Monday, February 15, 2016

Frequently Asked Questions On Procurement of High Value PLI Policies

FAQ on Procurement of High Value PLI Policies

Frequently Asked Questions on procuring High Value Policies in PLI issue by CPMG TN Circle

01.   What is High Value Policy in PLI?

If Sum assured is more than 20 Lakhs in PLI, It is called High value policy.

02.   Who is the accepting authority for High value policies?

For Single proposals more than 20 lakhs and up to 50 lakhs, the accepting authority would be the Chief Postmaster General.

New proposals of existing policy holders whose aggregate exceeds Rs 20 lakhs and up to 30 lakhs, the accepting authority would be DPS (HQ). 

New proposals exceeding Rs 20 lakhs  up to  50 lakhs and new proposals of existing  policy holders whose aggregate exceeds Rs  30 lakhs  and  up to  50 lakhs, the accepting authority would be the Chief Postmaster General.

03.   Who are all eligible for the enhanced coverage?

All existing policy holders as well as new insurants from the eligible clientele of  PLI can be given enhanced coverage within maximum or aggregate sum of Rs 50 Lakhs.

04.   What is the limit on age for taking High Value Policy?

The age limit will be the same as applicable at present for various plans.
(i)   Whole Life Assurance (Suraksha)  19-55
(ii)  Endowment Assurance (Santhosh)  19-55
(iii)  Convertible Whole Life Assurance(Suvidha)  19-50 
(iv)  Anticipated Endowment Assurance(Sumangal)
AEA 15 19-45
AEA 20  19-40 
(v)  Joint Life Assurance (Yugal Suraksha)  21-45

05.   What is financial eligibility for High Value Policies?

The maximum sum assured will be restricted as under:
(i)  Till 40 years of Age at entry: Sum Assured should be 10 times of Annual income (Gross) subject to total aggregate of maximum of 50 lakhs. 
(ii)  For 41 years and  above:  Sum Assured should be 7 times of Annual income (Gross) subject to total aggregate of maximum of 50 lakhs.

06.   What is the proposal form to be used for High Value Policies?

Combined proposal form circulated by Directorate is to be used for High Value Policies.

07.    Is there any special medical report to be enclosed for High Value Policies?

Yes. Apart from medical examination, the following Special Medical Reports are to be enclosed for all policies of sum assured above 20 lakhs (New policy & existing policies put together). Details of the test should be annexed to the proposal form as Sl no 29(f)
1  Age up to 35 years  ECG, Routine Urine Analysis, SBT 13 & Hb%
2  Age  between  36 to 45 years ECG, Routine Urine Analysis, SBT 13, CTMT  &Hemogram
3  Age between 46 to 55 years ECG, Routine Urine Analysis, SBT13, CTMT, Hemogram & HbA1c
4  56  years & above (for Revival Cases) ECG, Routine Urine Analysis, SBT 13, CTMT, Hemogram, HbA1c & X ray of chest
For SBT13 Proforma is in last page.

08.   Where these tests are to be conducted?

The tests shall be conducted and special medical reports obtained from Hospitals/Laboratories/Renowned Private Hospitals/Central State Medical Institutes.  The medical officer signing the proposal form shall countersign the medical reports also.

09.  Is any other item to be attached with the proposal form?

(i)  Information on gross salary drawn by the proposer during the last three months should be inserted as Item No 7(a) of Proposal form (to be obtained from the Pay drawing officer)
(ii)  A declaration by the proponent countersigned by Head of office  in proforma should be obtained and inserted as  item no 31(a) of proposal form (Proforma is in last page)

10.  Who will bear the cost for obtaining special medical reports? 

The fees will be initially paid for by the insurant and on acceptance of the proposal the rates as approved by CGHS for the tests would be reimbursed to the insurant and the expenditure will be debited to PLI fund.

11.  State whether special reports are required for revival of policies?

Yes.  The Special reports would be  obtained afresh if the policy had lapsed and is coming up for revival after 3 years and the total sum assured of all policies taken or revived within 3 years from the date of application of revival is more than 20 lakhs.

12.  Who can conduct medical examination for High Value Proposals?

Status of Medical Officer conducting medical examination of proposer(s) based special medical reports should be as under:
(i)  Civil Surgeon, Medical Officers in the employment of Government enjoying the status not lower than  that of a Civil Surgeon or Chief Medical Officer, nearest to the place of duty of the proponent. CMO Grade I/Specialist Grade II shall also be considered as equivalent to the rent of Civil Surgeon.
(ii)  Medical Officer (Allopathic) equivalent to Civil Surgeon employed in Central and State Government, Public Sector undertaking both State and Centre with at least 10 years’ experience, nearest to the place of duty of the proponent.
(iii)  Retired Civil Surgeon, CMO Grade I and Specialist Grade II.

13.  Is there any separate  premium table/Policy Bond  for High Value Policies?

No. The existing premium tables as applicable to EA/AEA/Whole Life etc will be used for High value policies. Similarly, the existing policy bond will be used for sum assured up to 50 lakhs

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