APSEB ENGINEERS' ASSOCIATION
(Regd.No.874/1975), HQ: Vijayawada
&
APSEB AEEs' ASSOCIATION
(Regd.No.1185/1977), HQ: Vijayawada
APSEBEA Vijayawada,
To
President
Dt.06.03.2024.
The Chairman & Managing Director,
Er. N. Samuel APTRANSCO,
Mobile: 9515977777
Vidyut Soudha, Vijayawada.
Associate President
Er. K. V. Rama Rao Respected Sir,
Mobile : 9493120004
Sub: APSEB EA & APSEB AEEA - Group Mediclailm Insurance Policy to all
Secretary General the Employees/Pension ers of AP Power Utilities - Request to convene
Er. K. Naga Prasad a meeting for implementation - Reg.
Mobile : 9491045380
Ref: Lr.No. Addl.Secy./DS(L,IR&Reg)/AS(M&P)/PO(Med )/Insurance-51/
22, Dt.12.02.2024.
Addi Secretary General
Er. D. Nagaraju ***
Mobile : 9440811915 The APSEB EA and APSEB AEEA are thankful to the management for
arranging "an awareness program and a meeting for doubts clarification on
Group Medic/aim Insurance Policy by AP Urban Infrastructure Asset
APSEB AEEA
Management Limited on 16-02-2024 & 05-03-2024 respectively at Vijayawada
for implementing the Group Mediclaim Insurance Policy to all
President
Employees/Pensioners of AP Power Utilities.
Er. 8. Suneel Dutt
Mobile: 98855 02235
In this regard, it is to submit that the sample terms of a Mediclaim Policy
provided by AP Urban Infrastructure Asset Management Limited are acceptable
Associate President
and a copy of the sample terms of the Policy is herewith enclosed for your kind
Er. G. Mallikarjuna
information. Further, it is to submit that the management of AP Power utilities
Mobile: 9440812175
have assured in many occasions to implement the cashless medical policy to all
General Secretary employees.
Er. S. Prathap
In this connection, it is requested to arrange to convene a meeting for
Mobile: 9493123695
finalization of Group Mediclaim Insurance Policy at the earliest.
Asst General Secretary
Er. A Murali Yours faithfully,
Mobile:94927 40789
1~,J-
(K. Naga Prasad)
/APSEBAEEA Secretary General/APSEB EA
Copy Submitted to:
The Special Chief Secretary/Energy Department/Govt. of AP/Velagapudi
The Managing Director/APGENCO/VS/Vijayawada
The Chairman & Managing Director/APEPDCL/Visakhapatnam
The Chairman & Managing Director/APSPDCL/Tirupati
The Chairman & Managing Director/APCPDCL/Vijayawada
I
Coverage, Sum insured & other Terms & Conditions of Group Mediclaim Policy
SI. Description
Coverage .. r 1 ·.•"... .. ; • , ,,. - .. ..y~• . '
No
Regular/ Deputation/ Contract/ Outsourcing Emplol'.ees: Self+ Spouse
Family Size/ +Dependent Children + Mother/ Mother-in-law + Father/ Father-in-law
1 ( l +5), (3 rd & 4th Child if any)
Definition
Retired Emplol'.ees: Self+ Spouse ( l + l)
I
Familv~·Pernsfori~'rs:"S~ff''orily )•"6 • •; r
2 Family Floater Sum
Rs. 4,00,000/- + Rs. 6,00,000/- (From Corporate Buffer)
Insured
Total= Rs. 10,00,000/-
Rs.6,00,000/- Per Family. (upon exhausting the Family Sum Insured, the
Corporate Buffer will be allowed and does not require any prior approval)
3 Corporate Buffer - • • • • . ,. . . . . .-. ·" ... • ...-i , ........ , . . . . ._ •• , •• -- •
Organisational Level Corporate-Buffer Sum Insured:
Rs. 20 Crore for all Power Utility Families. It may be noted that the
Insurance Companies charge about 15%+GST for Corporate Buffer.
i. Self (Other than retired employees): Up to 60 years complete. Age of
Regular Employees (Self) is being taken as 62 for those employees
Who confinue-t61Se-rrrservice of the corporation by virtue of a Court
Judgement/ Order/ Decree. Respective employee's dependents shall
also be covered in line with other regular employees.
ii. Self (Retired Employees): No Limit
4 Age limit
iii. Dependents: No Limit
iv. Male the children up to age of. 25 years-to be covered.
V. No age limit for mentally challenged & physically handicapped
children.
vi. In the case of female child, covered till marriage.
vii. Some employees who have more than 2 children, all such
DEPENDENT children be covered within Family Sum Insured.
Room rent Iim it as a
5 percentage of Family As per actuals
Sum Insured
6 Pre-existing diseases Covered
Waiver of time limits ... ..,__ I ,,... ,. ' - "' ..
- 30d Days/ l st Year
7
/ 2nd Year/ 3rd Year/ Waived I•
4th Year Waiting
Periods
Maternity with
8 waiver of 9 months . - ....... - . .. - . .-
waiting period
9 New-born Baby from Covered
day one
Pre & post-Natal
10
expenses: within
maternity limit
Pre & Post
11
Hospitalization: 30 & Covered
60 Days
12 Rs. 2,500/- Per Incident/ Hospitalisation within city limits and for out of
Ambulance Charges
city as per actuals.
13 Domiciliary Covered
hospitalization --
14 Covered
Day care procedures
--
15 Expenses pertaining
to Organ Donor No limit
16 Hernia &
Hysterectomy No Limit
17 Cataract Coverage
(Per Eye) Rs. 40, 000/- per eye
18 Ailment Capping &
No Ailment Capping, No Sublimit
Sublimit
19 Critical and Terminal
Covered without sublimit
Illness
20 Congenital diseases Covered [Both internal & External]
Dental Treatment Per Family Limit: No Limit. However, expenditure above Rs. 25,000/-
21
(Other than should be approved by the HR Department. [From Special Pool Amount]
Accidental):
22 Dialysis Covered without sublimit
Per Family Limit:
23 Hearing aids under
As per actual
ENT
[From Special Pool Amount] .
• 24 Skin related Subject to minimum 24 hours hospitalization.
•• treatments
-
t
I
= 25 Psychiatric Illness Covered
....•
E
26 AYUSH treatment to Covered as per Standard Group Mediclaim Policy
I
be covered
_. •
Additions to be On Prorata Basis
27 Included in the policy
during the Policy
period
Dependents missed To . be- informed to the insurance company within 180 days from the
28 out due to clerical commencement of policy for Final Declaration of Lives
mistake/ data entry
error or oversight
90 Days for Intimation
Intimations and 180 Days for Submission of Documents.
29
--..
Submissions Clause To be implemented itf the letter and spirit of IRDA/ HLTH/ MISC/ CIR/
216/ 09/ 2011 Dt.20.09.2011
Regular Employees: Any of the family member/s
Annual
30 Retired Employees: Self and Spouse.
(Comprehensive)
Per Family limit:Rs. 5,000/- Per Family within Family Sum Insured
Health Check-up
rFrom Special Pool Amountl
I .Any specific requests from the Corporation/ Management to include the
31 Others Board of Directors of the Corporation.
2.Reasonable & Customary clause applicable
'
32 Special pool Amount Rupees I 0.0 Crores.
.. • ,> .. .:, .. 1• ..t'>...·-./"'-' .,..-11..,,. .,
All/Any
33 Exclusions/Non- To be met from Special Pool Amount
Surgicals etc.,
NOTE: The above proposal is tentative. If any points needed will be
included in the polt~Y. b~J~lt~..fltA~.U~it~Pn. .,,
