AIBEA/GS/2015/90 16th November, 2015
Indian Banks’ Association
Reg: Attempts to backtrack from the agreed to Medical reimbursement policy by United India Insurance Co.
While the newly introduced Group Medical Reimbursement Scheme for the employees and retirees is slowly getting normalised, we are highly disturbed to be informed that United India Insurance Company has sent a mail to various Banks on 13-11-2015 stating that their Policy will not cover the following in the case of retirees:
1. Maternity Expenses.
2. Critical Illness Cover.
3. Domiciliary Expenses.
4. Corporate Buffer
5. Dependents are not covered ( Only employee + Spouse).
In their email, UIIC has also stated that “Please note that the 100% premium will be refunded to retirees (subject to NIL claims till date) if retirees of the Banks are not interested to continue the policy those who have remitted the premium to us.”
In this connection, please refer to the following provisions in Schedule IV as well as Appendix I and II under the recent 10th BP Settlement signed by IBA on 25-5-2015 with the Unions:
Ø The new Scheme as applicable to the officers/ employees in service would be continued beyond their retirement/superannuation/resignation, etc. subject to payment of stipulated premium by them.
Ø The new Scheme would also cover the existing retired officers/ employees of the Banks and dependent spouse subject to payment of stipulated premium by them.
Ø While reimbursement to the officers / employees shall be made by the Banks as hitherto, the Scheme shall be administered by the Banks through a scheme worked out between IBA/Banks and Insurance companies and officers / employees would in no way be directly bound by the terms and conditions of such scheme or arrangements.
Ø Continuity benefits coverage to officers / employees on retirement and also to the Retired Officers / employees, who may be inducted in the Scheme. ( Clause 1.2.2 of Appendix I of X BPS)
Ø Under Clause 1.4 of Appendix 1 of X BPS, Corporate Buffer is provided for.
Ø Under Clause 2.11 and 2.12 Appendix 1 of X BPS, DOMICILIARY HOSPITALIZATION and DOMICILIARY HOSPITALIZATION are covered under the scheme.
Ø Clause 3.1 of Appendix 1 of X BPS : Domiciliary Hospitalization / Domiciliary Treatment : Medical expenses incurred in case of the following diseases which need Domiciliary Hospitalization /domiciliary treatment as may be certified by the attending medical practitioner and / or bank's ’medical officer shall be deemed as hospitalization expenses and reimbursed to the extent of 100%
Ø There would be a continuity of this Scheme / benefits to the Retiring Officers / employees and their family and also to the Retired Officers / employees and their family.
Ø Clause 6 of Appendix II : The allocation and use of this Corporate Buffer would rest with the individual management of the member bank. At the end of the year we would have a joint review on how many banks have totally utilized their Corporate Buffer and how many other member banks have not utilized their Corporate Buffer totally. The unutilized Corporate Buffer of the member banks would now be proportionately available to the member banks whose Corporate Buffer has been totally utilized. This would be one of the major benefits of the Group underwriting of all the member banks under one policy
While the above are some of the provisions of the Settlement, it is totally impossible for UIIC to go back on these provisions after the commencement of the Policy and payment of premium to them.
Not covering maternity expenses of the retirees is understandable but still it is ridiculous to mention it.
Critical illness cover is also applicable to the employees only as it is clearly mentioned in the Scheme/Settlement.
But domiciliary treatment and corporate buffer are integral part and conditions of the Scheme and cannot be separated for the retirees.
The whole scheme has been worked out with all these ingredients and removing any portion of it will make the whole scheme to fall.
Further, UIIC’s position that “ Please note that the 100% premium will be refunded to retirees (subject to NIL claims till date) if retirees of the Banks are not interested to continue the policy, those who have remitted the premium to us ” is absolutely untenable and illegal at this stage. We feel that UIIC has crossed the line wrongly.
We are highly disturbed and agitated about these developments. UIIC cannot take IBA and UFBU for granted. UIIC cannot play with the bank employees like this.
IBA’s immediate and urgent intervention is necessary.