Section 15 in The Life Insurance Corporation Of India Development Officers (Revision Of Terms And Conditions Of Service) Rules, 1996

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Union of India - Section

Section 15 in The Life Insurance Corporation Of India Development Officers (Revision Of Terms And Conditions Of Service) Rules, 1996

15. Medical benefit. - This is as per circular of Central Office, Dept. of Personnel/ER. Ref. 3841/ASP/96, dated 2nd December, 1996 issued by the Chairman in exercise of the powers conferred by Regulation 4 read with Regulation 81-A of LIC (Staff) Regulation 1960.

A scheme is introduced applicable to Class I Officers and Class II Officers (Development Officers) as a reimbursement of medical expenses in respect of domiciliary treatment of which the salient features are as under--

(i)The Officer, his wife and maximum two dependant are covered.

(ii)'Dependant' includes legitimate child of the Officer who, in case of a male child, should have not completed 21 years of age or 25 years of age if studying (whole time) in a recognised educational institution and in case of a female child, should be unmarried and if widowed or divorced, should be residing with the officer. Further, the dependant should not have an earned income of over Rs. 500 per month.

(iii)Domiciliary treatment means treatment by a recognised medical practitioner who may be an allopath, homoeopath or ayurvedi; but does not include hospitalization, domiciliary hospitalization, convalescence or maternity care.

(iv)Monthly contribution by the officer shall be as under Class I officers are divided in two categories; category 'A' includes Officers with basic pay exceeding Rs. 8,280, category 'B' includes Officers with basic pay upto Rs. 8,280.

Class I Officer	Development Officer
Category A	Category B	Self only with family
Self only Rs. 5.00	with family Rs. 10.00	Self only Rs. 3.50	with family Rs. 7.00	Rs. 3.50	Rs. 7.00

(v)The coverage is divided in two parts (a) Dental treatment and non-surgical eye treatment; (b) other treatment.

(iv)The limit of benefit shall be as under :-

	ClassI Officers of Category 'A'	ClassI Officers of Category 'B'	DevelopmentOfficers
	(ForDental treatment and non-surgical eye treatment)
Permember	Rs.300	Rs.200	Rs.200
Forfamily	Rs.1,200	Rs.800	Rs.800
	(Forother treatment)
Permember	Rs.450	Rs.270	Rs.270
Forfamily	Rs.1,840	Rs.1,080	Rs.1,080

(vii)Claim can be made by the officer in respect of any one member equal to double the amount per member or part thereof but the total claim shall not exceed the limit for family.

(viii)The year for this scheme commences from 1st July and concludes on 30th June every year.

(ix)The full or any part of the limit of benefit, if not availed by the officer, such balance amount is permitted to be carried forward to immediate next year.

(x)On every claim submitted, the officer himself shall bear 10% of the same. It means the Corporation shall reimburse the expenses less by 10%.

(xi)The claim must be submitted during the period of treatment or within 30 days from the date of completion of treatment on a prescribed form enclosing therewith (i) the prescription of the treating medical practitioner; (ii) receipts of the chemist; (iii) reports of the laboratory test with receipt.

(xii)The reimbursement is allowed to the expenses for which treatment is undergone in India only.

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Union of India - Section

Section 15 in The Life Insurance Corporation Of India Development Officers (Revision Of Terms And Conditions Of Service) Rules, 1996

15. Medical benefit. - This is as per circular of Central Office, Dept. of Personnel/ER. Ref. 3841/ASP/96, dated 2nd December, 1996 issued by the Chairman in exercise of the powers conferred by Regulation 4 read with Regulation 81-A of LIC (Staff) Regulation 1960.