final decision would be taken at the time of renewal.

 
Source: AIBRF Website

Renewal of Medical Policy for retirees - new premium rates

United India Insurance Company has announced the premium rates for renewal of retirees policy for the year 2016-17 as under with two options.

Source - Andhra Bank Website - Retirees Corner
Click here to view circular by Andhra Bank

 

Health Insurance – For protection of Health but of WHOM – BANK OR UIIC ????

Letter received from Shri R K Pathak , our google group member , on the above subject is reproduced below.

Quote

Health Insurance – For protection of Health but of WHOM – BANK OR UIIC ????

Recently, IBA has issued communication No. [ORDINANCE] No. CIR/HR&IR/J/2015-16/1169 dated    October 1, 2016 to its Member Bank intimating the adamant attitude of UIIC for not extending the policy for 30 days to enable IBA to discuss in its Managing Committee & with Member Banks. IBA further advised to pay renewal premium which is 112% higher and threatened Member Banks in the said communication as “In the absence of renewal of the policy, liability on account of hospitalization claims by employees post 30.09.2016 will have to be honored by banks.” [Ex-A] In the communication of IBA, it is also mentioned that 15 banks have remitted the premium for renewal as demanded by Insurer i.e. UIIC.

The efforts of IBA were supported by the workman Union by advising their units on 1/10/2016 “ Our units in other Banks should immediately pursue the matter with their management to ensure that the policy is not allowed to lapse and employees do not get uncovered by the benefits of the policy.”[Ex-B] In the circular of Workmen Union, it is reported that 18 Banks have paid the premium. i.e. 15 reported by IBA and 3 more, Federal, UCo and Vijaya Bank. This facts itself reveals the role of Union to safe guard the Bank Employees to have continued cover.

The Officer Organization too issued communication to IBA on 1/10/2016 to get” renewal of the Insurance Policy as per the original terms negotiated “and in the absence of which, IBA must decide taking a legal recourse against the Insurance Company or approaching Consumer Forum and also member Banks may immediately be advised to honour the claims of the employees to the debit of their establishment expenses. [Ex-C]