Friday, September 29, 2017

Important Letters On Insurance Scheme

ALL INDIA UNION BANK EMPLOYEES’ ASSOCIATION
GS 1/148/ 17                                                                          27th September 2017.

To,
Managing Director  & CEO,
Union Bank of India,
Central Office,
Mumbai.

Dear Sir,

Sub :Renewal of Policies under Medical Insurance Scheme for Working & retired Employees.

We draw your kind attention to our GS/1/147/17 dated 19th September 2017.

While the Bank is taking all steps to renew the Policy for working employees by seeking Board’s permission for making the payment of premium etc, it is silent to our suggestions that will benefit the Bank.  As usual neither the Bank responded to our suggestions nor negated it with any valid rationale.

In the absence of our representative in the Board, we are not aware as to whether the Bank had placed our suggestions also before the Board as a healthy practice to allow it to know and thereafter take a decision. We learn that Bank has not done the same and allowed the Board to take a decision based on what have been placed from the Management side but without knowing the views of the employees who are the beneficiary under the policy.

Even then we still appeal to your office to review the decision of renewing the policy.

In the mean while, retired employees are also waiting for instructions from the Bank for renewal of their policy and remittance of Insurance premium.

Bank is aware that UIIC has increased the premium and retired employees are seeking some assistance as subsidy. Bank is already extending subsidy to family pensioners drawing family pension of Rs 10000/ Per Month and we hope that Bank will continue the same for this year also.

For the other retirees too Bank can extend subsidy to the possible extent.

Bank in the past has extended loan to retirees to meet the cost of premium and such loan has been recovered in 10 easy installments from their pension.  We request for extension of such loan to retirees this time also so as to enable them in getting covered under the Scheme.

We hope that our suggestions will be taken in right perspective and would find favorable consideration
.  
A line of reply shall be highly appreciated.

Thanking you,
Yours truly,

(N. Shankar)

General Secretary.

ALL INDIA BANK EMPLOYEES' ASSOCIATION
CIRCULAR LETTER No. 28/38/2017/38                           27-9-2017
TO ALL OFFICE BEARERS/STATE FEDERATIONS

Dear Comrades,

Group Medical Insurance Scheme

We have already informed that the Policy under the Group Medical Insurance Scheme for the employees and officers is being renewed for the next year Oct. 2017-Sept. 2018 and there is no change in the premium payable by the Banks.

For the retirees, those covered by the scheme (without Domiciliary), there is no change in the premium payable for the period Nov. 17-Oct.18.  For those covered with Domiciliary benefit, there is increase in the premium in view of higher claims and higher rate of ICR.

In addition, UIIC has also offered additional Top Up policy for Rs. 4 lacs for retirees(workmen) and Rs. 5 lacs for retirees (officers) at an additional premium of Rs. 2975+536 and Rs. 3225+581 respectively.

In the meantime, we have taken up with IBA that the difficulties and problems being faced by employees/retirees at the hands of the Banks, TPAs an UIIC are to be sorted out to make the scheme more availment-friendly.

IBA has called UFBU for a meeting on 6th October for this purpose along with UIIC, TPAs, etc.

We once again request our unions to let us know the problems encountered by the employees/retirees while availing the benefits under the scheme so that these can be taken up in the meeting for resolution/improvement.

With greetings,
    Yours comradely,
C.H. VENKATACHALAM
GENERAL  SECRETARY
Pto..
GROUP MEDIDCAL INSURACE SCHEME
AVAILMENT/UTILISTION DETAILS
( AS ON 17-9-2017)

IN SERVICE EMPLOYEES/OFFICERS

No. of employees covered
3,32,500
No. of officers covered
2,97,800
Total
6,30,300
Total covered including dependents
19,36,500
Premium paid by Banks
Rs. 767 crores


Claims settled/under process as on date
Rs. 707 crores
Under Cashless system
Rs. 379 crores
Under Reimbursement method
Rs. 229 crores
For Domiciliary treatment
Rs.   99 crores

RETIREES ( WITHOUT DOMICILIRY COVER)

Total retirees covered
1,04,300
Total covered including dependent
2,00,300
Premium paid by Retirees
Rs. 134 crores


Claims settled/under process as on date
Rs. 148 crores
Under Cashless system
Rs. 110 crores
Under Reimbursement method
Rs.   38 crores

RETIREES ( WITH DOMICILIRY COVER)

Total retirees covered
89,400
Total covered including dependent
1,74,800
Premium paid by Retirees
Rs. 149 crores


Claims settled/under process as on date
Rs. 262 crores
Under Cashless system
Rs. 132 crores
Under Reimbursement method
Rs.   54  crores
For Domiciliary treatment
Rs.   76  crores
ALL INDIA BANK RETIREES’ FEDERATION (Regd.)

