LETTER TO GIPSA ON Revised terms of Group Mediclaim Policy (floater) covering employees/retired employees.

To                                                        Date: 17.05.2013.

The Chairman,

G I P S A.

Sub: Revised terms of Group Mediclaim Policy (floater) covering employees/retired employees.

We have had the opportunity to go through the Revised Terms of GMC Policy covering employees/retired employees as contained in the Annexure - ‘A’, ‘B’ and ‘C’.  Our first hand observation on the subject are as below:

At the outset we record our strong dissensions and resentment at the high-handed, arbitrary and unilateral act and/or modus perpetrated by the framer of the said Revised terms of Group Mediclaim Policy, which it appears has been devised keeping an eye on Floater principle.  Whereas the GMC Policy concerns the interest of employees of GIPSA Companies, it is quite unbecoming that the authority did not have the courtesy to discuss the matter before hand with the representative bodies, not even the checked-off unions of respective classes of employees.  This amply demonstrates total biasness and prejudicial attitude of the GIPSA especially in dealing with employee matters as also maintaining cordial and harmonious relationship.

It goes without saying, the spirit and concept of the Mediclaim Policy was mainly intended to offer benefit to the insuring public and in the case of employees it was treated as a welfare measure.  But, strangely the number of conditions set out in the respective Annexure are totally to the contrary.  Stringent/derogatory and obnoxious conditions put forth to defeat the welfare aspect as a whole. 

In this background we urge that due steps m are initiated for modification of the conditions before giving effect to the revised terms of GMC Policy in consultation with the respective checked-off unions urgently. Pending such bipartite discussion vis-à-vis modification thereto implementation of the Revised GMC Policy be kept in abeyance.

For your due consideration we summarize hereunder our clause wise observation on the Revised terms of GMC Policy designed by GIPSA.   

Clause No            Suggestion/observation

02.1.1       For employees Basic Pay

02.1.2.2     For employees Basic Pay between Rs.22731 & Rs.29000 –

                  Eligible Sum Insured be  Rs. 7,00,000/-                                                                          

02.1.2.3      For employees Basic Pay > Rs.29000>      

                   Eligible Sum Insured be Rs.10,00,000/-

                       

02.1.3         Eligible Sum Insured for retired employees shall be determined

                   based on the Basic Pay Last drawn on the date of exit from services

                   which should be notionally updated  keeping in mind past wage

                   revision(s).

02.2.6        Choice of available optional Sum Insured be Rs.7,00,000,

                  Rs.10,00,000, Rs.12,00,000, Rs.15,00,000, Rs.18,00,000
                 & Rs.20,00,000.       

02.2.0       In every renewal option for increase/decrease of Sum Insured be

                 given to  all serving and retired employees.

03.1.1      NO CAP on Room and ICCU/CCU rent charges and no other sub-limit

                for any other expenses .

03.2.1      For Free Medical Check up separate account be maintained for each

                members of the  Family e.g, every members of the family should be

                given free medical check up facility once in 2 Claim free years of policy

                in respect of particular member.

                       

04.1.2      GMC policy for independent family members of serving & retired

                employees be Continued and not to be discontinued on or after 1.4.2013

04.5.1      Retired employees who are not covered under the expiring GMC Policy

                be allowed to opt for coverage under the GMC Policy as per revised terms.

09.1.1 & 09.1.2   PREMIUM:-

 Entire premium, service tax etc. upto eligible limit of Sum Insured be

 Borne  by the  Company for both  serving and retired employees.

 Difference of premium between optional Sum Insured and eligible Sum

 Insured be paid by the serving & retired employees.

OTHER POINTS:-

a)      Besides hospitalization Bill, fees for Physician/Surgeon/Anaesthesis etc.,

       if separately given be reimbursed without any condition .

b)      No deduction on account of Non-medical items like gloves, Mollysheet,

      micropore cotton etc., and all other items essential for hospitalization be

      included,

c)      80% advance for hospitalisation  for all types of diseases be given  to all

      serving and retired employees.

d)  No outsourcing of Claim settlement by TPA

     As we are settling claims in House of our client like LIC we are competent
     enough to settle our Claim for serving and retired employees. If require Claim
     Hub be formed for Health  insurance in each R.O. of the PSU Insurance companies.

e) Actual Ambulance charges be reimbursed.

Trust,   the suggestions stated above will find due considerations at your

 end before finalizing the Revised GMC Policy so as to cater the needs of

 all the serving and retired employees and we again demand that before

 finalization all the checked-off unions be called for a meeting.

Thanking you,

Yours faithfully,

Sd/xxx

(SUJIT BAGCHI)

GENERAL SECRETARY

Copy to : 
1. The Chairman-cum-Managing Director,  The New India Assurance Co. Ltd.
2. The Chairman-cum-Managing Director,  United India Assurance Co. Ltd.

3. The Chairman-cum-Managing Director,  Oriental Insurance Co. Ltd.
4. The Chairman-cum-Managing Director,  National Insurance Co.

………..for information and to take necessary action