Terms of reference for eoi (expression of interest) and /or RFP (request for proposal)

Terms of reference for eoi (expression of interest) and /or RFP (request for proposal)

We solicit expression of interest and detailed proposals for providing health insurance coverage to all the retired bank employees.

What we provide and guarantee:

1. All the relevant particulars such as professional details, date of birth and age, health history, pre existing debilities and health issues, habits etc. including contact details

2. A single remittance will be made for the entire premium

3. AVERAGE AGE OF THE GROUP MAY BE 70 /71 YEARS. 

TERMS OF REFERENCE AND WHAT DO WE NEED

1. We look forward towards a health scheme instead of health insurance coverage, with sum assured, to pup, super top up. In Case any organization wishes to be specific about sum assured, the same may be taken as Rs15. lakhs

2. ALL THE INSURED WILL BE A HOMOGENIOUS GROUP OF BANK RETIREES.

3. Insurance service provider shall have a wide network of hospitals and the entire treatment shall be under CASHLESS.

4. RIGHT FROM AMBULANCE, AMBULANCE SERVICES INCASE OF SHIFTING, REGISTRATION, CONSULTATION, SPECIALIST'S CONSULTATION, INVESTIGATIONS, DIAGNOSIS, TREATMENT BOTH AS IN PATIENT AND AS AN OUT PATIENT, MEDICINES, FOOD AS PRESCRIBED BY THE DIETICIAN, PRE HOSPITALISATION AND POST HOSPITALISATION AS PRESCRIBED BY THE MEDICAL PROFESSIOANL.

5. That is we need a comprehensive health scheme, where the insured will just go flash his id card issued by the insurer and he shall be provided the complete and com prehensive health care, which includes treatments like physiotherapy etc.

6. Only retired and his spouse are entitled for the coverage

7. Hospital network shall be pan india, which includes semi urban/urban and metropolitan

8. Annual free medical check up

9. Non traditional Indian medicine / alternative medicine shall also be covered

10. PRE EXISTING DISEASES TO BE COVERED FROM DAY ONE

11. NO EXCLUSIONS AND NO RIDERS

12. All the bills to be vetted by the patient and/or his/her assistant and a copy of the bill shall be sent to the association

13. No brokerage / commission shall be payable. If proved at a later date that such brokerage and or commission are paid, insurer shall be penalized for criminal breach of trust and shall refund the entire premium and services shall be provided during the currency of the policy.

14.  Life time renewal of the policy shall be ensured and guaranteed with a maximum hike of not more than 15% per annum on the previous premium paid. 

15. In case closure of the organization or such any eventuality, insurer must indemnify and foot 50% of the premium for the ensuing year before closure of the organization

16. Incurring the expenditure and claiming shall be dispensed with.

17. In case of non availability of network hospitals, insured may be permitted treatment with non-network hospitals and separate conditions may be stipulated for the same.

18. Organ transplantation is also included. IN ONE WORD IT SHALL BE A COMPREHENSIVE AND COMPLETE POLICY. INSURER IS AT LIBERTY TO FIX UP THE PRICE OR COST RANGE FOR ANYTHING AND EVERYTHING WITH THEIR RESPECTIVE NETWORK HOSPITALS AND IT SHALL NOT BE BINDING AND PREVENTIVE TO THE INSURED.

19. MEDICAL AIDS SUCH AS ARTIFICIAL LIMBS / SPECTS ETC HEARING AIDS ETC SHALL ALSO BE INCLUDED.

20. Foreign treatment wherever certified as advised and necessary a separate premium and conditions may be proposed.

21. ALL INCLUDING DENTAL SHALL BE COVERED AND ALTERNATE MEDICINE TOO TO BE ELIGIBLE.

22. Hyderabad shall be the jurisdiction for all the litigations. Arbitrator's or IRDAI's decision is final in case of any litigation

ALL HEALTH CARE ORGANIZATIONS, INSURANCE SERVICE PROVIDERS, those who are interested may please furnish their proposals with their profile and unconditional acceptance to the above terms and conditions and with an undertaking that  TPAs appointed shall be for the convenience of the insured and insured shall nto be put to any hardship.

All the proposals with their respective financial quotes shall  reach THE FOLLOWING ADDRESS ON OR BEFORE 30TH September 2023

ALL INDIA BANK RETIREES FEDERATION FOR HEALTHCARE AND WELFARE,  HYDERABAD

YSC BABU 9059563258  EMAIL ID saratprclgmail.com

Time line

Last date to submit proposal        30.09.2023

Scrutiny and L1 to L3 finalization and communication     04.10.2023

Draft policy submission by                                          06.10.2023

Finalization of list of proposed for insurance coverage and total premium to be paid 11.10.2023

Last date for payment of premium           31.10.2023

Insurance coverage       01.11.2023 to 31.10.2024

Delivery of policy document, ID cards, List of network hospitals, Letters of authorization directing the network hospital s with the procedure to be followed in  the case of present group of insured, shall reach the individual email IDS of insured and the association as well by 31.10.2023 duly mentioning therein that in case of non payment or non receipt of premium that particular individual's account shall be treated invalid.