AIIPA 2020 Latest News- Group Mediclaim Scheme
All India Insurance Pensioners Association
President : Com Ashok Tiwari
General Secretary : Com T K Chakraborty
Cir No : 01/2020
Date : 18th January 2020
Shri M R Kumar,
LIC of India,
Group Mediclaim Scheme
Every Year, AIIPA has been representing for judicious fixing of premiums under Group Mediclaim Policy and in recent times, our focus has been 100% subsidy in premium coupled with increase in Compulsory Sum Insured.
As you know, the purpose has been to make the scheme pensioner friendly and to ensure aged pensioners are enabled to go in for higher Optional Sum Insured to cater to their needs for additional reimbursements for hospitalisation expenses.
Even though the total Sum Insured has been Rs.50 Lakhs for sometime now, the Compulsory Cover continues to be low and because of this, a huge amount has to be borne by the pensioners for optional cover. In case our demand for full subsidy and increased Sum Insured under subsidy are conceded, pensioners will utilise the savings towards premium for higher optional cover.
With earlier pensioners getting more and more aged, their hospitalisation need increases, cost of treatment increases; but their pension entitlement remains low and more or less stagnant and such a situation tells upon their financial viability and psychological equilibrium.
As such, AIIPA urges upon the following demands:
- Increase in Compulsory Sum Insured;
- Full Subsidy in Premium;
- Premium to be charged for ages above 65 years is limited to the one charged for ages 55 to 65 years.
AIIPA has earlier pointed out how unfair it has been to proportionately disallow hospitalisation expenses where room rents incurred are beyond prescribed levels. AIIPA demands that such practice should be reversed and actuals should be reimbursed or actuals should be factored in by TPAs, under cashless treatment. A higher limit based on ground realities, should be adopted in relation to room rent.
AIIPA’s demand for Monthly Cash Medical Allowance for all pensioners still remains to be agreed upon though the AIIPA has been vigorously following it up. With nothing to fall back upon except their pension, pensioners find it difficult to meet increasing domiciliary treatment costs.
Needless to stress,that treatment for certain ailments may require frequent visits to the physician, repeated dosage of medicines and occasional scan or X-Rays without hospitalisation and for all these the individual has to bear the cost from out of his limited earnings and Monthly Cash Medical Allowance will go a long way to help them. Recent increase of allowance to Pre-1986 retirees is an appreciation of this fact.
AIIPA requests the Chairman to accede to the demands put forth above and also to favourably consider grant of Monthly Cash Medical Allowance payable along with pensions for the New Year that has just dawned.
AIIPA has been pressing for inclusion of reimbursement of cost of dental treatment as also cost of hearing aid, both of which are required for aged pensioners. We do hope these will be included in the Mediclaim policy in the ensuing year.
AIIPA also requests the Chairman to consider and concede the demand for an option to join the Group Mediclaim Scheme for those who are not covered for many genuine reasons.
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