Why Medical Insurance Is Still Better?

ALL INDIA UNION BANK RETIREES’ FEDERATION (Affiliated to All India Bank Retirees’ Federation) A/12, Girdhar Apt., Kastur Park, Shimpoli Road, Borivali (W), Mumbai 400 092       ChairmanPresidentGeneral Secretary D. A. Masdekar                              B. G. Raithatha                             R. K. Powar     9970899393                                   9427207021                               7710030963 damasdekar@gmail.comubiretirees@gmail.comrkpowar@gmail.com

No.105/2016-17                                                                 18th September 2016

Dear Members,

Group Insurance Medical Policy: Perceptions and Suggestions:

In September 2016 Union Bank had sent emailsto retired employees informing them that the premium renewal amount of the Medical Insurance Scheme of Insurance Policy for 2016-2017 was likely to be increased to Rs. 16,026.00 for retired Officers and Rs. 12020/- for retired Award staff.

Many retired employees were shocked at the unjustified and unilateral hike in the premium amount. Our All-India Federation had taken up the matter on 10/10/2016 with the Chairman & Managing Director of our Bank conveying the feelings of the retirees at this steep hike, &requesting Bank to understand the financial difficulty which a retiree is undergoing or likely to undergo because of this unjustified hike in the premium and also the short period within which the amount is required to be paid.

We understand that the Union Bank management is in the process of clarifying the issues taken up by our All-India Federation, more particularly the introduction of reimbursement of domiciliary treatment, under the new option by paying additional premium to the extent of Rs. 40,000/- and Rs. 30,000/- within the overall ceiling/insurance cover of Rs. 4.00 lacs and Rs. 3.00 lacs for officers and award staff respectively.

Many of the retired employees are constantly contacting the leaders of our All-India Federation stating that they are unable to take a decision whetherto continue to subscribe to the insurance policy or not, pending clarifications on the issues raised by Federation. Considering this, we are making the following clarificationsfor the consideration of our members.

1. PRESENT RULES OF MEDICLAIM POLICY OF OTHER INSURANCE COMPANIES:

1. Present individual medi-claim policies, for the person in age group of 51-65 and age group of 66 and above, require individuals to undergo pre-acceptance medical tests such as Medical Examination Report, Treadmill Test, Complete Blood Count, Lipid Profile, HBA1C, Serum Creatinine, Urinalysis, SGOT, SGPT and GGT, before accepting them as policy holders.

2. All pre-existing diseases/illness/injury/conditions as defined in the Insurance Policy would be eligible for reimbursement of hospitalization only after 36/48 months of continuous coverage have elapsed from joining the Policy.
3. The CO PAY policy - ranging from 15% to 25% is required to be contributed by the insurer out of the amount of claim.
4. Certain diseases such as cardiac, kidney and bone related major surgeries the claim is restricted to Rs. 2.00 to Rs. 2.50 lacs irrespective of higher coverage.
5. The premium amount of private insurance companies for an insurance cover of Rs. 3.00 lacs ranges from Rs. 26,593.00 to Rs. 36,802/-p.a.
6. Other Nationalized Assurance companies such as National Insurance Co Ltd., New India Assurance Co. Ltd., Oriental Insurance Co. Ltd. and SBI General Insurance Co. Ltd., will not be allowed to quote the premium for Group Insurance scheme because these companies are the co-insurers of the UIIC under Group Insurance Scheme for retired employees of banks to extent of 2.5% to 15% coverage.

2. WHAT SHOULD BE THE APPROACH OF THE RETIRED EMPLOYEES TO THE EXISTING INSURANCE POLICY:

1. In view of the above mentioned negative features of individual medi-claim policies, Banks should not opt out of the IBA Scheme, which could be calamitous for retirees.
2. Non continuity will spell disaster, as re-entry into medi-claim policies of any other insurance company will be difficult for retirees at such advanced age and may also become ineffective as pre-existing diseases will not be covered.
3. Subscribing to alternative insurance policy of other insurance company is not practical as criteria of loading premium will be the same in all cases, depending upon claim ratio, vis-à-vis premium paid.
4. The coverage under the existing group insurance policy is beneficial because of 100% coverage without any sub-limit riders as in other policies, and beneficial despite the higher cost of premium.
5. NO CO-PAY stipulation in the existing group insurance policy.
6. All pre-existing illness/diseases are allowed for reimbursement of hospitalization.
7. Coverage from the date of policy without waiting period i.e. cooling period.
8. No medical tests/examination was conducted as in case of individual medi-claim policy.

3. STEPS INITIATED BY AIUBRF:

1. A delegation of the AIUBRF met the GM & other Personnel Officials in the HO&conveyed members’ apprehensions, &proposed some suggestions to the authorities.
2. AIUBRF has written a letter dated 10/10/2016 to CMD of the Bank placing on record the feelings of the members, and making suggestions for financial assistance for the retiree such as:

1. The bank has decided to recover the premium amount from 24/10/2016. Many of the retirees may not have maintained sufficient balance to meet the increased amount of premium on 24/10/2016; hence Federation requested the Bank to release the pension earlier coinciding the recovery of premium amount, so that most of the retirees can continue to get cover of the Insurance Policy.
2. The AIUBRF leadership is now informed that the Bank is agreeable to credit pension on 25/10/2016, & will continue to debit pension a/cs thereafter till the last date possible for retirees to be covered under the Ins Scheme.
3. The Bank has also agreed to extend the date to accept Options upto 24th October, 5 p.m. received at CO by email or passed on by branches or handed over by our retirees themselves or through leaders.
4. The Bank has agreed to seek clarifications of the points raised by AIUBRF from UIIC on the rules and procedure for reimbursement of domiciliary treatment for retired employees, and to communicate the same to the Federation.
5. AIUBRF has requested the Bank to consider subsidizing the premium amount from UBIREMAS for retirees, as has been done by several Banks.
6. AIUBRF has also asked the Bank to increase the diagnostic charges in REMAS, to meet the increased cost of the same by hospitals/Clinics.
7. AIUBRF has requested the Bank for specific exemption in the case of family pensioners, since only single life is covered.

3. Federation has also written a letter to TPA to clarify the procedure adopted by them for scrutiny and sanction of domiciliary treatment. Other clarifications on the increase of premium such as notice period, quantum of increase etc. have also been raised.

Replies & Information adduced from these letters will be circulated to all members as soon as they are given to us.

WHAT SHOULD BE THE DECISION OF THE RETIRED EMPLOYEE?

The retired employees should introspect on all the above aspects dispassionately and should take informed decisions to ensure medical cover for self and spouse for any unforeseen medical exigencies.

Any information on further improvements or mitigation of financial difficulties by the Bank will be conveyed to all immediately,

With Greetings,

Yours faithfully

 (R. K. Powar)

General Secretary