United India Insurance Company Super Top-up Policy for Bank Retirees - CBPRO circular

Circular issued by CBPRO is reproduced below

Quote 

Circular 015/2018                                                             Dated 31.08.2018

Dear Comrades

Sub: United India Insurance Company Super Top-up Policy for Bank Retirees

We are pleased to advise our Bank Retiree Comrades that after detailed discussions the United India Insurance Company, who have  presently given the basic Mediclaim Insurance Policy to the Bank Pensioners and Retirees consequent to 10^thBipartite Settlement which was concluded in 2019,  have now offered a Super Top-up Policy over and above the Basic Mediclaim Policy.

The salient features of the offer from the United India Insurance Company are as under:

1.    The Basic Policy for Award staff and Supervisory staff is Rs. 300,000 and Rs. 400,000 respectively.

2.    The Super Top-up Policy for Award staff and Supervisory staff will be Rs. 400,000 and Rs. 500,000 respectively.

3.    The eligibility for domiciliary treatment shall be 10% of the Basic Policy only.

4.    There shall not be any domiciliary treatment reimbursement under the Super Top-up Policy.

5.    The Super Top-up Policy will be operative from 1^st November, 2018 coinciding with the renewal of the present Mediclaim Policy.

6.    The Premium on the Basic policy and Super Top-up Policy is payable by the concerned Pensioner/Retiree/ Insurer.

7.    The Insurance Premium payable on the Super Top-up Policy is as under:

a.    For Rs. 400,000 Super Top-up Policy the premium shall be Rs. 2,975 plus GST.

b.    For Rs. 500,000 Super Top-up Policy the premium shall be Rs. 3,225 plus GST.

We are expecting a communication from the IBA very shortly.  However we have received communication from M/s K M Dastur Reinsurance Brokers Pvt. Ltd giving details of the offer of United India Insurance Company which we are reproducing hereunder.  They have also written to the Member Banks of IBA of their offer which has been forwarded to us by them.  We request our comrades to go through the contents carefully and decide about their option.

We have come across another kind of Super Top-up Policy offered by New India Assurance Company Ltd. retaining the Basic Policy of United India Insurance Company.  At the outset we do not want to get into any competition in regard to the offers of two Public Sector Insurance Companies.  We also do not want to make any comments about the efficiency or otherwise of the United India Insurance Company or the promised efficiency of service from the New India Assurance Company Ltd. as the scope for grievances is always there in any kind of arrangement.

As a responsible Organisation we will only strive to give higher coverage of Super Top-up Policy as offered by United India Insurance Company and especially when the premium for the Super Top-up Policy is almost the same as offered by New India Assurance Company Ltd. excepting that the Super Top-up Policy by United India Insurance Company is for the higher amount i.e.  Rs.400,000 and Rs. 500,000.

We are also of the opinion that it is better to have the Super Top-up policy form United India Insurance Company with whom we are having the basic policy for better administration and settlement of claims.  Additionally United India Insurance Company has been part of the Mediclaim Insurance Policy floated by the IBA during the 10^th Bipartite Settlement which is known as IBA’s Retirees Policy.

We urge upon our members not to unduly hurry up in regard to the option of Top-up policy as the renewal is due from November 2018 only and further detailed communication is likely to come from IBA in a matter of few days.  The IBA has already advised about the renewal of the Mediclaim Policy and the premium for the serving employees and officers which is due from 1^stOctober, 2018.  There is no need to go for option right now and no need to panic as there is sufficient time to give our options to a much better and higher offer from the United India Insurance Company with whom we are having the basic policy.

We request our comrades to wait for our further communications in this matter.

With regards,

Yours Comradely,

         

 A.Ramesh Babu                        K.V.Acharya

           

               Joint Conveners

The exact contents of the mail received by us from K M Dastur Reinsurance Brokers Pvt Ltd. on 31.08.2018

Thank you for your mail.

