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Rupali Life Insurance Co. Ltd

        Group Insurance Plan

Group Insurance is a cost effective way of providing protection against the financial loses caused by death, disability or retirement to a group of individuals who are associated with the policyholder by some common relationship other than insurance.

Rupali Life offers group insurance schemes to various groups such as Employer-Employee, Professionals, Co-operatives, NGOs,  etc. The main feature of the schemes are low premium, simple insurable conditions such as employee not being absent from duty on grounds of ill health on the day of entry, and easy administration by way of issue of a single master policy covering all the employees/members. Group insurance is usually a service benefit provided by the employer to its employees.

Who can take the scheme?

Any organization, institution, Professionals or NGO having at least 10 employees/members can take a group insurance scheme.

How the Employer Benefits?

Most employers instituted provide group life/hospitalization insurance as a service benefit. by providing employees student, beneficiary with a plan of group life/hospitalization insurance coverage, an employer derives the following benefits:

Ø It contributes to employee morale and productivity.

Ø It helps to recruit and retain employees.

Ø Employer can obtain a Tax deduction for the cost of contributing to   the plan.

Ø Employer’s public and employee relation image is enhanced.

How the Employee, S Benefits?

Individuals and families have a great need for life and health insurance plans. Unfortunately, many people are unable to purchase individual coverage because of preexisting medical conditions and/or the high cost of purchasing insurance. Therefore, many people rely on employer- sponsored plans as their sole source of life and health insurance. An employer sponsored plan provides the following benefits for employees:

Ø Virtually all members of a given group may be insured, regardless of their prior health history.

Ø If the plan is contributory, the employee usually pays a lower rate per unit of benefits than is available with individual coverage.

Ø If the plan is noncontributory, the employer pays for coverage that employees would otherwise have to pay for with personal money.

How to take the scheme?

Simply, we need a formal letter from you asking quotation for group insurance scheme along with a list of employees/ members to be insured giving following particulars:

If the sum assured does not depend on monthly basic pay (i.e, sum assured depends on designation/class of employment) then this column should be ignored otherwise fill up basic pay  column and state sum  assured as a multiple of 12.18.24.30 or 36 times of monthly basic pay.

Rupali life will then calculate the premium rate and submit the quotation on receipt of premium pragati life will issue ‘Cover Note’ taking the risk of life subsequently to sign a formal Group Insurance contract accordingly. 

How to Pay the Premium?

Premium is payable advance before commencement of risk preferably by an A/C   payee cheque /PO/DD in favour of the company or by cash at our head office however , for payment of renewal premium one month’s grace period is allowed .

Claim Procedure:

Claim procedure is very simple under a group insurance scheme Usually we need following documents at the time of processing a claim.

A formal request letter from the organization in respect of the (death /disability) claim.

A certificate from the organization to the effect that the insured member was in service till his death / disability

An attested copy of age proof certificate issued by a competent authority (Usually S.S.C in absence service record).

A death certificate issued by the last attending physician-usually from a registered doctor, Hospital or Clinic.

In case of accidental or unnatural death / disability, an attested copy of the first Intimation report ( FIR) along with an attested copy of the post – mortem report (if post- mortem has been done). If the post- mortem is waived then the documentary evidence of such waiver by such waiver by a lawful authority must be submitted.

All claims are settled by an account payee Cheque in the name of the employer unless otherwise mentioned in the group insurance contract.

Group Insurance products

Group Term Life (GT)

Scope: The Scheme shall cover the risk of death while in service of an employee occurring any where in the world and by any reason for an amount ( sum assured)

      as per list to be employer.

Duration: The scheme for which premium are payable yearly shall be for a period of 3 (three)  years initially and thereafter may be extended for further period(s) on mutual agreement.

profit- sharing  rebate: At the end of three years period if there arises a profit under the scheme i.e.. if  the resultant is positive after deducting management expense and all claim  from the total premium then a part of the resultant (depending on the number of employees ) is allowed as rebate and credited against the renewal  premium of the scheme. profit sharing  rebate is allowed for  organizations having more than 200 insurable employees .

2.Group Endowment Insurance:

Scope : provides for payment of full sum assured at death by any reason  of a member while in service .In case of survival of  an insured  employee to retirement age, 100% 50% or 25% of respective sum assured shall be paid with or without profit as per choice of the employer.

Surrender and paid-up value: The scheme acquires paid –up and surrender values after at least two annual  premiums have been paid.

SUPPLEMENTARY COVERS

Together with the basic insurance scheme, one or all of the supplementary covers may be taken on payment of additional premiums.

Accidental Death Benefit (ADB)

An additional sum equal to sum insured is payable on death if caused by accident.

