If you are a retired employee of SBI, then you may be interested in the medical benefits that you are eligible for. Recently, the SBI Retired Employees Medical Benefit Form was updated, so it is important to ensure that you are aware of the changes. In this blog post, we will discuss the medical benefits available to retired SBI employees, as well as how to access them.
The following are some details about sbi retired employees medical benefit. You can browse it before filling out the gaps.
| Question | Answer |
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| Form Name | Sbi Retired Employees Medical Benefit |
| Form Length | 2 pages |
| Fillable? | No |
| Fillable fields | 0 |
| Avg. time to fill out | 30 sec |
| Other names | sbi health assist scheme for retired employees, sbi retirees health insurance 2021 22, portal for sbi retired employees, sbi retiree health assist |
STATE BANK OF INDIA
RETIRED EMPLOYEES' MEDICAL BENEFIT TRUST
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CLAIM FOR REIMBURSEMENT OF DOMICILIARY TREATMENT |
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01 |
Name of the employee (member pensioner) |
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02 |
Date of Retirement |
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Membership Number |
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03 |
Whether claimed for self/spouse |
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04 |
Address & Telephone No. |
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05 |
Retired As |
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06 |
Pension Paying Branch SB A/C No. |
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07 |
Nature of illness |
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08 |
Name of the dependent family member for |
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whom the Medical Expenses made |
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Name |
- |
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Age |
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Relationship |
- |
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08 |
Duration of illness |
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09 |
Name & address of the attending Physician |
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10 |
Details of expenditure incurred & claim to |
Total Amount |
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be submitted alongwith Doctor's |
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11 |
I certify that I have incurred above expenses |
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for myself & / eligible family |
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members |
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` |
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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 |
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Amount of the expenditure claimed for Domiciliary treatment |
Rs. |
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Amount of expenditure for Domiciliary treatment |
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already claimed during the year |
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Balance available for domiciliary treatment |
Rs. |
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sanctioned Rs. |
Towards Domiciliary treatment |
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Chief Manager (HR) |
Assistant General Manager (ADMIN) |
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