Posted on June 12th, 2013 in SBISA Circulars
We are very happy to announce that after protracted rounds of discussion and after our long persuasion with the staff members to opt for the above scheme, we could at last sign a MOU with National Insurance Company Limited on 10th May, 2013 at Kolkata LHO, Samriddhi Bhavan. The total membership who have opted for the scheme and are covered under the captioned scheme is 5435 at present throughout the Circle. All the above 5435 members are covered from 10th May, 2013 onwards till midnight of 9th May, 2014. In this respect, as per our previous Circulars since the agreed policy of Group Medical Insurance Scheme is on family floater basis, a member has to lodge his claim for the residual part of the Medical Bill submitted to the Bank for self or for the dependent family members which has not been reimbursed by the Bank. In this connection, the claim has to be lodged to the Third Party Administrator (TPA) namely Family Health Plan TPA Limited (Address – 66/2, Lake View Road, Kolkata – 700 029 Phone : 033-65503901/02/03 Fax No. 033-24659377) who has been assigned as the TPA by National Insurance Company Ltd. In case of any hospitalization of self or his dependent family members, the staff member has to intimate to the TPA within 7 days by Telephone or preferably by email or by fax. (email – www.fhpl.net Fax No. 033-24659377) and thereafter the certified copies of the entire Medical Bill along with all relevant papers and the photo copy of the sanctioned letter of the Bank where the total amount reimbursed by the Bank is reflected will have to be sent by the Registered Post or through the Courier to the above address of the TPA directly. The assigned person of the TPA will be made available at LHO twice in a week, at each Zonal Office fortnightly and in ZO, Siliguri once in a month for required assistance. The entire Group Medical Insurance Policy and its necessary stipulation and other definition / exclusion / condition are updated in our Site along with the Claim Form which can be downloaded directly from the Site. In case of reimbursement of Medical Bill related to critical diseases (Coronary artery surgery, cancer, renal failure, i.e. failure of both kidneys, stroke, multiple sclerosis, major organ transplants like kidney, lung, pancreas or bone marrow, paralysis & blindness) as stipulated in the Group Medical Insurance Policy, photocopy of the certified Medical Bill or the photocopy of the sanctioned letter of the Medical Bill along with the amount of the claim settled by the TPA will have to be invariably dispatched to the Union Office to get the extra coverage from the additional amount from the Buffer Amount allotted to the Association by National Insurance Company Ltd. The staff members are also required to send all the particulars of the Medical Bill sanctioned by Bank in case of themselves or their dependent family members and also the amount of the claim settled by the TPA to the Union Office.