We have got  a sanction from United India Insurance Co. Ltd., for the Super Top Up Policy as informed to all the Banks, the Union Associations and IBA. We have informed to IBA and they are happy about the proposal. We are marking a copy of this mail to IBA and United India Insurance Co. Ltd.

In the policy confirmed by United India Insurance Co Ltd.

1.    The extra coverage under the Super Top Up Policy is Rs. 100,000 more than the one proposed by New India Assurance Co Ltd.

2.    This Super Top-up Policy will be seamless and can be availed by the Retirees with the basic policy just by informing their Bank at the time of the renewal of the basic policy as of 1^st November 2018 to debit the extra premium payable on the Super Top Up Policy.

3.    The claim process too will be seamless as the same TPA will be settling the claim and all the Retirees would have to do is to inform the TPA of the Super Top Up Policy number too when a claim is lodged.

4.    The TPA will be the same.

5.    There is no minimum number of Retirees essential for the policy to commence, hence the Retirees are ensured of the coverage the moment they apply for the same together with their basic policy.

6.    There is a mention of SBI policy through United, where we are not involved. It is being done by Ms. Anand Rathi Insurance Brokers Pvt. Ltd. and they have no connection with us in any matter.

7.    We at K M Dastur have worked on structuring this IBA  policy for three and a half years and are happy to inform that we were also involved in drafting the medical portion of the 10^th Bipartite Settlement and our name is mentioned in the Mapping of the Medical Scheme under the same. We are also members for the claim rejection committee and with this experience we assure you of a better implementation of the IBA Medical Scheme in the days to come.

We give you the details of the Super Top Up Policy as below:

Pleased to inform that after protracted negotiation with United India Insurance Co. Ltd they have agreed to offer Super Top Up Policy to the IBA retirees.

Please note that domiciliary claims will not be paid by the Super Top Up Cover.

How does the Super Top Up work.

Super Top Up Policy will be in addition to the limit of the basic IBA Policy.

To illustrate below our claim example:

For a 3 lakh basic IBA Policy, the Super Top Up Policy is for a Sum Insured of Rs. 400,000.

If there is a claim up to 3 lakhs there would be no claim under the Super Top Up Policy.

In case there is claim for 6 lakhs then 3 lakh would be paid from the basic policy and another 3 lakh from the 4 lakh Super Top Up Policy.

If there is a further claim within the same year and the basic IBA policy is exhausted the balance will be paid from the Super Top Up Policy.

Similarly, For a 4 lakh basic IBA Policy, the Super Top Up Policy is for a Sum Insured of Rs. 500,000.

The Rs. 3 lakh basic Policy becomes Rs. 700,000 after the Super Top Up Extension. (Basic Sum Insured Rs. 3 lakhs + Super Top Up Sum Insured Rs. 4 lakhs = Rs. 700,000)

Similarly the Rs. 4 Lakh basic Policy becomes Rs. 900,000 after the Super Top Up Extension. (Basic Sum Insured Rs. 4 lakhs + Super Top Up Sum Insured Rs. 5 lakhs = Rs. 900,000)

Sum Insured’s of the two New Super Top Up Policies		Threshold i.e. the Sum Insured under the main Policy after which the Super Top Up Policy will trigger	Premium excluding GST
	Rs.	Rs.	Rs.
1	4,00,000	3,00,000	2,975
2	5,00,000	4,00,000	3,225

If you need any further clarifications please do contact us

Best Regards,

Maneck H Dastur

K. M. Dastur Reinsurance Brokers Pvt. Ltd.

                                                              

On seeking our clarification from K M Dastur Reinsurance Brokers Pvt Ltd on utilisation of TOP-up Policy they responded as:

QUOTE

“We refer to the telephonic discussion with Mr. Acharya and confirm that if the claim is of Rs. 3 Lakhs under the 3 lakh policy then the claim would be totally paid by the basic 3 lakh policy and there would be no need for the Super Top Up Policy. In case the claim amount exceeds the 3 lakh Sum Insured under the basic policy then the claim under the Super Top Up Policy would trigger.”

