ADVISORY : PERSONAL ACCIDENT INSURANCE COVER TO SBIDSP ACCOUNT HOLDER

Transcription

1 ADVISORY : PERSONAL ACCIDENT INSURANCE COVER TO SBIDSP ACCOUNT HOLDER 1. As part of MoU with Indian Army, all Defence Salary Package(DSP) Accounts holders have been provided benefits of free Personal Accident Insurance (PAI) Death cover by SBI. 2. The agencies involved for providing PAI Cover on behalf of SBI in last three years is as given below:- (d) From 04 Jan 12 to 03 Jan 13. United India Insurance Company Ltd (e) From 04 Jan 13 to 03 Jan 14. New India Assurance (f) From 04 Jan 13 to 03 Jan 14 Reliance General Insurance Company Ltd (RGICL) 3. Insurance cover for DSP Account holders under the new policy of PAI is as under:- Variant PAI Purchase Protection Applicable to (Card Holder) (Rs in Lakhs) Cover (in Rs) Silver 3 Rs. 5,000/- JCO/OR Gold / Diamond 5 Rs. 5,000/- Offrupto Col Platinum 10 Rs. 5,000/- Brig & Above 4. The Free PAI cover and Purchase protection cover will be governed by the following:- (a) The PAI (Death) Cover will be available only for death due to an accident. (b) The PAI (Death) Cover will be available ONLY to Salary Package Accounts where at least two months salary is credited to the account preceding the date of the incident. (c) The policy will be for existing as well as new Salary Package Account holders and on ATM card issued to Salary Package Account holders. (d) Insurance cover will be available to all the Salary Package Account holders from the date of opening/conversion of accounts under Salary Package and valid ATM cardholders of the Salary Package Accounts from the date of the delivery of the card. (e) Only Primary Account Holders of Salary Package accounts are covered. (f) In case of multiple accounts related to a single CIF, ONLY ONE account where salary is credited will be taken into consideration. (g) policy (h) (j) Pensioners of DSP as well as joint account holders are not included under this Death due to Terrorist action is included. The Claimant on Death of the primary Salary Account holder shall be: (i) The nominee, registered with the bank for the SB account held in single name. (ii) In case of accounts having more than one name, the surviving account holder/s would be the claimant(s)/beneficiaries for the purpose of insurance claim.

2 2 5. Intimation of Incident. In the event of death of the Salary Account holder, intimation as per Annexure 3 of Appx attached is to be given by Claimant to RGICLwithin 90 Days of the incident. (a) The intimation is to be sent on the following address:- Reliance General Insurance Co. Ltd., to 337, 4 th Floor, Sagar Plaza, Abids Road, Hyderabad Andhra Pradesh rcarehealth@rcap.co.in Toll free Number: Fax: (b) Intimation can be by tele, or fax. The following details are to be provided when giving information:- (i) (ii) (iii) (iv) (v) Name of the deceased salary packaged account number. SBIsalary package account number. Date of accident. Cause of accident. Place of accident. 6. Submission of Claim. The claim to be submitted as per Annexure 4 of the Appx attached within 90 Days after the date of intimation of incident alongwithdocus as mentioned below (Also ref Para 5 of Annexure 2 to appxatt):- (a) (b) (c) Attested copy of Death Certificate. Attested copy of police report and F.I.R. Attested copy of Post Mortem Report. (d) Cert by the Home Branch of the Salary Package Account as per Annexure 5 (e) Cancelled cheque leaf of claimant s Bank account/ Photo copy of the first page of the Bank Pass Book containing the name of account holder, Bank account number, IFS code (f) NEFT form containing details of claimant s Account Number (i.e. Bank, Branch, Account No, MICR Code No, and IFSC No) as per Annexure 6 certified by claimant s Bank, for the purpose of payment in respect of settlement of claim.