Dismemberment benefit (DB)

Full sum insured is payable in case of total and permanent disability caused by accident such as loss of two hands above the wrist, or two feet above the ankle, or total sight of both eyes or one of the said limbs along with another. Half of sum assured is payable in case of partial and permanent disability caused by accident such as loss of one hand above the wrist or one foot above the ankle or total sight of one eye (DB is allowed only in conjunction with ADB, which will then be termed as AD&D)

Permanent and Total Disability(PTD)

In case of Total and permanent Disability resulting from bodily injury directly through accidental means. which prevents the Insured Employee from engaging in any business. occupation or work whatsoever for remuneration or profit and which disability has continued uninterruptedly for a period of at least six months and  has been certificate to be incurable  by a physician  approved by the company. then  subject of this Contract the Company shall pay to the Employer the sum insured  stated in schedule and   the insurance for the said Employee shall terminate loss of.

both eyes,

both hands above the wrist,

both feet above the ankle,

one hand above the wrist and one foot above the ankle,

one eye and one hand above the wrist,

one eye and foot above the ankle

Should an Insured Employee becoming totally and permanently disable should die within 365 days from the date of such disablement the Company shall pay the sum insured as stated in the Schedule in respect of the said Employee.

Permanent Partial Disability (PPD):

In case of a Permanent Partial Disablement caused by an accident, indemnity according to the terms and conditions mentioned hereinafter shall be made by the company to the Employer as specified in the following schedule and where applicable, only one sum namely the larger sum will be paid for multiple injuries resulting from one accident:

HEAD

a) Compete deafness of both ears of traumatic origin               %

b) Complete deafness of one ear %

c) Loss of one eye %

d) Removal of the lower jaw           %

UPPER LIMBS

e) Loss of one hand above the wrist                        %

f) Considerable loss of osseous substance of the

arm (definite and incurable lesion)

g) Total amputation of thumb            %

h) Total amputation of four finger including thumb             %

i) Total amputation of index finger only           %

j) Total amputation of middle finger only              %

k) Total amputation of ring finger only         %

l) Total amputation of little finger only         %

LOWER LIMBS

m) Loss of one leg above the knee %

n) Total loss or total loss of use of lower limb below the knee    %

o) Total loss of foot      %

p) Anchylosis of the hip %

q) Anchylosis of the knee %

r) Total amputation of all the toes    %

s) Total amputation of four toes including big toe %

t) Total amputation of the big toe %

u) Total amputation of one toe other than the big toe    %

Permanent disabilities not mentioned above shall be compensated in accordance with their severity as compared to those listed. Permanent, partial or total loss of the use of a limb shall be deemed to be the same as permanent, partial or total loss of the said limb.

No indemnity is payable for any pre-existing degree of disablement and if further injury occurs, only the difference between the condition prior to and after current injury shall be considered.

Major Disease Benefit (MDB):

Under this supplementary insurance in the event of a member is diagnosed to have one of the diseases mentioned below but not until at least six months have been elapsed since the commencement of this supplementary coverage, a certain percentage (25% or 50%) of the respective sum assured shall be paid immediately. the diseases are-

i). Myocardial infarction (heart attack) .ii) Stroke iii) Coronary artery surgery, iv) Cancer v) Kidney failure vi) Multiple sclerosis, vii) Paralysis, and viii) Major organ transplant.

When MDB is paid, the sum assured in the original group policy for that particular member will be reduced by 25% or 50% as stated in the policy.

Why Health Insurance?

Health Is Wealth. Every one likes to lead a peaceful, prosperous and healthy life. But, population explosion and its accompanying health hazards like massive environmental pollution, lack of safe drinking water and balanced diet, increasing incidences of accidental injuries, continuous psychological stress consequent upon deteriorating law and order situation, social & political unrest, financial crisis, rapid spread of existing and upcoming fatal diseases like dengue, hepatitis, etc. leave no scope for us to remain healthy. We are always at risk to become sick or meet an accident at any moment. Proper medical treatment, now a days is very expensive and in many cases may remain beyond our reach, unless arrangements are made in advance through proper health planning and here comes the scope for Health Insurance. Health Insurance is now the only means that can bring the modern treatment facilities affordable to individuals from all socioeconomic classes of our society, especially the fixed income group.

What is Rupali Hospitalization Plan?

Rupali Life Hospitalization Plan, the proprietary name of the Hospitalization Insurance Scheme of Rupali Life Insurance Company, is an attractive and comprehensive Health Insurance Plan under which hospitalization treatment expenses of its insured are covered.

What is covered under the scheme?

Expenses incurred for in-patient treatment of an insured is covered under the scheme, which includes:

*  Hospital Accommodation               * Consultation Fee  

*  Medicine                                         * Investigations

* Surgical Operation                           * Ancillary services like; Intensive care, Coronary care, Post operative care, Blood transfusion, Oxygen therapy, Ambulance service, Dressing etc.

For Whom the Scheme?

The scheme is suitable for a company, institution, organization or a group. It is designed with several benefit grades to suit the requirements and financial set up of  any group who earnestly desire to ensure proper and timely treatment of any ailment of its members to keep them active and in good health.

