There was a round of discussions between UFBU and IBA held on July 19, 2023, mainly to discuss group medical insurance policy for retirees among other things.
In view of the increasing cost of premiums payable by retired employees/officers, the need has arisen to review the scheme as applicable to the retired employees and officers with a view to enabling a possible reduction in the premium payable by them.
With this in view, the issue was discussed between the parties and agreed as under:
a) The scheme applicable to retired employees and officers will be a separate scheme.
b) Based on this a separate scheme worked out by and between the parties, the benefits of which would accrue accordingly for retired employees and officers.
c) IBA would float tenders/RFP based on this separate revised scheme for the retired employees and officers.
d) The scheme and terms as applicable to in-service employees/officers will henceforth not be applicable to retired employees and officers.
e) Under this Scheme, the sum insured under the uniform base policy would be Rs. 2 lakhs.
f) Stand-alone ceilings will not affect claims payable in other procedures covered under the policy.
g) The bidder will also quote separate premium for those retirees, where the policy cover only one person.
h) The above separate scheme/Base Policy for the retired employees and officers would be based on the following:
i) Bed Charge/room rent/Boarding expenses per day:
Metro/Urban centres Rs. 3000
Other centres Rs.2500
ii) ICU Charges per day:
Metro/urban centres Rs.6000
Other centres Rs.5000
iii) Standalone Ceiling/cap on treatments:
| Treatment | Max. reimbursement |
| High fever, typhoid, jaundice, other ailments, etc. requiring hospitalisation: | Rs.40000 Max |
| Coronary Angiogram | Rs.16,000 |
| Angioplasty | Rs.1,00,000 |
| CABG – bypass surgery | Rs.200,000 |
| Open heart surgery for valve replacement | Rs.200,000 |
| Cataract | Rs.30,000 |
| Cost of intra-ocular lens | Rs.10,000 |
| Knee Replacement | Rs.100,000 |
| Lithotripsy – multi sitting – kidney stone removal | Rs.35,000 |
| Hip replacement | Rs.100,000 |
| Lasik surgery package per eye | Rs.15,000 |
| Hernia | Rs.40,000 |
| Hydrocele | Rs.20,000 |
| Piles/hemorrhoidectomy | Rs.30,000 |
| Appendicectomy | Rs.30,000 |
| Cholecystectomy | Rs.40,000 |
| Prostatectomy | Rs.40,000 |
| FESS | Rs.30,000 |
| Dialysis | Rs.2,000 |
| Female Diseases/Surgery: Hysterectomy | Rs.40,000 |
Cost of implants Max.:
| Temporary Pacemaker implantation | Rs.30,000 |
| Permanent Pacemaker Implantation | Rs.40000 |
| Cost of Stent | Rs.30,000 |
In case the patient is to be moved to a hospital/nursing home outside the urban agglomeration / municipal limits, then the expenses incurred on conveyance may be reimbursed at the following rates:
Ambulance Category Ceiling:
(i) Non-Cardiac Rs.2,500/-
(ii) Cardiac Rs.5,000/-
Other Charges :
(i) Ventilator or respiratory charges – Rs.5,000/- per day + oxygen charges.
(ii) Oxygen charges Rs.100/- per hour (Max. Rs.1,000/- per day)
Physician Consultation Charges per visit :
(i) Registration charges – Rs.200/-
(ii) Consultation / routine visit – Rs.400/-
(iii) Night visit/emergency visit – Rs.600/-
(iv) Specialist Consultation charges per visit:
(a) Consultation / Routine day visit – Rs.500/-
(b) Consultation with ECG / Night visit / Emergency visit – Rs.700/-
(c) Physiotherapy charges – Rs.300/- per day
Charges for Operations (maximum) :
| Type | Surgeons Fee | Anesthesia | Theatre Charges |
| Minor operation under LA | – | Rs.5,000/- | – |
| Minor operation under GA | Rs.5500 | Rs. 2500/- | Rs.3000 (fixed) |
| Minor operations | Rs. 17,000/- | Rs. 7,000/- | Rs. 7,000/- (fixed) |
| Supra Major Operations | Rs. 26,000/- | Rs. 9,000/ | Rs. 10,000/- (per hour) |
– Option for Insurance coverage of a single person to be provided.
– All other terms and conditions of the Medical Insurance Scheme as mentioned in the 10th Bi-partite/7th Joint Note which is not explicitly mentioned in this amendment shall continue. Further, it is agreed that the coverages that have been added subsequently in the Scheme shall also continue, subject to the caps, if any, as mentioned herein.
Top-up facilities:- For additional insurance from one lac to Rs.10 Lacs, over and above.
The base policy is to be offered, without above mentioned ceilings.
– Pending formal amendment to the concerned provisions of Bipartite Settlement/Joint Note dt. 25-5-2015, the IBA may proceed with the revised scheme for the Base Policy of Rs. 2 lacs in order to complete the process of RFP, etc., and to finalise the scheme for implementation w.e.f. 1-11-2023.
Signed this day, the 19th of July 2023
For INDIAN BANKS’ ASSOCIATION: Sd..M V Rao, Ashok Chandra, Rajeev Kumar,. Lal Singh, Anupam, Gopal Murli Bhagat,. Brajeshwar Sharma
Workmen Unions: AIBEA, NCBE, BEFI, NOBW, INBEF,
Officers Association: AIBOC, AIOBA, INBOC, NOBO