UNQUOTE

                                                                                                                                

Launching of Super Top Med claim Insurance Policy for bank retirees - AIBRF circular

 Circular by AIBRF is reproduced below

Quote

Ref:2018/91                                                           Date: 28.08.2018

    

    The office Bearers/ Central Committee Members/ State Body Chiefs

    A.I.B.R.F

    Dear Comrades,

                         Re: Launching of Super Top Med claim Insurance

                               Policy designed by New India Assurance. Co. Ltd

                               For Bank Retirees

We request you to refer our circular no. 2018/78 dated 15.07.2018 regarding launching of Super Top Insurance Policy for bank retirees and giving details of the policy.

2. We have since finalised the procedure details of the policy  after holding discussion with the officials of New India Insurance Company/ Pragmatic Insurance Broking Pvt. Ltd. Details are given below

PROCEDURE TO BE FOLLOWED BY THE RETIREES TO BUY AIBRF SUPER TOP POLICY OF NEW INDIA ASURANCE  CO. LTD

(a)        As advised earlier, bank retirees who have purchased insurance cover from United India Insurance Co. Ltd. Under IBA scheme and opt for renewal for 2018-2018 will be eligible to apply for this Super Top Policy.

(b)        Sum Insured under this scheme will be Rs. 3 lakhs for award staff and Rs. 4 lakhs for officer staff.

(c)        Annual Premium will be as under

For Rs 3 lakhs       Rs 3511 ( inclusive of GST )

For Rs. 4 lakhs      Rs.3806 ( inclusive of GST)

(d)        This policy will be effective from 1^st November 2018 to 31^stOctober, 2018.

(e)        Complete details of the scheme is given in the form of  enclosed FAQ ( Frequently Asked Questions).

(f)         Those who desire to buy this Super Top Policy should submit the request in the enclosed proposal form duly filled in.

(g)        All columns should be properly filled. Coloured photo of the self and spouse should be pasted in the given space in the proposal form.

(h)        The following documents should accompany the proposal form(i) one additional photo of  self and spouse & (ii) Copy of health card of United India Insurance Company- Self & Spouse.

(i)         Cheque should be in favour of “ AIBRF New India Super Top up Policy”

(j)         Cheques along with proposal form should be sent at the following address by Speed Post on individual basis or by after activists after collecting from members in one packet:

 

            Pragmatic Insurance broking Services Pvt. Limited  

            202, Sunshine Avenue, opp. Balaji Traders

            Near Datta Mandir Chowk  Viman Nagar

            Pune- 411014

            Contact Person Cap. Sanjay Moholkar

                                         Mobile No.7738894698

        E-Mail Address: moholkarsanjay29@gmail.com

(k)        On receipt of the cheques, acknowledgement will be sent by SMS to the concerned retiree.

(l)         The following details should be written on the back of the cheques(i) Name of the applicant (ii) Mobile No. (iii) Health Card number of United India Insurance Co.

(m)      The cheques will be encashed only after receipt of targeted number of applications within the stipulated period. In the unlikely event of not achieving the target, the cheques will be returned to the applicants.

(n)        After encashment of cheques and the policy becoming active, health card for Super Top policy will be uploaded on the web site of the insurance company from where members can download and keep on record. In the event of any problem in this regard, you may contact (i) on above address of the insurance broking firm (ii) Central office of AIBRF or (iii) Pune Office of AIBRF- Contact No 9823853653

(o)        Insurance Company will upload names of TPAs ( They will be identical to base policy of United India Insurance Co.), names of network hospitals, format of claim forms for the use of members in case of need shortly.

(p)        Insurance Company/ Broking firm will establish Help Desk for after sale service to the policyholders under the scheme. Details will be advised shortly.  

