FAMILY FLOATER POLICY - LETTER TO ZM, SOUTH ZONE

Dear Sir, 

Family Floater Policy – lacuna removal leading to full-fledged, smooth operation

Lacuna removal operations required...

We are happy LIC CO has atlast been able to negotiate with GIPSA & New India & introduced the FFPolicy with Optional SA Deadline given

was 31 May, 2014, day 

before. Exact position will be known after a few days only. Pensioners are worried whether all pensioners earlier included in existing scheme were able to send Option Form for a smooth transition to enjoy the benefits of this FFP, which indeed is a worthy one.

Even in earlier scheme, many were not able to pay the premium before 31 March either because they were abroad or hospitalized & none to help them or any other valid reason.  It must be our aim that such employees/pensioners come back to this New FFP scheme. We recall in May 2010 when 75% subsidy existing for Employees was extended to Pensioners, One Time Option was given. Similarly, now also, it will be in the fitness of things if  OTOption is extended with a deadline.

2.  Now that this New scheme takes off, LIC must allow mediclaim premium deductions from pension for pensioners in the same way as for Employees every month. It is a different matter that SZ allowed 3 monthly deductions for pensioners & SCZ 2 deductions. It is regrettable that this administrative benefit existing for Employees is not being granted to pensioners. Total premium now payable will be higher than original existing scheme & so all the more, same facility given to Employees by every month deduction for FY must be extended right now to enable them to continue intact & not lose the much-needed health cover. After this facility is allowed, there will be no need to ask the pensioners to give a letter again while submitting Family Particulars Form & whatever the premium depending on age etc. 12 monthly deductions can be done.

3.  Interconnected with new scheme & really to make it savoury & smooth to operate & benefit, Cashless Service has to be integrated positively. Hospital admissions are a contingency & emergency & the family will be in dire distress, cannot be allowed to fend for themselves. So, equity demands that LIC can issue Identity Card or TPA Medi Assist can issue Smart Card with details of Employee or Pensioner & dependants if any, with Total SA, which will be ensure easy, hassle-free hospital admission.

It is strange that Employees also, apart from pensioners, have not availed Cashless, mainly because of the great lacuna & sooner it is rectified & Cards issued, it is better.

• Lastly, mediclaims submitted in the beginning of FY are not taken up for settlement & gets accumulated in LIC Offices at various levels. Sometimes. it takes many months, reason being New India does not know which NI office is earmarked that year, Policy Schedule is still not received, containing various provisions macro, micro & ceiling level for hospitalization expenses for each item & other restrictions. Some remedy has to be found out to ensure that simultaneously, all concomitant requirements to make the Scheme operational are done at finalization stage itself by CO. Claimants/employees/ pensioners cannot be told to wait, amounting to discourtesy or denial.
• IRDA provisions to pay interest on delayed settlement may exist, but really NI Office must issue instructions about allocation of claim settlement work to concerned NI Offices. It looks that Same NI Offices who were undertaking the work should continue to do so & we find no reason then for any delay. More so if delay occurs every year, all the more a pragmatic solution must be found so that no backlog accumulates, leading to financial distress for employee/pensioner.
• Quite a few claims are for big amounts & one cannot afford to wish away the agony, subsequent residuary treatment has to be taken involving cost & so, either Advance on the lines of employees for cashless, or discretion to settle large % of amount claimed must be invoked, after scrutiny thus empathizing with pensioners & earning their goodwill. NI also must make earnest effort to speed up such outstanding claims &  expedite settlement since already considerable time has elapsed.

We plead with your goodself to appreciate the peculiar difficulties of pensioners & whichever solutions you can take to alleviate the sufferings of pensioners shall be greatly appreciated by pensioners.We pray a comprehensive solution to all these lacuna are found & initiated.

Thanking you,

Yours faithfully,

R.B.KISHORE

ED(Retd)& VP, AIRIEF

(All India Retired Insurance Employees Federation)

To 
Sri T.Sitharthan, ZM, SZ.