Saturday, November 7, 2015

Clarification on Med.Ins. Policy for Retired!


No. CIR/HR&IR/2015-16/XBPS/J/1593
October 31, 2015

Chief Executives of Member Banks which are parties to the Bipartite Discussions

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 pre-existing 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,

1 comment:

Unknown said...

The cashless medical insurance scheme has been implemented in some banks such as PNB from 01.11.2015. But the banks are still in the peocess of issuing and in my view it may take one more month to complete this formality. The banks have not issued any details as to what should be done if somebody has to face hospitalisation during this period. Banks should issue detailed instructions in this regard. Already six months have passed but we have not reached anywhere till date.