    3.WHY AIBRF LAUNCHING SUPER TOP POLICY FOR MEMBERS

As advised in our earlier circular, We have been feeling  that some reliable option at reasonable and affordable cost  should be available to the retirees for buying super top up insurance policy in addition to the basic policy of United India Insurance Co.  introduced by IBA in 2019 to meet growing expenses on medical treatment and to avoid risk of not getting additional cover at the later stage in view of advancing age. We made multiple efforts in this regard  by contacting IBA and Unions for introduction of super top up scheme for retirees. We were of the view that bank managements can service such product effectively.  But when no response was coming for long time despite our continuous follow up, we took initiative to launch independent insurance scheme for additional cover. Basically our efforts in this direction  are with the object  to ensure welfare of our members.  

 

4.SUPER TOP POLICY PROPOSAL OF K.M. DASTUR CO. 

After announcing Super Top up policy of New India  by AIBRF in July 2018, insurance broking firm , K.M. Dastur & CO.  circulated proposal for Super Top policy more or less on similar  terms and conditions with higher cover of Rs. 1 lakh for both the categories. Thereafter we have been receiving several quarries from members that why retirees should not go for K.M. Dastur proposal where higher cover is available or why AIBRF should not persuade New India to enhance cover on the lines of Dastur proposal. In this connection we have to bring following facts for your consideration to enable you to take decision on Super Top policy.

(a)        We find that communication of K.M. Dastur  addressed to Unions and circulated by mail is merely proposal of the broking firm at least as on today. Super Top policy as per the proposal of K.M Dastur  is not readily available today even if somebody wants to opt for it unlike New India scheme which has already been  launched  and retiree can formally apply for it. In our  view, it would not be proper to talk discuss and compare which is not available.

(b)        After circulation of the proposal by K.M Dastur, we wrote to UFBU to ascertain whether they will support it for approval by IBA. There is no formal response to our communication in the matter from UFBU yet. However we understand informally that it is not being not pursued.

(c)        We have contacted IBA officials to ascertain the position from them. We understand that it is not under their active consideration. We have also checked from managements of 3/4  banks who have informally advised that they would launch the scheme only if it is approved by IBA.

(d)        In view of the above facts, there is no certainty that K.M. Dastur proposal would become reality in near future/ within the stipulated time.

(e)        As all of you know,  experience of retirees with K.M. Dastur in handling domiciliary expenses issue during 2019-16 has not been satisfactory.

(f)         We find that United India Insurance Company for renewal of medi-claim policy of Rs 8 lakhs meant for SBI retirees is charging premium of around Rs. 42000 for the year 2018 against total cost in our case for Rs. 8 lakhs will be in the region of Rs 20000 to 21500.

(g)        We have discussed K.M. Dastur proposal with New India Officials with the request to review terms and conditions of their scheme. However they have expressed their inability to do so at this stage as they feel that the premium quoted by them is very reasonable considering attractive terms and conditions offered and high claim ratio in basic policy. They have pointed out that otherwise also medi-claim business is

  not profitable for insurance sector and their policy is to ensure stability in premium in future instead of giving concession in first year and then heavy increase in  premium in subsequent years.

5. Considering the above we feel it is reasonable proposal for those who want to go for super top policy. Our affiliates and members are requested to consider the above facts and take informed decision.

6.  We have since been informed by the following affiliates the number of retirees who have expressed their interest in Super Top policy of New India

1.   Canara Bank Retirees Ass.                                   1886 Retirees

2.   Allahabad Bank Retirees Ass.                              1240 Retirees

3.   Bank of India Retirees Ass.                                 2100  Retirees

7. Other affiliates are requested to take effective steps to implement the scheme and advise the figures of interested members at the earliest.

   

                   With Regards,

                                                                           Yours Sincerely,

                                                           

                                                                    

                                                                       ( S.C.JAIN)

                                                                GENERAL SECRETARY

Unquote

 Click here to view/ download FAQs

 Click here to  view /download proposal form