Ref:2017/101                                                           Date: 25.09.2017
   

   The office Bearers/ Central Committee Members/ State Body Chiefs
   A.I.B.R.F

   Dear Comrades,

                   Re: REVISED OFFER OF NEW INDIA ASSURANCE LTD
                         ON SUPER TOP POLICY FOR AIBRF GROUP

In respect of Super Top Policy of New India Assurance Ltd. For bank retirees, we would like to give following clarifications on the points being raised.

  1. We do not expect any bank to issue circular for Super Top Policy of New India for bank retirees as it has been designed at the instance of AIBRF. Therefore members who are interested  are advised to take necessary steps to buy this policy before the stipulated last date of 10.10.2017 without waiting circular from the concerned banks.
  2. Basic policy with UIICL is to  be renewed with the concerned bank by paying necessary premium for 2017-2018 before the last date fixed. We find that UIICL has already advised renewal premium rates  to IBA. However IBA is yet to advise the rates to member banks and in turn member banks have so far not issued communication for payment of renewal premium by retirees. We are following up with IBA for early communication. We request our affiliates to follow up the matter with the concerned banks.
  3. As advised earlier, we also find that UIICL has given offer to IBA for introduction of Super Top Up policy for retirees w.e.f. 01.11.2017. But IBA is yet to issue communication to member banks. Most of the banks have also to take final call on UIICL offer for super top policy. It will become operational only after IBA/ banks accept it and issue communications for its implementation. It may also be mentioned that provisions of settlement dated 25.05.2015 only deals with basic policy of Rs. 3lakhs/ 4 lakhs. Therefore introduction of super top policy by IBA/ banks will be outside the preview of the settlement.  
   
                  With Regards,
                                                                          Yours Sincerely,

Letter From Broker
We thank you for your mail addressed to iba@kmdastur.com . In response to the same we would like to quote that :
For the year 2017-2018 United India Insurance Co. Ltd has renewed the Retiree policy without the domiciliary cover without any increase in the premium, even though the incurred claim ratio as on today is 126% and may touch 132% at the close of the policy period.
Also please note that the incurred claim ratio for the Retiree Policy with the domiciliary cover has touched 200% and will increase at the close of the policy period.
As regards to the Retiree policy with the Domiciliary cover initially we got the below quote from United India Insurance company Ltd. which was very high.
Initial Premium Quoted by United India Insurance company Ltd
Sum Insured
Net Premium
GST @18%
Total Premium
Rs. 300000
Rs. 27,894/-
Rs.5,021/-
Rs. 32,915/-
Rs. 400000
Rs. 37,189/-
Rs.6,695/-
Rs. 43,883/-
 The point raised by United India Insurance Co. Ltd. was that in this policy with domiciliary cover most of the retirees’ and their spouse claimed 10% domiciliary which turns out more than the premium collected for the same.
After various rounds of negotiations from our side with the United India Insurance Company Ltd HO we got the premium reduced as below:
 Sum Insured
Net Premium
GST @18%
Total Premium
Rs. 300000
Rs. 23,517/-
Rs.4,233/-
Rs. 27,750/-
Rs. 400000
Rs. 31,354/-
Rs.5,644/-
Rs. 36,998/-
 Even after increase in premium this year the retirees will be benefited.
 For the Rs.3,00,000/-policy the retiree and spouse will claim a total amount of Rs. 30,000 as against the premium Rs.23,517 + GST 18% 4,233    =  Rs 27,750/-.
 And against Rs. 4,00,000/- policy the retiree and spouse will claim Rs.40,000/-domiciliary against the premium of  Rs. 31,354  + GST  5,644  = Rs  36,998/-.
Inspite of the above increase in premium, United India Insurance Co. Ltd., feels that there would be an adverse claim ratio under this policy with the domiciliary cover.
 The incidence ratio under Retiree policy with the domiciliary cover policy works out to be 169% as against a normal high incidence claim ratio as per the Highest Industry standard of 18%
 In view of the above though we were able to reduce the initial premium quoted with United India Insurance Co. Ltd. but they did not agree to go down any further.

