Friday, December 13, 2013

Dear friends,
We are extremely sorry for not updating the blog. We were so busy with preparing statistics to be given to the Counsel at his request and also continuous travel to Delhi every week took our energy out. Let me appraise you the happenings after our Oct 24 th hearing.

After October 24 th the case was posted to 13th November, when our case was no.1 listed for the day, to our disappointment the second judge Shri Chellameshwar was not well and he was replaced by Shri Kurian Joseph that day. Even though we were well prepared for the case we had the apprehension whether we should go for the trial or seek adjournment. since if this case is heard by this bench the same bench should hear if the case is not finished the same day and it is most likely that it will continue for the second day also as there are 3 petitioners and 3 Respondents to give their arguments. Hence we went to the court with lot of apprehensions in our mind and to our advantage judges themselves asked us whether the case can be concluded the same day and we told them our inability quoting the reasons stated above. After due consultations within themselves they adjourned it to 27th Nov.
We went to Delhi on 23rd itself and had conference with the Senior Counsel in the morning as the counsel would not be able to be present on 26th to have conference.  By that time we finished we got information that the counsel for the Respondents Adv.Andhi Arjuna was appointed as Amicus Curie for the Coal block case and the case is listed for 27th and management advocate would seek  adjournment.
Hence we waited till 26th, when the mentioning for adjournment will be taken, and we opposed vehemently stating that we are pensioners and many people have lost their lives even without seeing the light of the case and the Respondents are taking adjournment for the sixth time. But since the appointment was by the Supreme Court themselves we could not do anything more, but we wanted to have the case on 5th December or 11th December. but the judges refused and asked us to get it in January 14 after the Christmas vacation (Bet.17th Dec and 3rd Jan). Hence we stayed in Delhi for one more day and after consultation with all the partied the case is now listed for 8th January 14.

Friends, Just imagine our plight. Of the above happenings nothing is in our hands. In spite of our full efforts it has been postponed to 8th Jan 14. Only God should interfere and help us in this and once the case comes for trial we are sure to impress upon the Bench and come victorious with the help of the Almighty. One advantage in these happenings is that we had 4 to 5 conferences with the Senior counsel and he is now thorough with our case and we could prepare well for the case.

We would again appeal to one and all that please send your contribution to the Association and strengthen our finance. We are also glad to see the comments for the Blog and while appreciating the participation we would also request you to give your identity and not as anonymous. You all know the value of Anonymous letters.
with regards
NAGARAJAN
GENERAL SECRETARY

Sunday, October 13, 2013

FINAL HEARING

Dear friends,
Our final hearing will commence on 24th Oct.13, and with two to three sittings it will be over and then we may have to wait for the Decision.
On 18th and 26th of September our case was heard but on both the occassions the management was vociferous in getting the adjounment placing various reasons but our Adovocates resisited it and on 26th we agreed with much pursuation for the final hearing on 24th Oct. with  a written order that the counter should be filed before 17th of Oct. and our Rejoinder if any will be given before 22 Oct.
Our case will be taken first in order next to any case partly heard the previous day.
Now the fight is on and well geared up NISVRREA is ready to face the mighty Management on 24 th of this month.
We have the backing of all our members and we appeal to one and all to pray the Almighty for our success in this case.
with regards
nagarajan
GENERAL SECRETARY

Friday, September 13, 2013

Dear friends
Our case has finally came for hearing on 10 th of this month but because of the in disposition of the  judge the could not be taken for hearing. now the present position is it may be taken up for hearing next week so let us wait and pray for the success.
With regards
nagarajan

Sunday, August 11, 2013

Dear friends,
Slowly and steadily we are inching towards the hearing date. Now it is only time as all the formalities are over. At this juncture we have two good developments in the fight with the management of the insurance industry.
The first one and which is more relevant to us is the Highcourt case won by our friends at Jodhpur and the order is in our favor on the case of payment of Arrears of 2002 Scheme.
The second one is, even though it is relevant to the LIC pensioners the points with which they have won a case at Supreme court has very good advantageous points in the judgement which will defienietely help us in our Case.
So friends please wait patiently for some more time for our case to come up in the Sup. court.
We say thanks to our friends who pioneered these victories one to Mr. Asthana of LIC and to all the petitioners and the Advocate Shri Anil Bhandari (a retired GIC UI man who is practising as lawyer at Jodhpur).
with regards
nagarajan
nisvrea

Tuesday, June 18, 2013

New Med Claim Policy Introduction

Dear friends,
Our request for improvements in the new medclaim floater policy along with the Unions and Associations have forced the Management to defer the introduction of the same till Septembers 2013. The GM's of all the four companies will consult and finalise the improvements. Let us wait. Pensioners who have already given the cheques can get back the same from the respective offices.
with regards
nagarajan
GENL SECTY. 

