Blunders in recent medical ins agreement signed on 19.07.23 bet "UFBU" and IBA.

[Mani B]

Received the following msg thru whatsapp and i am sharing it for the infm of all.

🇮🇳🇮🇳🇮🇳🇮🇳🇮🇳🇮🇳🇮🇳🇮🇳🇮🇳

🌹🌹 *चाय पर चर्चा* 🌹🌹

Bala

( English summary)

*Congratulations and best wishes to all of you on the Independence Day of India.*

Today in a discussion on TEA , we will talk on a topic which is directly related to our life and risk management. That is *Medical insurance*

IBA and UFBU have entered into an illegal agreement on 19.07.2023 *without involving any retired representative or Retirees association.* IBA kept the proposal and UFBU accepted the proposal without thinking and without if and but.   Once again a *new trap has been brought in the name of reducing the premium amount of medical health.*

☘️ On the pretext of reducing Mediclaim Premium for retirees, the basic cover  has been reduced from the existing coverage of Rs.4 lakhs to half of Rs.2 lakhs. *Many medical facilities are being snatched from us.* This will prove to be very harmful for the retirees.

With 4 lakh basic coverage, we retirees used to get treatment for many diseases and used to resort to top-up when needed. But now Top Up will start only after 2 lakhs. This is a direct loss of 4-2 = 2 lakhs . 

we will explain this with an example.....

*Present 4 lakh policy and top-up ...*

Suppose we submitted 6 bill in a year with different diseases and time..

                           Bill      Total 

*1* First Bill       34000   34000

*2* Second bill  64000   98000

*3* Third bill     38000   136000

*4* Fourth bill 100000   236000

*5* Fifth bill     74000    310000

*6* Sixth Bill  190000   500000

All medical bills passed, 4 lakhs from basic policy and 1 lakh paid from top-up.

Total medical bills paid  Rs 5 lakhs.

*Now Upcoming 2 lakh policy and Top-up...*

*1* 1st bill 34000  34000

*2* 2nd bill 64000 98000

*3* 3rd bill 38000 136000

*4* 4th bill 100000 236000 

Here 2 lakhs paid from base policy and 36000 from top-up. 

But, after the basic policy coverage of 2 lakhs is over, the remaining bills cannot be passed. Your loss is Rs.500000 - Rs.236000 = Rs.264000/- 

*Brother, we will have to pay Rs.264000/- from our own pocket.*

One more  loss

*Importance of Hospital Room Rent!!!!*

Room rent is directly related to the Hospital Bill. If Room rent is 3000/- in your policy. But in 90% cases, it has been seen that in big and good hospitals of big cities, room has to be taken compulsorily at the rate of 5000 or 6000 per day. Hospitals also do not stay behind to take undue advantage of a sick person.

Your Entitlement 3000/- You got room 5000/- i.e. 60% costlier. According to the rules of Hospitals, your expenses related to the hospital whether your doctor's fee, special doctor's visit, nursing and other daily charges will have to be paid 60% more according to the room respectively. *All this will go from your pocket, insurance companies will not pay.*👉 According to the report of a government insurance Co, the insurance premium of the retirees has to be increased because the premium comes less and the claims are increasing. According to them:-

2016-17    130% claims 

2017-18    164% 

2018-19    188%

2021-22    147%

In my opinion, The main reason for this is not our treatment but mismanagement. In the name of insurance, the meter of the hospital bill starts running. TPA, Hospital and Insurance Co all together multiply the medical bill.   Along with this it seems that Commissions and Brokerages would also be taken from our premium. Otherwise the claims cannot be so high.  As per *Rule 4 of IRDA, commission/brokerage and office expenses cannot be included in premium and have to be specified separately in Medical offers.*. This means that the burden of those expenses is also put on our premium. That's why insurance companies get a profit in crores.--

*Somethings to think !!*

Only 2 people are insured in the retirees policy, while 6 people in the working class policy, including two senior citizens like us, yet their claims are less than their premium!

 IBA in its document mentioned that Rs 100 crore is available in the Employees Welfare Fund of banks for medical health insurance policy  for the year 2023-2024.  This amount is for insurance policies of both serving employees and retirees as per the findings of the Finance Ministry and the Khandelwal Committee. Therefore, it is quite clear that this amount of Rs. Rs 100 crore is to be divided equally between both the serving employees and the retirees. Therefore, the retiree's share of Rs. 50 crores can be used to pay medical health insurance  premiums for the poor retirees,  So that at least in the last few years of their life, the financial burden on the retirees can be reduced. 

 👉In response to an RTI, the bank has admitted that 85.5% of the welfare fund money is spent on working employees. Only 14.5% are spent on retirees. While this amount should be 50% 50%. Discriminatory behavior with retirees should stop.

We appreciate that IBA is looking to reduce the premium to be paid by retirees  But the method , terms and conditions chosen by IBA and UFBU are suicidal for the retirees ? *IF THESE NEW TERMS AND CONDITIONS ARE APPLIED THEN ALL THE SENIOR CITIZENS RETIRED WILL GO TO HEAVEN WITHOUT GETTING TREATMENT FROM HOSPITAL DUE TO THEIR POOR FINANCIAL STATE AS THEIR PENSION HIMSELF IS VERY LOW AND NO PENSION UPDATION BY IBA/BANKS FOR LAST 28 YEARS*

 As per the instructions of the Ministry of Finance, the banks should pay the full premium of this medical health insurance policy for the retired people, like the working employees, the premium of the retirees should also be borne by the banks.

*सौ बातों की एक बात*

At present, all the facilities given in the Mediclaim policy of IBA should be ensured in the new policy and the premium of the retirees should also be paid by the banks or instead of reducing the facilities for the retirees, the premium should be reduced by 60%.

*Care....*  Recently a Big   organization of retirees told in its circular that Top-up and Super Top-up are the same thing. But in the agreement of IBA and UFBU it is written only and only about Top-up and not about Super Top-up. We should not be under any misconception. There is  difference between the two. The major difference lies in the fact that a *Super Top-up Plan offers coverage for complete hospitalization bills above the threshold limit, whereas a top-up policy only covers a single hospitalization claim above the threshold limit.*

Friends, please check all if and but of the policy according to your circumstances before taking any decisions ON INSURANCE POLICY. 

JAI HIND

*आप स्वस्थ रहें, सुरक्षित रहें तथा प्रयासरत रहें*

🙏🙏 *Dharam* 🙏🙏

New Delhi--9810900536