Discrimination in Room Charges in A Class cities under Group Mediclaim Policy

The Group Mediclaim Policy renewed for the year 2018-19 lays down that the maximum room charges for Floater cover of Rs 40 lks & 50 lks will be Rs 8500 for A Class cities while it will be only Rs 7500 for members covered for lesser Sums Insured.It will not be fair for the members who opted for Sums Insured upto 30 lks as room charges are part of claims and a part of claim quantum cannot be segregated for discrimination based on sum insured.Room tariffs of hospitals are fixed and not variable depending on Insured cover.

This discrimination will also attract violation of provisions of policyholders' protection of IRDAI and cannot stand the test  of regulatory conformance.

Pensioners' organizations need to take it up with LIC Management for negotiation with NIA to ensure that the maximum room charges are kept uniform at Rs 8500 for all sums Insured under Floater cover.

Greetings.

C H Mahadevan