Agency Section, Marketing Department, 3° floor, Central Office, “Yogakshema”, Jeevan Bima Marg, Mumbai 400 021 Ph: - (022) ~ 66598333, 8334, e-mail: [email protected] Ref: CO/Mktg./ZD/A/11/PY 2024-25 Dated: 10.05.2024 To, All HODs of Central Office All Zonal Offices, All Divisional Offices, All Branch Offices & Satellite Offices Audit & Inspection Departments ZTCs & STCs Re: _ Group Personal Accident and Disability Benefit Scheme for Agents - Policy Year 2024-25 This is further to the circular letter Ref: CO/Mktg,/A/GPAS/PY 2024-25 dated 03.05.2024 regarding the captioned matter. The Group Personal Accident and Disability Benefit Scheme for the Agents of the Corporation has been renewed w.e-f, 01.05.2024 (for the period 01.05.2024 to 30.04.2025) with The United India Insurance Co, Ltd,, 020500/DO5, Rohit Chambers, 5th floor, Janmabhoomi Marg, Fort, Mumbai-400001. ‘The salient features of the scheme are as follow: The Policy Number is 0205004224P101593076 ‘+ The Master Policyholder shall be Executive Director (Marketing). ‘+ The Scheme is fully subsidized by the Corporation. ‘© The Coverage is for Sum Assured of Rs.2,00,000 for all eligible Agents. ‘+ The Scheme has been renewed with A.R.D. 01.05.2024 for the Policy Year 2024-25 Benefits covered under the Scheme: 1. Coverage of Death due to Accident. 2. Coverage of Permanent Total Disability (PTD) due to Accident. 3. Coverage of Permanent Partial Disability (PPD) due to Accident Eligibility conditions for Coverage under the Scheme:- 1. All Agents who were In-force and Active for the previous financial year are eligible for coverage under the Scheme, for example, an Agent whose agency was In-force and Active as on 31,03,2024 shall be eligible for the coverage under Policy Year 2024-25. The conditions for eligibility shall be applicable for the Policy Year 2024-25 and can be changed by the Competent Authority in the subsequent years. 2. All Exempted Agents need to be Active in the previous financial year in order to be eligible for the coverage. Page | 1Agency Section, Marketing Department, 3+! floor, Central Office, “Yogakshema", L Jeevan Bima Marg. Mumbai 400 021 Seagate on Ph: - (02) ~ 66598333, 8334, Tae e-mail: [email protected] 3. To avail claim under the policy, status of the Agency should be In-force at the lime of occurrence of the contingent event. The Agents’ against whom any Disciplinary proceeding is in process, or being contemplated at the time of the incident, shall be excluded from the scope of this scheme. o . The agent against whom the Disciplinary proceeding is disposed-off during the current Policy Year shall be included in the schome from the next policy year, subject to fulfillment of eligibility conditions as on 31* March of the Qualifying Financial Year. e.g. Agent against whom the Disciplinary proceeding is disposed-off during the P.Y. 2024-25 shalll be covered under the scheme from the next Policy Year i.e, 2025-26. 6. No addition/entries to the Scheme is allowed during the PY. The agents Reinstated/Reappointed/Newly Appointed during the Policy Year shall become eligible for coverage under the scheme from the next policy year, subject to fulfillment of eligibility conditionsas on 31 March of the Qualifying Financial Year. £.g, Agent Reinstated/Reappointed/ Appointed during the P.Y 2024-25 shall be covered from the next Policy Year i.e. 2025-26. ‘Various Annexures related to implementation of the Scheme: 1. The major benefits under the Policy are as per Annexure -I & IT 2. Personal Accident Claim Intimation Form Annexure -III 3. Personal Accident Insurance Claim Form Annexure -IV 4. KYC Form Annexure -V 5. Nodal Officer Certificate as per Annexure -VI 6. The procedure for claims and checklist of documents to be submitted for availing the claim and Grievance Redressal, as provided by the Insurer, is given in Annexure VIL 7. Terms & Conditions of the Policy No. 0205004224P101598076 as provided by the insurer for ARD 01.05.2024 are attached as Annexure VIII. Procedural Aspects: With a view to ensure that the beneficiaries of the Policy are well-informed regarding the Terms and Conditions of the Policy, all Branch Offices should be advised as under:- * The Terms and Conditions of the Policy should be mandatorily and prominently displayed on the Branch NOTICE BOARD throughout the Policy Year. * All eligible Members covered under the Scheme for the Policy Year 2024-25 should be communicated officially (by e-mails, Whatsapp messages, SMS messages, etc.) regarding their inclusion in the Scheme and advising them to be in touch with the respective Branch Offices for obtaining the Terms and Conditions and all relevant documents related to the Policy. Page | 2Agency Section, Marketing Department, f 3+ floor, Central Office, “Yogakshema”, LIC Jeevan Bima Marg Mumbai 400 021 Phi - (022) ~ 66596333, 8334, e-mail: [email protected] ~ The Branch In-charge of the respective Branch Office shall be the Nodal officer for the Scheme. ‘The Nodal Officer shall receive the intimation of contingency event from the claimant and forward it to the Insurer within 30 days from the date of occurrence of contingency. Hence, it is essential that all the eligible agents of the branch office are well informed about the sanctity of time lines. * The Nodal Officer has to ensure that all the documents as per check list mentioned in Annexure VII are received from the claimant within 70 days from the date of confirmation of Death/Disability. All these claim related documents received from the claimant, duly attested by the Nodal Officer, should be forwarded to the Insurer at the address mentioned in salient features of the Policy, within 90 days from the date of confirmation of DeatlyDisability, along with the Nodal Officer's Certification (Annexure VD), failing which the claim shall not be admissible. * Please ensure that the Claim Form is duly filled in with correct address, contact number, email id and updated NEFT details and all relevant enclosures to avoid any delay. © Copy of the Nodal Officer's Certificate should be properly filed in the branch records, so that it can be made available, as and when called for. ‘* AO (Gales) at the Divisional office shall be the Monitoring officer at Divisional level to administer the Scheme and keep liaison with their respective Branch Nodal officers and the office of the Insurer. It will be the responsibility of the Divisional Monitoring Officer i.e. AO (Sales), to obtain a confirmation from all the Branch Offices under their jurisdiction regarding compliance of the above instructions. Please nol ‘ In any case, no claim documents should be sent to Central Office. % The copy of the Nodal Officer's forwarding letters addressed to the Insurer should not be marked to Centre ffice Marketing Department. You are requesipd to co the above to the notice of all concerned. Executive Director Cv & CMO Enel: Aner ~ Major benefits under the Policy Annexure III - Personal Accident Claim intimation Form Annexure IV Personal Accident Insurance Claim Form Annexure V_-KYC Form Annexure VI - Nodal Officer's Certification Annexure VII - Procedure for claims and checklist of documents Annexure VIII - Terms & Conditions of the Policy Page | 3