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Very important & useful information for all bank retirees brothers who have opted for Mediclaim Insurance coverage.
As received from my friend Shri Suresh Bihany.
Delhi HC : Mediclaim Insurance Policy A & B : Writ Petition ( Civil ) No 264/2018 : Manohar Lal & Others Vs SBI & UIIC : In the Court of Hon’ble Mr Justice Vibhu Bakhru ( Court No 14 ) : As already Informed Writ was filed by our team on 10.01.18 & it was placed before the Hon’ble Court today at 12.34pm
Our Counsels pleaded that as per Guidelines for IRDA : Health Insurance Cover : circulated vide Gazette Notification dated 16/07/17 ( page no 35 ) ‘ Premium on Health Cover for Senior Citizens has to be Fixed for initial 3 years whereas Bank , UIIC have hiked it to multiple times making it unaffordable to the extent that premium now Fixed is equal to 4-8 months Pension, in violation of above guidelines.
Hon’ble Court was convinced and told the Banks’ Standing Counsel to look in to the matter urgently and respond to the petitioners within 15 days time . Hon’ble Court also told our Counsels to approach IRDA , an Statutory Body for the purpose and if not satisfied with their responses than to come back to the court for further hearing/ order .
Stay connected for updates.
तीमारदार से हास्पिटल स्टाफ- स्टेचर वाले- का पहला सवाल,
बीमा है क्या? हां,
तो दूसरा सवाल मार डाला तब लाये हो?
अब बिना किसी जांच पड़ताल स्टेचर आई.सी.यू. में घुसेड़ा, मीटर चालू। डा.से अ मभी भेंट नहीं।
तीसरा, अमुक राशि कैश काउंटर पर जमा करो।
तीमारदार ने कहा कि बीमा है, यह अस्पताल बीमा की स्वीकृत अस्पताल है, कैशलेश सुविधा है।
जवाब, पहले पैसा जमा करो, इलाज चालू हो। बीमा बाद में देखा जायेगा। अभी तक कोई डा. नहीं आया? फोन गया है, आ रहे हैं। इलाज तो चालू है न?
इस तरह से भय दोहन शुरु होता है। अब क्या बीमा है तो सारी जरुरी और गैर जरुरी जांच करवा दो। एक बीमारी थी दूसरी इलाज के दौरान रिएक्सन में हो गई। मरीज ठीक है, मुक्त हो सकता है, पर डा. कहता है अभी रिस्क लेने लायक नहीं है। बात रिस्क की नहीं, बात तो अभी बीमित राशि का बचा होना है, जिसे ऐठना है। इस तरह से मीटर चलता रहता है। बीमा में कमरे का किराया निर्धारित है तो बिल उसी दर पर बनेगा, चाहे कमरे का किराया कम ही क्यों न हो। मरीज को साम देर से छोड़ा जाता है,ताकि उस दिन का रुम का किराया पक्का हो जाये। मरीज बाहर का है तो होटल में जायेगा और होटल का उस दिन का किराया देना होगा। बीमार को एक दिन का दो किराया।
अस्पताल का बिल एक दो घंटें में टी.पी.ए. से पास हो जाता है क्योंकि टी.पी.ए. के साथ अस्पताल का अंडरहैंड डील है। वही बिल अगर बीमार आदमी अपना खर्च कर भेजता है तो कितनी क्योरीज की जाती हैं और कितना समय लगाया जाता है और कौन कौन से दावे रिजेक्ट होते है इसका तो कोई हिसाब ही नहीं है। अब जब इस तरह से लूट का ढांचा है तो बीमा का प्रीमियम आसमान तो छूयेगा ही। बैंकें कार्यरत कर्मचारियों एवं अधिकारियों के प्रीमियम का भुगतान करती हैं तो किसी स्टाफ को कोई फर्क नहीं पड़ता, लेकिन पेंशनर्स को अपना प्रीमियम स्वयं देना होता है। बढ़े प्रीमियम का बोझ पिछली बार हजारों रिटायरी नहीं उठा सके और वे बीमा से बाहर हो गये। ये सब सबार्डिनेट वर्ग के थे। इस बार बीमा प्रीमियम दुगुने से ज्यादा होने जा रहा है और हजारों लोग प्रीमियम नहीं दे सकेंगे और बीमा सुविधा से वंचित होंगे।
हमारी यूनियनें तमाशबीन बनी हुई हैं। पहले बैंकें कुछ सबसीडी देती थी, वह पूर्णत: बंद कर दी गई है। पेंशनर्स की पेंशन 30 वर्षों से संशोधित नहीं हुई है. 1990 का रिटायर्ड जी.एम. आज के रिटायर चपरासी के बराबर पेंशन पा रहा है। यह तमाशा जारी है। बैंकों में आज भी पुरानी पेंशन की पात्रता रखने वाले 5 लाख से ज्यादा लोग कार्यरत है। एक दिन उनके साथ भी यही होने वाला है जो आज उनके बड़े भाईयों एवं भाभियों के साथ हो रहा है। अभी तो गनीमत है कि इन बड़े भाइयों एवं भाभियों के हमदर्द पेंशन आपटीज बैंकों में हैं, यूनियन में हैं लेकिन उनके टाइम में बैंकों में उनके कोई हमदर्द नहीं होंगें, यूनियन में नहीं होंगे। अत: पेंशन नीति के साथ इस तरह का वर्ताव बैंक इम्प्लाइज आंदोलन पर कलंक है। पता नहीं किसका जमीर जगेगा और इस पर, सवाल करेगा। सवाल को तो नेता बगावत मानते हैं।