Saturday, June 8, 2013

NEW STAFF GROUP MEDICLAIM POLICY

Dear friends,
We are happy to inform you that a new Floater policy is introduced from July 1st of 2013.
The above policy has got some advantages and also the Premium rate is higher. The policy cover is increased to 20 lakhs but on floater basis. Our EC has discussed the for and against points yesterday and we are sending letters to GIPSA and all the four companies regarding the above policy. The main features of the present policy compared with the new policy is given down below. for your perusal. Please opt for a higher sum insured before June 30th.

Revision in Group Mediclaim Policy for Serving & Retired
Employees of our Company w.e.f 1st July 2013

The Group Mediclaim Policy (GMC Policy) covering our serving and retired employees and their family members which is
in force now, has undergone modifications with effect from 1.07.2013. For ready reference, some important features
are outlined below :-

Current Provision
Revised Provision
Company’s Contribution towards Premium in case of Serving Employees (for employee, spouse & two dependent children) :-
Class I – 2/3rd premium + loading, if any,
-       up to Eligible S.I + Service Tax
Class II/III/IV- 3/4th premium + loading, if any,
-        up to Eligible S.I + Service Tax
Company’s Contribution towards Premium in case of Serving Employees (for employee, spouse & two dependent children) :-
75% of the premium payable (including loading on account of applicable TPA fees and Service Tax)
- up to the Eligible Sum Insured.
Company’s Contribution towards Premium :-
For Retired Employees :-
-       Loading portion of premium up to Eligible S.I + Service Tax

For Spouse of Deceased Employee/ Spouse of Retired & Deceased Employee :-
-       Loading portion of premium up to Eligible S.I + Service Tax

Company’s Contribution towards Premium :-
For Retired Employees :-
- 75% of the premium payable for retired employee &
  spouse (including loading on account of applicable TPA fees & Service Tax) - up to the Eligible Sum Insured.
For Spouse of Deceased Employee/ Spouse of
Retired & Deceased Employee :-
- 75% of the premium payable for spouse (including loading on account of applicable TPA fees & Service Tax)
                       - up to the Eligible Sum Insured.
Employees’ Contribution towards Premium in case of Serving Employees :-
For employee, spouse & two dependent children :-
Class I – 1/3rd premium + loading, if any,
-       up to Eligible S.I + Service Tax
-       the entire differential premium for differential higher Sum Insured opted by Employee over & above the Eligible Sum Insured + Service Tax
Class II/III/IV- 1/4th premium + loading, if any,
-        up to Eligible S.I + Service Tax
-       the entire differential premium for differential higher Sum Insured opted by Employee over & above the Eligible Sum Insured + Service Tax
For dependent ineligible children/dependent parents/ dependent parents-in-law/independent children & their family members :-
-       the entire cost of premium for opted Sum Insured + Service Tax
Employees’ Contribution towards Premium in case of Serving Employees :- (Class I/II/III/IV) –
For employee, spouse & two dependent children :-
- 25% of the premium payable + TPA fees + Service Tax
                                - up to the Eligible Sum Insured.

