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Saturday, April 6, 2013

MEDI-CLAIM POLICY RENEWED FOR THE YEAR 2013-14



Dept : Personnel/ER "Yogakshema",
Jeevan Bima Marg,
Cir. No.: CO/PER/ER-A/031/2013 Mumbai - 400021.
05th April, 2013.
To
ALL OFFICES OF THE CORPORATION


Our Group Mediclaim Policy covering in-service employees, retired employees and their dependents has been renewed for the year 2013-2014, on existing terms and conditions with The New India Assurance Co. Ltd. All existing benefits shall continue to be available under the Policy. The claims shall be administered directly by The New India Assurance Co. Ltd. through its designated servicing offices. Click on 'Read more' below to read the full Circular issued by LIC.

The premium chargeable per person for various age bands and sum insured for the policy year 2013-2014 are as follows:
S.A.
Age band wise Premium per person
0-35
36-45
46-55
56-65
66-70
71-75 ^76hand ] above
85000
1220
1334
2025
2348
2791
3002
3861
110000
1582
1732
2623
3037
3610
3885
4996
165000
2370
2599
3926
4549
5408
5821
7486
100000
1434
1577
2382
2761
3281
3530
4540
200000
2705
2971
4740
5476
6545
7048
9061
300000
3784
4151
6761
7867
9416
10142
13039

The ratio of sharing of premium between the in-service/ retired employees and the Corporation shall be 1:3. Needless to add, the sharing of premium shall be for the basic sum insured only. Sharing of premium for in-service employees will be for in-service employee, spouse and two dependent children and in case of retired employee sharing of premium will be.only for retired employee and spouse. Those employees / retired employees who have opted for enhanced sum insured have to bear the full premium for the enhanced portion of the sum insured.
2. Mediclaim Data and Statement.
The data of all beneficiaries as on 01/04/2013 is essential for finalization of the premium. All the Zonal Offices are required to provide the updated data of the beneficiaries as on 01/04/2013 in enclosed Excel formats (Annexure -I) and consolidate the same in (Annexure -A) and submit the same to Central Office by 23/04/2013. The data provided in Annexure-I is required by the insurer for the settlement of claims.
3. Claims Data

In addition to this, all the Divisional offices are required to maintain records for claim payments in enclosed Excel format (Annexure -II). Data for claim paid and pending (soft copy) is to be sent to the respective Zonal Office. The Zonal Office will consolidate the data for all the offices under its jurisdiction and submit it to Central Office as follows:
Claim Data
Last Date for receipt at C.O.
Data for the period 01/04/2013 to 31/12/2013
07/01/2014
Data for the period 01/01/2014 to 28/02/2014
07/03/2014
Data for the period 01/03/2014 to 31/03/2014
07/04/2014

It is to be brought to the notice of all the members of scheme that intimation of claim should without fail reach the office within 7 days of admission to hospital and the claim must be filed within 20 days of discharge from the hospital.
All other terms and conditions of the Scheme shall remain unaltered.
Executive Director (Personnel)