इनटालरेंस का जायजा लेना हो तो किसी नेता से सवाल कर के देखो। स्त्री-पुरुष का खयाल किये बिना नेता सवाल करने वाले में घुसेड़ देगा। कहने को तो लोकतंत्र है, लेकिन अधिनायकत्व का असली चेहरा देखना हो तो यूनियन नेताओं को देखो, उनके व्यवहार, रहन सहन, एशोआराम को देखो। आदर्श के उपदेश किसी संत महात्मा से उत्तम तो हमारे नेता लोग देते है और कर्म राम-रहीम, रामपाल और यदि आशाराम का नाम न लूं तो वे नाराज हो जायेंगे, जैसे हैं।
न्यूनतम स्वास्थ्य सेवा की सुरक्षा का इंतजाम बैंकों से नहीं करवाया जा पा रहा है। सरकार की नीति तो सबके लिए स्वास्थ्य जरुरी है, पर बैंक यूनियनो की नजर में पेंशनर्स उनके कुछ हैं ही नहीं। ईश्वर की कृपा है कि पेंशनरों को पेंशन पेंशन फंड की आय से दी जा रही है। कहीं अगर पेंशन का भुगतान बैंकों की आमदनी से होता तो बैंकों के खराब वित्तीय स्थिति का ठीकरा पेंशनर्स के सिर यूनियने पहले फोड़ती, मैनेजमेंट सायद बाद में!
बैंकों को पेंशनर्स के लिए कम से कम 3 लाख तक का मेडिकल बीमा अपनी लागत से देना चाहिए। 3 न सही 2 लाख तक तो अनिवार्यत: होना चाहिए। पर भला ऐसी भली नियत बैंकर्स की क्यों होगी, जो पेंशनर्स को भूखा मालने पर आमादा 30 वर्षों से है। अब यूनिरन नेताओं के विषय में कुछ नहीं कहूंगा। वे उनका ही भला नहीं कर पा रहे है जो उन्हे चंदा और लेवी देते हैं।
( जे.एन.शुक्ला/ इला. 4.8.18)
Dated: 03.08.2018
Shri V. G. Kannan
Chief Executive
Indian Banks’ Association
Mumbai
Dear Sir,
Renewal of Medical Insurance Policy for Bank Retirees
We refer to our various letters on the above subject. We have been hearing disturbing news about proposed exorbitant enhancement in the premium and the move on the part of IBA to abandon the entire medical insurance scheme so as to go back to the earlier hospitalization scheme at the Banks’ level. Now that your letter dated 01.08.2018 to the Convenor of UFBU and United India Insurance Company’s letter dated 02.07.2018, addressed to IBA are available on social media, our worst fears have come true. The contents of these two letters have shocked and dismayed all the Bank Pensioners and Retirees who are now feeling as if they were trapped 3 years ago by introducing medical insurance scheme for Bank Retirees at reasonable amount of premium which was further subsidized by the individual Banks. On introduction of this scheme thousands of Bank Pensioners and Retirees discontinued their individual medical insurance policies which were taken several years ago. They are now feeling robbed.
In this connection we submit the following for your kind consideration:
1. Department of Financial Services, Government of India vide its letter no. 14/7/92-IR(Vol-II) dated 24.02.2012 advised IBA to formulate a Medical Insurance Scheme for both serving and retired employees after several representations and prolonged negotiations, IBA introduced Medical Insurance Schemes for both serving and retired employees during 2015 while concluding Bi-partite settlement/Joint Note for Salary revision.
2. The said letter of the Government did not envisage discriminatory treatment between the serving employees and retired employees with regard to the payment of premium. The settlement of 2015 between IBA and UFBU providing for the premium to be borne by the retired employees was against the spirit of the Government’s advice to IBA vide their letter dated 24.02.2012.
3. While implementing the Medical Insurance Scheme, the individual Banks decided independently on discriminatory treatment about the premium in case of retired employees vis-a-vis serving employees. Consequently some Banks collected entire premium from their retired employees while few Banks opted to Part-subsidize the premium. In the later years most of the Banks collected the entire premium from the retired employees.
