GMP for OPD to RBI Pensioners-Delay in reimbursement of claims for spouses

Reproduced below is the letter addressed to RBI Governor on the above subject by RBI New Delhi OERS Optees and Pensioners Welfare Association on 20th April,18

” We express our thanks to the Bank through you for introducing the above scheme for Pensioners above 70 years of age at your own instance particularly considering the dire need for it in view of the financial hardships faced by these pensioners in getting costly medicines as out patients in clinics and hospitals. Although the scheme was officially launched from January 1, 2018, it was circulated vide CO. HRMD. No. G.69 /10631 /19.01.00/ 2017-2018 on November 10, 2017.

However, it will not be a happy augury to note that despite a lapse of about 4 months since the introduction of the scheme, not a single claim pertaining to the reimbursement of the cost of medicines incurred by these eligible pensioners on their spouses has been reimbursed so far. This inordinate delay is being attributed by the Insurance Company to not providing the data of such spouses by the Central Office of the Bank. Insurance company thereafter is required to forward the data to the TPAs to enable them to start processing the claims pending with them.

We are certain that your good self must be unhappy about it as 4 months’ delay is a matter for grave concern for the efficiency of the Bank in supplying the requisite data to Insurance Company, especially when the data was readily available with all the offices of the Bank.  It is all the more a matter for worrying that this inexplicable delay in providing the data to Insurance company that was already available with the offices and now stated to have been transferred to Central office cannot be overlooked causing agony and torture to the persons now over 70 years of age. Rather, it puts a question mark on the scheme itself particularly when it is not a bounty but only a nominal relief in the form of reimbursement of expenses already incurred by the Pensioners.

We shall, therefore, appreciate your response to this aspect and humbly request you to personally look into the matter and direct the concerned Central Office Departments to expedite the matter without any further delay.  In the meantime, let the Bank advise the Insurance Company to process all the claims received by it in respect of spouses of pensioners on the basis of data available with pensioners/ validation forms if already available with the Company.

In no case, such claims should be kept pending for reimbursement as it amounts to hardship and suffering for the pensioners on account of deficient functioning of the Scheme by Insurance Company for which Bank cannot claim immunity as per law being the originator of the scheme duly published and circulated.  

While thanking in anticipation, we hope for positive results in response to this communication.”

Yours faithfully
(V K WADHAWAN)
PRESIDENT