3 3 (g) PAN card copy of the Claimant. If PAN card copy is not available, then form 60 may be submitted. (h) Other suitable document to prove legal heirship in case claimant is not a nominee/joint account holder as per Bank s record (j) For Armed forces, Defence authority report in case FIR is not available. (k) Additional requirement: Viscera Report / chemical analysis report in case where post mortem report shows the cause of death due to poisoning or alcohol or any substance abuse. 7. The contact details for submission of claim are as given above in para5. 8. The other conditions and guidelines in detail are given in SBI letter NO PB/C&17U/2008 dated 27 Jan (Copy enclosed as Appx) The claimant in also suggested to approach dealing SBI branch maintaining the DSP Account of indl for necessary guidance. 9. It has been viewed that claimants are still forwarding their claims to older agencies, thereby missing on crucial period of intimation. This is leading to non admissibility of the claim amount and causing financial loss to the grieved NOK. It is therefore requested to disseminate the above mentioned information to all formations and units under command at the earliest so that necessary action can be taken accordingly in case of any untoward incident.

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6 Annexure 2 PERSONAL ACCIDENT INSURANCE DEATH COVER (PAI) AND PURCHASE PROTECTION COVER (PP): CLAIM PROCESS Policy Number: Personal Accident Insurance (Death) Purchase Protection A) FOR ACCIDENTAL DEATH CLAIMS 1. The claim process consists of 2 stages : a) Intimation of death b) Submitting the claim forms 2. In the event of death of the Salary Package account holder, an Intimation as per Annexure 3 is to be given by the claimant to RGICL within 90 days of the death of the customer. The intimation of death of Salary Package Account holder can be sent to the following address: Reliance General Insurance Co. Ltd., to 337, 4 th Floor, Sagar Plaza, Abids Road, Hyderabad Andhra Pradesh rcarehealth@rcap.co.in 3. The intimation can also be given through the following channels: a) Call RGICL call centre on Toll Free Number b) Fax complete claim intimation form (Annexure 3) to c) complete claim intimation form (Annexure 3) to rcarehealth@rcap.co.in (The following details are to be provided to on toll free number a) Name of the deceased salary package account holder b) SBI salary package account number c) Date of death d) Date of accident e) Cause of accident f) Place of accident 4. Immediately on registering the claim, a reference number would be advised to the claimants by RGICL. 5. The claimant shall submit the claim as per Annexure 4 to the address mentioned under para 2 above, within 90 days after intimation of death with the following documents: a) Attested copy of Death Certificate b) Attested copy of police report and F.I.R. c) Attested copy of Post Mortem Report.

7 d) Certificate by the Home Branch of the Salary Package Account as per Annexure 5 e) Cancelled cheque leaf of claimant s Bank account/ Photo copy of the first page of the Bank Pass Book containing the name of account holder, Bank account number, IFS code f) NEFT form containing details of claimant s Account Number (i.e. Bank, Branch, Account No, MICR Code No, and IFSC No) as per Annexure 6 certified by claimant s Bank, for the purpose of payment in respect of settlement of claim. g) PAN card copy of the Claimant. If PAN card copy is not available, then form 60 may be submitted. h) Other suitable document to prove legal heirship in case claimant is not a nominee/joint account holder as per Bank s record i) For Armed forces, Defence authority report in case FIR is not available. j) Additional requirement: Viscera Report / chemical analysis report in case where post mortem report shows the cause of death due to poisoning or alcohol or any substance abuse. 6. Claimant will submit claim with relevant documents mentioned under Para 5 above directly to RGICL. The claimant must mention the system generated Claim Number/ Salary Account Number while sending the physical documents. The claim number or account number can be used for any further follow up with the RGICL claim department. 7. However in exceptional cases, if the claim application is received by the branch having the Salary Account, it will be forwarded to RGICL for processing at their end and a copy of the same will be endorsed to the claimant to enable him/ her to pursue subsequently with RGICL. 8. The total period for intimation and claim submission is 180 days maximum i.e. period for intimation + claim = = 180 maximum 9. RGICL will settle claims independently without the involvement of the Bank. The Bank will not be a party to any dispute between the claimant and RGICL. 10. Subsequent correspondence shall be between the claimant and RGICL. 11. All claims shall be entertained by RGICL where accident has occurred within the period of policy and death has occurred: a) within the period of policy or b) after the expiry of policy B) FOR PURCHASE PROTECTION COVER CLAIMS 1. The claimant has to intimate RGICL on discovery of theft or burglary (within a maximum of 10 days by calling RGICL call centre on Toll free No Following information to be provided while intimating the claim : a) Name of the Insured (Salary Package Account Holder) b) Address c) SBI Salary Package account no