4. Such collection of increasing premium from the retired employees has resulted in some of the pensioners finding it grossly inadequate to bear the premium out of their meagre pension more particularly the family pensioners. It is worth mentioning here that family pension in some cases is as low as Rs. 4,000/- per month.
5. It would be appropriate to furnish hereunder the details of Medical Insurance Premium having been charged
• The insurance cover for award staff was for Rs. 3,00,000 and the amount of premium charged were slightly lower than that of the officers.
** Including GST
We understand that United India Insurance Company which has been providing Medical Insurance Policies for last three years both to serving and retired employees has now quoted exorbitant increase in premium amount for the year 2018-19 (proposed renewal) which in case of retired employees
6. The proposed premium mentioned above reflects an increase of around 144% and IBA’s request to United India Insurance Company to reconsider their decision on enhanced premium has been turned down by the Insurance Company.
7. United India Insurance Company is reported to have given the high claim ratio as the reason for such exorbitant increase in the rate of premium. The Insurance Company has also indicated that based on future incurred claim ratio, the loading on premium for the subsequent year (2019-20) would range from 25% to 150% depending on actual claim ratio.
8. While entire premium in case of serving employees is borne by the Banks, the increase in premium for serving employees may not be a cause of concern to the employees. But in case of retired employees who have been forced to bear the cost of medical insurance, any increase in premium is not only becoming unaffordable but may also escalate the miseries of the retired employees. It is also pertinent to mention here that apart from the serving employees free and full medical reimbursement is available to the retired CMDs/MDs/Dy MDs/CEOs/EDs. This makes recovery of medical insurance premium only from the retired officers and award staff beyond comprehension, inequitable, unfair, unreasonable and discriminatory. We believe that while serving employees are provided medical facilities as a component of package for their services, the retired board level appointees are provided full and free medical reimbursements for their past services which in some cases could be as low as 2-3 years. Under these circumstances the retired employees of the Banks, having served the Banks for 30-40 years are unjustifiably denied full free medical reimbursement. It defies logic and appears inhumane.
9. We are also at a loss to understand as to why the medical insurance to the retired Bank employees should be restricted to United India Insurance Company alone. It would have been more appropriate to invite quotes from other Public Sector Insurance Companies before releasing the premium rates quoted by United India Insurance Company on social media.
Such a release on social media may tend to make the proposed rates fait accompli even if the quotes are invited from other companies at this stage.
10. It is more appalling that the prohibitive cost of medical insurance may drive many retirees out of the scope of even the medical insurance otherwise available for individuals as the last three years medical insurance coverage under IBAs policy has rendered them ineligible for cover due to the age bar, pre-existing diseases, discontinuation of old individual medical insurance policies etc. In view of the great emphasis by the Government on medical insurance, IBA/Government should not drive senior citizens – Bank retirees to land into such a helpless situation with nowhere to go for their medical needs.
In view of the foregoing facts, we request you to initiate necessary steps to ensure that Bank retirees are provided medical reimbursement facility at par with retired board level appointees and serving employees.
We also request you to call our organizations which represent all the Bank Retirees for a meeting to discuss and settle the issue of Medical Insurance Scheme at the earliest.
Thanking you
Yours faithfully
(A. Ramesh Babu) (K.V. Acharya) (S.C. Jain)
Joint Conveners, CBPRO General Secretary, AIBRF
बैंक रिटायर्ड साथियों ★★★
हैल्थ इन्श० प्रीमियम Proposed 2018-19 (Domiciliary Treatment)
◆◆◆◆◆◆◆◆◆◆◆◆◆◆◆◆◆◆◆◆
घरेलू उपचार के लिए रिटायर्ड अवार्ड़ स्टाफ व अधिकारी स्टाफ के लिए पालिसी मे कुल 30000/- व 40000/- ₹ तक की क्लेम राशि निर्धारित है।। इस वर्ष uiic ने इसके लिए प्रीमियम 41801/- तथा 55721/- लेने के लिए IBA को सूचित किया है।।
Award- 67721-25920= 41801₹
Officer- 90289-34568= 55721₹
UIIC ने सभी बैंक रिटायरीज को क्या बेवकूफ समझ रक्खा है कि वो 30000/- क्लेम के लिए 41801/- की बीमा प्रीमियम व 40000/- क्लेम के लिए 55721/- की बीमा प्रीमियम का भुगतान कर दें।। UIIC व IBA मे क्या सभी इतने मूर्ख बैठे हैं कि बिल्कुल भी दिमाग़ नही लगाया व सुर्कलर पत्र जारी कर दिया।। थोड़ा सा भी mind apply करते तो इतनी बड़ी गलती ना करते या फिर घरेलू उपचार राशि 30000/-, 40000/- (10% of sum assured) से बढ़ाकर 20% or 25% ie 60000/- 80000/- या 75000/- 100000/- ₹ घोषित करते।।
सभी रिटायर्ड़ साथियों से निवेदन है कि uiic की इस पूरी health ins. Scheme व premium पर गहराई से विचार करते हुए, सभी रिटायर्ड यूनियन नेताओं, ufbu, बैंक व iba का विरोध करें व एक साफ सुथरी health ins. scheme कम से कम प्रीमियम पर लाने हेतु दबाव बनायें।। धन्यवाद।। कृप्या अपने सभी रिटायर्ड़ साथियों के बीच इसे शेयर करें।। rkj, kota
LETTER RECEIVED BY AIBRF FROM K M DASTUR AND CO,
IN THE MATTER OF RENEWAL OF HEALTH INSURANCE
=======================================================
Dear Mr. Jain
Thank you for your mail.