- the entire cost of premium payable for dependent
  ineligible children and dependent parents + TPA Fees +
  Service Tax

- the entire cost of premium payable for dependent
  parents-in-law, independent children and their family
  members, in the applicable cases + TPA Fees +
  Service Tax

- the entire differential premium payable for differential
   higher Sum Insured opted by Employee over & above
   the Eligible Sum Insured for self, spouse & two
   dependent children + TPA Fees + Service Tax

                                                                                                                                                                
Current Provision
Revised Provision
Employees’ Contribution towards Premium in case of Retired Employees :-
For self, spouse & two dependent children :-
-the entire cost of premium for opted Sum Insured + Service Tax (except Loading portion of premium up to Eligible S.I + Service Tax)


For dependent ineligible children/independent children & their family members :-
-the entire cost of premium for opted Sum Insured + Service Tax
Premium Contribution by Spouse in case of Spouse of Deceased Employee/ Spouse of Retired & Deceased Employee :-
-the entire cost of premium for opted Sum Insured + Service Tax (except Loading portion of premium up to Eligible S.I + Service Tax)


Employees’ Contribution towards Premium in case of Retired  Employees :-
For self & spouse :-
- 25% of the premium payable + TPA fees + Service Tax
                                - up to the Eligible Sum Insured.
- the entire differential premium for differential higher Sum Insured opted by Employee over & above the Eligible Sum Insured for self & spouse + TPA Fees + Service Tax
For dependent children/ dependent parents :-
-the entire cost of premium payable for opted Sum Insured
  +TPA Fees + Service Tax

Premium Contribution by Spouse in case of Spouse of Deceased Employee/ Spouse of Retired & Deceased Employee :-
- 25% of the premium payable for spouse + TPA fees
   + Service Tax - up to the Eligible Sum Insured.
- the entire differential premium for differential higher Sum
  Insured opted over & above the Eligible Sum Insured +
  TPA Fees + Service Tax
Eligible Sum Insured :-
Basic less than – Rs.22,731          Rs.   70,000/-
Between Rs. 22,731 & Rs. 29,000 - Rs. 1,00,000/-
Rs. 29,001 & above                   –  Rs. 1,55,000/-
Eligible Sum Insured :-
Basic less than – Rs.22,731          Rs. 3,00,000/-
Between Rs. 22,731 & Rs. 29,000 - Rs. 4,00,000/-
Rs. 29,001 & above                   –  Rs. 5,00,000/-
Maximum Optional Sum Insured :-
Rs. 5,00,000/- per member
Maximum Optional Sum Insured :-
Rs. 20,00,000/- on floater basis

Who can be covered :-
Serving Employees :-
Spouse, Dependent Children
Dependent ineligible children
Dependent Parents/ Parents-in-law
Independent Children/their family members



Retired Employees :-
Spouse, Dependent Children
Independent Children/their family members

Who can be covered :-
Serving Employees :-
Spouse, Dependent Children
Dependent ineligible children
Dependent Parents
Independent Children/their family members &
Parents-in-law can be continued to be covered provided
they are already covered – but no fresh inclusion from
1.04.2013.
Retired Employees :-
Spouse, Dependent Children
Dependent Parents
Other provisions :-

Ambulance Charges – Not payable
Other provisions :-

Ambulance Charges (cumulative actual charges
                                          per policy period) –
Distance up to 50 Km.   - Rs. 1,500/- maximum
Distance beyond 50 Km.- Rs. 3,000/- maximum
         (payable against hospitalization claim only)
                                                              










Current Provision









Revised Provision
Other provisions :-

Room rent Charges – no sub-limits









No Medical Check-up facility


Cover to Infant-after 3 months from date of birth
Pre-existing diseases  covered
Maternity Benefits (for two living children) –
-        Rs. 50,000/- maximum

Other provisions :-

Room rent charges 
Actual room rent charges per day shall be limited to an amount which is equal to the sum of :-
-1% of S.I. up to Rs. 5 lacs + 0.5% of S.I.> Rs. 5 lacs
which shall not exceed -
7,000/- per day maximum in Metro/ A Class Cities
4,500/- per day maximum in B Class Cities
4,000/- per day maximum in C Class Cities
Stay in ICU/CCU :- Maximum reimbursement limit per day shall be double that of above room rent entitlement.
Medical Check-up facility-
Once in 04 claim-free years (w.e.f 1.07.2013) :-
                                   - Rs. 5,000/- maximum
Cover to Infant -  from Day 1.
Pre-existing diseases clause  - stands waived.
Maternity Benefits (for two living children) -
Rs.25,000/- maximum per child for normal delivery
Rs.50,000/-maximum per child for caesarian delivery
Being a single master policy for all the employees (serving & retired) along with all the covered members, data relating to collection of premium and claims paid are kept collectively for Class I to Class IV. Percentage of loading of premium was decided on the basis of Incurred Claim Ratio as a whole.
 Now, policies shall be underwritten separately for –
a)Class I, b) Class II and c) Class III & IV. Therefore, data relating to collection of premium and claims paid should be kept from 1.07.2013 on the basis of the above classes separately and send the class-wise data to HO Fund Department on quarterly basis.

the above points will guide you about the policy. we are also giving you the method of calculation of premium with some examples down below.

