Need for review of Mediclaim Rules for family pensioners

I forward a copy of the mail sent by me today to Chairman, LIC suggesting a change in Mediclaim rules to ensure that spouses who become family pensioners are allowed to be continued under Table B for determining premium on reduction in sum insured allowed on death of regular pensioner.I hope Central Office considers the suggestion favourably.

C H Mahadevan 

---------- Forwarded message ----------
From: Colinjivadi Mahadevan <chmahadevan@gmail.com>
Date: Monday, November 11, 2019
Subject: Need for change in Mediclaim Rules for family pensioners
To: "chairman@licindia.com" <chairman@licindia.com>

Shri M R Kumar,

Chairman,

L I C of India,

Mumbai

Dear Sir,

                                        Re:Need for review of Mediclaim Rules for family pensioners

As per the present rules of the Mediclaim Scheme, spouses are included as  secondary members covered by the Family Floater cover with special consideration of a reduced premium under Table B for the sums insured opted for by the retiree- pensioners under Family Floater cover.It works well as long as the regular pensioner is alive.

Once the retiree-regular pensioner unfortunately dies,although the family pensioner is allowed to opt for reduced sum insured proportionately as per the CO circular date 23/9/2017, she will be required to migrate in the Scheme  as   primary member to Table A for the purpose of determining Mediclaim premium because her status changes to that of a spouse of the deceased retiree thus resulting in her having to pay a much higher premium even for the reduced sum insured.

This creates enormous burden on the family pensioners of having to pay a much higher Mediclaim premium despite getting a much reduced pension compared to that which was being paid to the retiree in the scheme of things.

For your ready reference,I attach an illustrative calculation in respect of retired officers  of the various periods of retirement in the cadre of ADM who would have opted for a Family Floater cover of Rs 40  lks and in respect of spouse-family pensioners who opt for a reduced sum insured of Rs 20 lks on death of the regular pensioner.

It will be observed from the illustration that for the various generations of family pensioners in the age slabs of 66 and above,while the family pensioners have to suffer a reduction in gross pension  between 64% to 70% compared to that earned by the regular pensioner,the Mediclaim premium increases by 117% to 130% compared to subsidized premium payable as per Table B.

This is only  illustrative and such a trend will definitely obtain for the various cadres and different sums insured. 

If the dependent spouse unfortunately  predeceases the regular pensioner, the pensioner can opt for proportional reduction in sum insured while continuing to get his normal pension .The family pensioner is at a disadvantage because of the rules requiring their migration to Table A rates from Table B rates in the face of a much lesser  monthly family pension amount at her disposal.

It is therefore my humble suggestion that on the death of the regular pensioner,the family pensioner should be allowed to  continue to pay the premium as per Table B  on the reduced sum insured instead of enhancing the premium under Table A.It is also significant to note that family pensioners constitute 34% of total pensioners and the proportion is steadily increasing year after year.This means that increasing number of family pensioners are likely to suffer if the present rules are not modified.

Kindly consider my suggestion to remedy the situation.

Thanking you,

Yours sincerely,

C H Mahadevan

https://drive.google.com/file/d/1-mf9IFGabYuHwuOf3cjxwOko7ZatBqgq/view?usp=drivesdk