In addition to the above, United India Insurance Co. Ltd. has also given a very competitive super top up policy for a very low premium to benefit the retirees.
 Request you to communicate this to the Retirees’ Association.
 In case of any further clarification please do revert or call us on +91 22 66179852/ +91 22 66179852/+91 22 66179891 / +91 22 66179824
 Thanks & Regards,
 Dr. Jasmine Tijoriwalla
K M Dastur Reinsurance Brokers Pvt. Ltd.
Eros Theatre Building, 3rd  Floor,
42 Maharshi Karve Road, East Wing,
Churchgate,
Mumbai 400020.

ALL INDIA BANK EMPLOYEES' ASSOCIATION
CIRCULAR LETTER No. 28/33/2017/33                           23-9-2017

TO ALL OFFICE BEARERS/SschemeTATE FEDERATIONS/
ALL INDIA BANKWISE ORGANISATIONS / ALL UNITS

Dear Comrades,

Reg: Group Medical Insurance Scheme

Units are aware that under the 10th Bipartite Settlement, a new Group Medical Insurance was introduced in lieu of the earlier in-house reimbursement scheme.  This scheme is in operation from October, 2015 and management is paying the entire insurance premium for all the employees and officers with a cover of Rs. 3 lacs for Awardstaff and Rs. 4 lacs for Officers along with buffer scheme, ex-gratia for special diseases, cashless treatment, etc.  

From our experience and feedback received from our unions, last year we took up certain issues with IBA and pointed out some of the difficulties faced by the Banks/employees/retirees in the implementation of the Scheme.  Some of the issues taken up were:

  1. While the Scheme covers reimbursement of Rs. 3 lacs and Rs. 4 Lacs for clerks/substaff and officers respectively plus additional coverage from Corporate Buffer, some of the managements are maintaining that the coverage is only restricted upto Rs. 3 lacs and R. 4 lacs.  The correct position should be suitably clarified to all the Banks and in turn by all Banks to the employees at large regarding proper utilisation of the buffer amount.
  2. An important advantage of the Scheme is the Cashless facility available for treatment in hospitals.  But instances are coming to our attention that in many centres, many hospitals are not covered by tie-up and hence employees are asked to pay for the treatment and then seek reimbursement.  IBA and Banks should take up with the TPAs to ensure that maximum hospitals are covered by tie-up so that employees are not put to difficulties to avail cashless treatment facility.
  3. The Settlement and the Scheme clearly provide that employees would submit the Bills to the Banks as in the past and the Bank should submit the Bills to the TPA to get the reimbursement.  But some of the managements are asking the employees to submit the Bills directly to the TPA or delaying the bills to be forwarded to the TPA.  This should be stopped and suitable instructions should be given.
  4. There are instances of death occurring during treatment in hospital and if it happens to be Sunday or holiday, the hospital/TPA do not come to the rescue and the family is facing problems in getting the body of the patient in time.  Such things should not be allowed to happen.
  5. Instances have also come to our attention where certain 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.  Hence our scheme should be properly implemented by the TPAs and employees should not be put into such hardship.
  6. 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 and necessary steps are to be taken.
  7. Though Corporate Buffer facility is available for claims over Rs. 3 lacs/Rs. 4 lacs, many Banks are yet to issue open guidelines for utilisation/claims under the buffer limit.  This defeats the very purpose of the facility.  IBA should advice all the Banks to issue proper instructions on utilisation of the corporate buffer amount.

IBA assured to look into these issues and wanted to the unions to inform them any other problem that employees face generally.

In the current negotiations with the IBA on our charter of demands for 11th Bipartite Settlement, we have again taken these issues with them. In the meantime, the Group Medical Insurance Policy is being renewed for one more year from October, 2017 to September, 2018 with the same rate of premium.

We once again request all our unions to let us know the details and types  of problems being faced by our members at the hands of managements/ TPA/ UIIC.

We solicit urgent and priority attention to this issue by our unions.

With greetings,
    Yours comradely,
C.H. VENKATACHALAM
GENERAL  SECRETARY

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