We have read the email of UBIRETIREES RAJKOT in detail. We understand the serious concern expressed for the Retirees at large.
In view of the results of the existing programme, we have been working on a solution for the retirees for some time now. This involved a detailed analysis of the programme and the results. As mentioned we are very confident of providing you with a solution which we believe will address almost all of the concerns raised by the retirees. In addition, improvements in coverage and cost will be achieved.
When we conceived and conceptualised the IBA Medical Scheme, it was with the sole objective of providing the best quality of healthcare to the bank employees and the retirees. As you are aware, it was our involvement as brokers for the scheme both for employees and retirees that we were able to achieve the broadest form of cover at a competitive price. We would like to mention that not even the employees and the Retirees of the PSU insurance companies are provided such a cover and price.
We are extremely saddened to learn from the mail that in our absence United India Insurance Co. Ltd. have increased the premium by 110% for the Non- Domiciliary and 144% for the Domiciliary policy.
Please find below a brief outline of the solution we propose. Please note that the existing coverage will be maintained and the outline only highlights improvements / value additions suggested by ourselves.
Improvements in Coverage:
1) A dependent handicap child is now covered under the family definition.
2) Cataract which was earlier limited to Rs.35,000 by United India have now been increased to the limit of Rs.60,000 per eye.
3) All Advance medical treatments like Cyber Knife, Robotic Surgery etc. are payable up to 50% of the sum insured.
4) Adjuvant, Neo Adjuvant Therapy and Immunotherapy which is most commonly given along with cancer treatments today and are currently not being paid by the insurance company, under other medical treatments are now added as a part of the day care procedures.
5) Dental treatment has been included up to Rs.5,000 for Root Canal treatment at a Dental Clinic.
Sum Insured:
We have suggested one uniform Sum Insured of Rs 4 lakhs, irrespective of the grade of the retiree. As suggested by you, retirees should be given an option for different Sum Insured from One lakh to five lakhs to be selected by the retirees. However we would kindly point out that although there may be slight reduction in premium which may not be in proportion to the Sum Insured. The coverage would be inadequate because of the age of the retirees, as besides the Sum Insured all expenses including the room rent covered under the policy would be reduced proportionately for the coverages of 1 lakh and 2 lakhs. We therefore propose that even if a choice is to be given, the option should be from three lakhs to five lakhs.
Premium:
We have proposed a substantial reduction in the premium rate by thirty percent on domiciliary and seven and a half percent for without domiciliary covers on the current premium rates.
Domiciliary Treatment:
We have given two options of coverage i.e. with domiciliary and without domiciliary. Domiciliary will be covered only up to 10% of the Sum Insured and the Buffer will not be available for the same.
Personal Accident:
We have included a Personal Accident cover of Rupees one lakh for all members under the Retiree Policy.
Special Additional Coverage – 100 crore Buffer:
We have also structured a 100 Crores Buffer for a group of five lakh families. The amount payable to any family will be up to the Sum Insured i.e. persons opting for a 3 lac cover will get 3 lac additional buffer and so on. Domiciliary treatments shall not be paid out of buffer. Kindly note that we have achieved all the above for a minimum of five lakh retirees being enrolled in the programme.
To enable us to present to you with a formal proposal incorporating the above and including the premium, we request for a mandate letter from Bank Retirees’ Federation as per the IRDA regulation (copy of sample letter enclosed).
Please note that by issuing such mandate letter to KMD, from your Organisation , you will not be required to pay any fees, cost, etc. to KMD. Hence we request you to issue the mandate urgently so that we may present to you a formal proposal.
With warm regards,
Maneck H. Dastur.
+919820044153
K. M. Dastur Reinsurance Brokers Pvt. Ltd.
===============
Circulated by Vijaya Bank Retirees' Association, Central Office, Bangalore.
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