GMP For OPD to RBI Pensioners 70+; TPA cards for spouse and related issues

Subsequent to  our post dated 13th February 2018, regarding issue of  spouse cards, RBREA Chandigarh  have now raised urgent issues about the implementation of the scheme. In their letter dated 12th April,2018 they  have requested the Bank to revisit the scheme.

Some of the issues, among others,  that have been addressed to the Bank are:

1. The scheme should have been extended to all retirees.
2. The work should have been entrusted to the local Medical sections, instead of outsourcing the job to the TPAs at exorbitant premiums to Insurance company and brokers, whose strategy of dilatory tactics  regarding settlement of claims is widespread and insensitivity towards the suffering claimants is extensive.
3. Central office is required to monitor the large scale pendency of claims with TPAs. Bank must  introduce a system wherein reasons for delay/pendency maybe  called for, say MIS (Monthly Information Statment)  showing the details and reasons for pendency.
4. A very large number of claims pertaining to spouses are lying pending with TPAs  since January 18 .This is despite the fact that an assurance was given by the TPAs and the bank  that Claims regrading spouse will be  reimbursed even if cards to spouse has not been issued, on the basis of the existing data of pensioner  and spouse available with bank.
5. As already stated in our earlier post, TPAs have informed that unless data about the spouse is not provided to  them by Central office, they will keep the reimbursement of such claims pending with them, as  the condition of lodging the claim is within 60 days of the treatment.
   This practice of acknowledging the claims and keeping them pending  makes no valid sense to us. Rather,  this practice disregards the  spirit of the scheme and  also breaches  the provisions of the scheme wherein the claims once acknowledged are required to be reimbursed within 15 -20 days irrespective of the fact that whether the claims belong to pensioners or their  spouse. Data issues can be looked into and sorted subsequently and corresponding data entries in the records made afterwards.
6. As per sources, Central office may take another month  to provide the data to the insurance company who are required to transfer the data further to TPAs concerned.

Delay of about four months in providing the data that is already available with offices and has since been transferred to Central office  does not speak well of the functioning  in the Bank. Die hard advocates of the bank  who prefer to  overlook inordinate delays in almost all matters pertaining  to retirees  and shower praises on  the Bank for bringing the scheme on its own, must also consider that a suffering claimant’s account needs  reimbursement that in many cases runs in thousands. Of what use the praise of the bank is to him?

Eulogies may be kept pending for other issues, such as pension update and opening of pension option, where the bank could have acted on its own under the law but is evasive.

A letter in this regard is being  faxed to the Governor.