8 d) ATM Card No e) Date of loss f) Details of items lost g) Place of loss h) Contact number and address of salary account holder 3. The unique claim number generated by the system and advised on the toll free number should be provided as reference number on all further correspondence/ communication with RGICL. 4. The claimant should submit the following documents for claims: i. Claim Form as per Annexure 8 duly filled and signed by the claimant ii. Attested copy of F.I.R. iii. Original Cash Memo iv. Charge slip indicating purchase of stolen goods was made through ATM Card v. Original cancelled cheque of bank account on the name of the claimant or NEFT form (Annexure 9) of claimant. 5. The claimant should submit the claim together with documents mentioned under para B(4) above to the following address : Reliance General Insurance Company Limited, 210, Sai Infotech, R B Mehta Marg Patel Chowk, Ghatkopar (East) Mumbai The purchase protection will be available up to 60 days from the date of purchase excluding perishable items if purchase takes place within the policy period. 7. Bank will not be a party to any dispute between the card holder and RGICL. Such claims will be settled on production of the bill of purchases made using Debit Card and the declaration by the card holder. C) Forms: forms/ certificates and respective Annexures are: Cover Forms/Certificate Annexure No. PAI Claim Intimation Form Annexure 3 PAI Claim Form Annexure 4 PAI Branch Manager s Certificate Annexure 5 NEFT Form for the Claimant Annexure 6 (for internal use) Annexure 7 PP PP Claim Form Annexure 8 NEFT Form for the Claimant Annexure 9

9 D) Settlement by Insurance Company. 1. Claimants will submit claims either directly to RGICL or through Branch of the Bank concerned. 2. On receipt of the claim, RGICL will send an acknowledgement to the claimant/sender. 3. RGICL will, on receipt of complete set of documents, process the claim. Any requirement/deficiencies in the documents submitted, shall be sought by RGICL within 10 working days of receipt of the claim. 4. All the documents being in order, RGICL will settle the claim within 15 working days from the date of receipt. 5. All the correspondence related to claim will be directly taken up by RGICL with the claimant. Branch can be a facilitator. 6. All the settlement/ disputes will be between the claimant and RGICL and the Bank will not be a party to such disputes and shall have no liability whatsoever in respect thereof. 7. RGICL will settle claims independently and the claim settlement will be entirely the responsibility of RGICL. Bank will not be a party and have no liability towards any claim/dispute between the claimant and RGICL. 8. In case of any delay RGICL shall pay interest as per IRDA Norms. 9. Status of the claims in process can be sought from any one of the following channels by quoting the system claim number obtained after lodging of claim : Sl. Channel Details No 1. RGICL s call Toll free No centre 2. Message Claimstatus<space><claim number> to RGICL Toll free No Claim reference No to rcarehealth@rcap.co.in 4. Website Navigation: Under Claim Junction tab>write claim number>click -Track Now

10 10. Grievance in Claim settlement: If the claimant has a grievance that he/she wants the Insurer to address, he/she may contact the insurer with the details of his grievance though: Sl. Channel Details No 1. services.rgicl@rcap.co.in/ 2. Telephone Letter Address: Reliance General Insurance Co. Ltd., to 337, 4th Floor, Sagar Plaza, Abids Road, Hyderabad Andhra Pradesh 11. The Claim escalation matrix for PAI (Death) and PP claims are as under: CLAIM Level Name ID Mobile No. PAI 1 st Yaksharaaj Vengala yakshraaj.vengala@rcap.co.in (Death) 2 nd Akula Ventateshwara Rao venkateswara.akula@rcap.co.in rd Akansha Chaudhary akansha.chaudhary@rcap.co.in th Mahesh Yelapure mahesh.yelapure@rcap.co.in PP Anupam Shukla Anupam.shukla@rcap.co.in The details of Insurance ombudsman are also available on IRDA website: and on website of General Insurance Council: and RGICL s website.

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