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Friday, February 07, 2014

GROUP MEDI-CLAIM


The Executive Director (P) 3 Feb, 2014
LIC Of India,
Central Office “ Yogakshema”
Mumbai

Dear Sir,

Reg:- Group Mediclaim Policy of Employees & Retired employees 2014-15

In the last March 2013 we had called on your goodself with the request to consider over the need of enhancement in the eligible Sum Insured. We submitted the present Sum Insured does not take care of the inflationary trend in the present scenario of health care cost. Hospitalization cost has gone up. We inferred that you are in agreement with our submission. We also brought to your knowledge that Public Sector General Insurance Co. are in process of making changes in the Group Mediclaim Policy of their employees and Retired employees.

The General Insurance Cos. have implemented the revised Group Mediclaim Policy covering the employees and retired employees effective from 01/02/2014 with the approval of their Board and Govt. of India. We enclose a copy of the circular issued by the Oriental Insurance Cos. in this regard for ready reference.

We request you to kindly consider as under immediately since the Policy is due for renewal w.e.f. 01/04/2014.

1. Please provide the Family Floater Policy.
2. The minimum of Eligible Sum Insured may be

Present SA. Revised SA.

a) Rs 85,000.00 Rs 4,00,000.00
b) Rs 1,10,000.00 Rs 5,00,000.00
c) Rs 1,65,000.00 Rs 7,00,000.00

3. Please extend the Cashless Service for all hospitalization cases or provide the advance to retirees at par with working employees. Please refer our letters dt. 16/09/2012, 29/11/2012 & 16/04/2013 (copy enclosed) and personal discussion on 22/03/13.

4. To reduce the Claim Ratio it is desirable to put cap on such expenses which are not material for the medical treatment, such as room charges. The criteria may be that room should be hygienic. The claim Ratio is bearing on the Premium fixation. The public Sector General Insurance Co. introduced the system w.e.f. 01/02/2014 in the Group Mediclaim Policy for employees and retirees.

5. The other benefits of the existing policy remain unchanged.
We are confident the management will consider our request to provide the proper health care to the Retirees. This will be a welfare measure.
Thanks
Your faithfully
(P.N. Srivastava)
Vice President
All India Retired Insurance Employees Federation
Kanpur