Sbi Retired Employees Medical Benefit PDF Details

Navigating through the healthcare needs of retired employees represents a crucial aspect of post-retirement support, and the State Bank of India (SBI) extends this support through its Retired Employees' Medical Benefit Trust. The trust facilitates a structured approach for retired employees to seek reimbursement for domiciliary treatment, embracing a comprehensive procedure articulated in the SBI Retired Employees Medical Benefit form. This form is a key document that retired staff members, including pensioners, use to claim financial backing for medical expenses incurred for themselves or their spouse. It incorporates detailed sections requiring the employee's personal information, date of retirement, membership details, and the nature of the illness. Furthermore, it broadens its scope by covering details about dependent family members who the medical expenses are claimed for, the duration of illness, the attending physician's particulars, and a breakdown of the expenditure incurred. The form also emphasizes the importance of accountability and transparency through the certification by the retired employee and subsequent endorsement by the branch manager, aimed at facilitating the reimbursement process. This robust framework underscores SBI's commitment to ensuring their retired employees' well-being by easing the financial burdens associated with domiciliary treatment.

QuestionAnswer
Form NameSbi Retired Employees Medical Benefit
Form Length2 pages
Fillable?No
Fillable fields0
Avg. time to fill out30 sec
Other namessbi rembs policy 'a, sbi health assist policy b, sbi health assist scheme for retired employees, sbi retired employees medical benefit scheme

Form Preview Example

STATE BANK OF INDIA

RETIRED EMPLOYEES' MEDICAL BENEFIT TRUST

 

CLAIM FOR REIMBURSEMENT OF DOMICILIARY TREATMENT

 

 

 

01

Name of the employee (member pensioner)

 

 

 

 

02

Date of Retirement

 

 

Membership Number

 

 

 

 

03

Whether claimed for self/spouse

 

 

 

 

04

Address & Telephone No.

 

 

 

 

 

05

Retired As

 

 

 

 

 

06

Pension Paying Branch SB A/C No.

 

 

 

 

07

Nature of illness

 

 

 

 

08

Name of the dependent family member for

 

 

whom the Medical Expenses made

 

 

Name

-

 

 

Age

-

 

 

Relationship

-

 

 

 

 

08

Duration of illness

 

 

 

 

09

Name & address of the attending Physician

 

 

 

 

10

Details of expenditure incurred & claim to

Total Amount

 

be submitted alongwith Doctor's

 

 

prescription--as per reverse

 

 

 

 

11

I certify that I have incurred above expenses

 

 

for myself & / eligible family

 

 

members

 

 

 

 

 

 

`

 

 

Signature of the pensioner

member

Forwarded for payment

Branch Manager

Branch ______________

DETAILS OF THE BILLS

BILLNO.

DATE

PARTICULARS

OF THE BILL

AMOUNT

TOTAL

Signature of the pensioner member

AT ADMINISTRATIVE OFFICE

Amount of the expenditure claimed for Domiciliary treatment Rs.

Amount of expenditure for Domiciliary treatment

Rs.

 

already claimed during the year

 

 

 

Balance available for domiciliary treatment

Rs.

 

sanctioned Rs.

Towards Domiciliary treatment

 

 

 

Chief Manager (HR)

 

Assistant General Manager (ADMIN)

 

 

 

 

 

 

 

 

 

 

 

 

 

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sbi retiree health assist blanks to complete

Write the necessary particulars in the Nature of illness, Name of the dependent family, whom the Medical Expenses made, Name, Age, Relationship, Duration of illness, Name address of the attending, Details of expenditure incurred, I certify that I have incurred, Total Amount, Signature of the pensioner, and member box.

stage 2 to finishing sbi retiree health assist

You'll be required specific key information in order to prepare the Branch Manager, and Branch field.

part 3 to finishing sbi retiree health assist

Spell out the rights and obligations of the parties inside the section PARTICULARS OF THE BILL, and TOTAL.

step 4 to filling out sbi retiree health assist

Review the areas Chief Manager HR, and Assistant General Manager ADMIN and thereafter fill them out.

Filling in sbi retiree health assist stage 5

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