Main Details of the Policy.

Existing                                               Revised                        Co's Contribution
Eligible S.I.                                         Eligible S.I.                  75% of Premium Payable
70,000                                                  3,00,000                       up to Eligible Sum Insured
1,00,000                                                4,00,000                      ( for employee &spouse )
1,55,000                                                5,00,000                      plus TPA Fees &Service Tax

                                               If you take Sum insured for 10 lacs
                                               

Members                      Relation                       Age (Years)                  Amount
(Rs.)
A                                  Self                              63                                 17,358
B                                  Spouse                        55                                  6,702
C                                  Dep.Child 1                  24                                 3,003
D                                  Dep.Parent                   85                                 14,792

Yearly Premium-                      Total :              41,855
                                                     (plus TPA Fees &S/Tax)

                                                Eligible S.I. - 3 lakh                             

Members                      Relation                       Age (Years)      Amount         
                                                                                                 (Rs.)            Co's Contribution
A                                  Self                              63                     8,274
B                                  Spouse                        55                     3,205           75% of PremiumPayable
C                                  Dep.Child 1                  24                     1,408           up to EligibleSumInsured
D                                  Dep.Parent                   85                     6,769          (for employee &spouse)

             19,656  plus TPA Fees &ServiceTax
   

Co's Contbn.-      75% of 11,479 
             (i.e 75%of A & B)               8,609

Emp's Contbn.-                                    Yearly -                        11,047         ( For S.I.-Rs. 3 lakh)
                 
                  (19,656 - 8,609)
                 (plus TPA Fees & S/Tax)



Emp's Contbn.-                                    Yearly -                        33,246          (For S.I. - Rs. 10 lakh)                                                                              
       (41,855 - 8,609)
(plus TPA Fees & S/Tax)


















RETIRED EMPLOYEE
Example for Calculation of Premium underStaff Mediclaim Policy on Floater Basis 
Sum Insured - Rs. 10 lak
 Eligible sum ins.4 lakh

Members          Relation           Age (Years)                  Amount(Rs.)                 Co's Contribution

A                      Self                   63                                11,292
B                      Spouse             55                                4,365                75% of Premium Payable
C                      Dep.Child 1       24                                1,913                up to Eligible Sum Insured
D                      Dep.Parent       85                                  9,213               ( for employee & spouse )

26,783 plus TPA Fees & Service Tax

Co's Contbn.-               75% of 15,657
(i.e 75%of A & B)          11,743

Emp's Contbn.-            Yearly -                        15,040.00              ( For S.I.-Rs. 4 lakh)
        (26,783-11,743)
  (plus TPA Fees & S/Tax)

Emp's Contbn.-            Yearly -                        30,112                   (For S.I. - Rs. 10 lakh)
        (41,855 - 11,743)
   (plus TPA Fees & S/Tax)

                                            IF YOU TAKE 10 LAKHS AND ELIGIBLE SUM INSURED 
                                                                      5LAKHS

Members          Relation           Age (Years)                  Amount(Rs.)                 Co's Contribution
A                      Self                  63                                 13,446
B                      Spouse            55                                 5,192                75% of Premium Payable
C                      Dep.Child 1      24                                 2,327                up to Eligible Sum Insured
D                      Dep.Parent       85                                 11,459              ( for employee & spouse )
            
32,424  plus TPA Fees & Service Tax
Co's Contbn.-               75% of 18,638
(i.e 75%of A & B)          13,978

Emp's Contbn.-            Yearly -                        18,446.00            ( For S.I.-Rs. 5 lakh)
       
          (32,424-13,978)
          (plus TPA Fees &ServiceTax)

Emp's Contbn.-            Yearly -                        27,877                 (For S.I. - Rs. 10 lakh)
          (41,855 - 13,978)
          (plus TPA Fees & ServiceTax)