Any employee or a member aged between 18 and 65 years is eligible to be included under the plan. Besides, spouse, dependent children from 3 months upto 25 years and parent's upto the age of 65 years residing with the employee or member may also be included in the scheme. To enjoy the benefits of Group Health Insurance, the total number of insured should not be less than 25 in a group. Similar scheme is available for individuals, family or small groups consisting of less then 25 members.

How to take the scheme?

Simply write to Health Insurance Department of the Company about your desire or call on 01731116208 (Ext. 151).  It will be our pleasure to provide you with all information in details and necessary guideline.

Usually no medical examination or attendance before a physician is required but Delta Life reserves the right to ask for a medical examination if necessary.

A new member may be included under the plan at any time during the contract. A plan co-coordinator on behalf of your organization shall communicate with Delta Life for all matters relating to the scheme. 

Attractive Features of the scheme

Choice from four grades of benefit.

Affordable yearly premium.

Treatment coverage round the clock.

Treatment at any renowned hospital or clinic.

Treatment by consultant of own choice.

Direct payment at designated hospitals.

Scope for inclusion of spouse, children & parents.

Membership ID Card for each insured.

Option for maternal benefits of Pregnancy and Childbirth.

Option for Overseas Treatment Facility.

Substantial Group Discount depending on group size.

Scope for Tailored Plan if desired.

Full tax relief on payable premium.

No Claim Discount on renewal Premium.

Hospitalization Procedure

An insured may opt to take treatment at any government or renown private hospital/clinic of own choice. When advised by a consultant for hospitalization, he simply needs to notify the company before admission. The Company shall send an approval letter (Authorization) within 48 hours of such notification. A member may opt for Direct Payment, incase of hospitalization at Designated Hospitals when all eligible treatment expenses shall be paid by the Company directly to the hospital. In case of hospitalization due to medical emergency, prior approval is not required but the member should notify the company immediately after hospitalization.

Claim Settlement Procedure:

(A) Direct Payment:

When a member opts for direct payment, the Company shall pay all eligible expenses incurred for his treatment, directly to the hospital. This facility could be availed incase of treatment at designated hospital only.

(B) Reimbursement:

When treatment is taken at a hospital with whom the company has no agreement regarding direct payment (Non Designated Hospital) or direct payment is not opted by the member during claim notification, the Company shall reimburse all eligible treatment expenses to the member himself. The member should submit claims to the Company along with all supporting documents, within 30 days of discharge from the hospital. The Company shall settle the claim within 21 working days, from the date of receipt of all relevant documents.

Premium

Premium is very reasonable in contrast to the benefit limit and is payable yearly in advance. Premium rate depends on benefit grade and the age of an insured, although a fixed rate is sometimes offered for Tailored Plan. Rupali Life offers attractive Discount on the total premium depending on group size, job nature of the employees and other factors. Pro-rata premium is charged for inclusion of a member under the plan after commencement of the contract.

Premium Rates are exclusive of VAT

Renewal

For renewal of the contract, Rupali Life will notify an employer at least 30 days before the date of renewal. No Claim Discount is offered on renewal premium if there is no claim in the previous year.

Exclusions

Major Exclusions are: -

Any congenital infirmity

Any pre-existing condition

Mental disorders, narcotic addiction and its consequences.

Attempted suicide and self-inflicted injury.

Any dental treatment

Any pre or post hospitalization & out patient treatment expenses.

War risk, civil commotion or violence.

Rest, convalescence or rejuvenation cures and slimming treatment.

Treatment for family planning purposes, infertility and sterility.

Health check-ups, radiotherapy, chemotherapy.

Any Eye treatment.

Maternity Benefits

Maternal benefits for pregnancy or childbirth could be availed by female Members of child bearing age group (18 to 45 yrs.) on payment of additional premium, within the following limitation:

The benefit is payable to a member when her membership is in force for at least nine month under the plan. However, emergency hospitalization resulting from the following complications of pregnancy shall be covered from the date of inclusion under the plan.

* Hyperemesis Gravidarum                          * Extra Uterine Pregnancy

                                    * Eclampsia of Pregnancy

Why should you select the Scheme of Rupali Life?

Because Rupali Life

is the pioneer of Health Insurance in Bangladesh.

has fast and easy claim settlement

provides personalized customer care service.

has proven dependability with excellent service record.

has countrywide hospital network with direct payment

impose no restriction on client to select hospital or consultant.

has strong financial base & skilled manpower to run such Scheme.

has several benefit grades under the plan to choose from.

offer overseas treatment facility & attractive maternal benefit.

is able to offer a tailored plan if desired by a client.

Employers benefits by taking Health Insurance Scheme

Helps to set a fixed health budget for the employees in advance.

Relief from management expense and fund abuse for this purpose.

Allow the employer to enjoy full tax relief on payable premium.

Minimize loss of working hours by ensuring timely treatment.

Helps to create grateful and dedicated employee.

Assist in the employee retention policy by improving rapport.

Increases reputation of the institution enhancing job attraction.

Every effort has been made to explain the features of the plan as accurately as possible; but if there is any difference between this brochure and contract, then the terms and conditions of the contract shall prevail.