THE CATHOLIC SYRIAN BANK OFFICERS' ASSOCIATION
MEDICAL EXPENSES REIMBURSEMENT SCHEME
 
  Salient features
 
(1)

Under the scheme, expenses as are reasonably and necessarily incurred by the members of the Association in India for medical treatment for himself/herself and/or for dependent spouse for illness/decease/injury sustained either under hospitalisation or domiciliary treatment, not reimbursed by the bank under the scheme formulated for the purpose subject to the terms and conditions laid down hereunder will be considered for reimbursement.

 
(2) This is subject to the following clauses
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  CSBOA                                     « «
  AIBOC                                      « «
  FORMS & DOWNLOAD           « «
  RULES & BYELAWS                « «
  RELIEF FUND                            « «
  MEDICAL EXPENSES               « «
  REIMBURSEMENT SCHEME
  GALLERY                                 « «
  OFFICE BEARERS                  « «
(1)
Claim should invariably be made to the Bank for reimbursement of such expenses for obtaining the amount of eligible claim. In respect of members the aggregate amount of expenses, less the amount of claim obtained from the Bank will be treated as the amount of claim under the scheme. For reimbursement of expenses incurred for the treatment of dependent spouse the amount of claim admitted by the bank subject to rules and ceilings prescribed by the bank less the amount paid by the bank will be treated as the claim to the Association.
   
(2)
In case a member has not put up the claim to the bank for reimbursement of amount of eligible claim, such member will not also be eligible for claim under the scheme.
   
(3)
No claim will be entertained, if the amount of claim under the scheme does not exceed Rs.500/-
   
(4)
Separate claims for different illness/decease/injury are to be submitted and the amount of claim in respect of each case will be examined to determine the eligibility under clause No.2.3.above. Anyone illness/ decease/injury will be deemed to mean continuous period of treatment for the same upto the date certified by the Doctor for having cured the illness/decease after elapse of 45 days will be considered as fresh illness and separate claim is to be put up for the same.
   
(5)
The reimbursement of expenses will be made only if a qualified Medical practitioner attends the illness/decease/injury. A qualified Medical practitioner means a person who holds a degree/diploma of a recognized institution and is registered by Medical Council of respective state of India.
   
(6)
Illness/decease/injury which are required to be attended by a specialist should invariably be attended by a specialist of the specified branch only. Claims for reimbursement expenses for illness/decease/injury attended by specialists other than the specified branch will not be entertained under the scheme.
   
(7)
Hospitalisation expenses including room rent, bed charge and charges for surgical operations, diagnostic tests and researches etc. will be reimbursed only if the same is undertaken by a hospital/nursing home. A hospital/nursing home for the purpose means an institution in India established for indoor care and treatment of sickness and injuries and which has been registered either as a hospital or nursing home with the local authorities and is under the supervision of a registered and qualified Medical Practitioner as defined under clause No.2.5 above.
 
(8)
Room, Board, Nursing expenses per day will be restricted to the charges (preferably) of the lowest pay ward. The Executive Committee depending upon the merit of each case will decide quantum of the lowest pay ward.
 
(9)

The maximum claim under the scheme is restricted to Rs.50,000/- in a calendar year of which the claim for medical treatment of dependent spouse shall not Rs.25000/-.
 
(10)

Expenses incurred for the treatment of the following will not be allowed as claim under the scheme.
  (1) General debility
  (2) Venereal diseases
  (3) Intentional self injuries
  (4) Illness due to use of intoxicating drugs.
  (5) Cost of tonics and vitamins
  (6) Pregnancy and normal delivery
 
(7) Cosmetic treatment of any description, plastic surgery other than those necessitated due to accident or as part of any illness.
  (8) Routine eye examination and cost of glasses and contact lenses.
  (9) Sterility
  (1O) Naturopathy
   
(11)

Claims arisen out of racing on wheels or on horse back, Big game hunting, mountaineering, winter sports, ballooning and gliding etc.
   
(12) Domiciliary treatment for:
   
  (a) Asthma
  (b) Bronchitis
  (c) Diabetes
  (d) Epilepsy
  (e) Hypertension
  (f) Influenza, Cough and Cold
  (g) All psychiatric and psychosomatic disorders
  (h) Tonsillitis, Gaunt and Rheumatism
   
(3) Claims:
   
 
(1) All claims under the scheme should be submitted to the General Secretary, Catholic Syrian Bank Officers' Association supported by photo copy of claim application, bills, vouchers and certificates submitted to the bank duly countersigned by a member other than the claimant, as far as possible.
 
(2) Claims for the purpose should be submitted within 30 days after obtaining sanction for the eligible claim amount from the Bank photo copy of the banks sanction order should be submitted with the claim.
 
(3) The Executive Committee of the association shall be the final authority for deciding all the claims under the scheme and the decision of the Executive Committee shall be final and binding on the members.
  (4) Claims sanctioned under the scheme will be liable for adjustment towards the dues to the Association, if any, under any account.
   
(4) Subscription towards the scheme by members:
   
  (1) All members of the Association who are subscribing towards the Relief fund should also subscribe towards the scheme.
  (2) . Monthly subscription will be Rs. 6O/- per member, which is liable for \ deduction from the salary payable to the member by the bank.
  (3) Members who are defaulting payment of the subscription will not be eligible for claims under the scheme.
   
(5) Nomination:
   
  The members may, at their own interest, appoint a nominee for receiving the amount due to him/her death.
   
(6) If any claim is subsequently proved to be false, such person will be summarily removed from membership of the Association and any amount due to him will be appropriated towards amount reimbursed and suitable action/proceedings will be initiated against him/her.
   
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