Sbi Retired Employees Medical Benefit PDF Details

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.

QuestionAnswer
Form NameSbi Retired Employees Medical Benefit
Form Length2 pages
Fillable?Yes
Fillable fields75
Avg. time to fill out15 min 30 sec
Other namessbi retirees health insurance 2021 22, sbi retiree health assist policy download, group mediclaim policy for sbi retirees policy b 2021 22, portal for sbi retired employees

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)

 

 

 

 

 

 

 

 

 

 

 

 

 

How to Edit Sbi Retired Employees Medical Benefit Online for Free

It's easy to fill out the sbi rembs policy 'a empty lines. Our PDF tool will make it almost effortless to edit any type of PDF file. Down below are the basic four steps you'll want to take:

Step 1: Seek out the button "Get Form Here" and click it.

Step 2: Now you're on the form editing page. You may modify and add content to the document, highlight words and phrases, cross or check particular words, include images, sign it, delete unrequired areas, or eliminate them completely.

Provide the content requested by the system to fill out the document.

sbi retired employees' medical benefit scheme 2021 blanks to complete

Write the necessary particulars in the Pension, Paying, Branch, S, BAC, No Nature, of, illness Name, of, the, dependent, family, member, for whom, the, Medical, Expenses, made Name, Age, Relationship, Duration, of, illness Name, address, of, the, attending, Physician and Total, Amount box.

stage 2 to finishing sbi retired employees' medical benefit scheme 2021

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

part 3 to finishing sbi retired employees' medical benefit scheme 2021

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

step 4 to filling out sbi retired employees' medical benefit scheme 2021

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

Filling in sbi retired employees' medical benefit scheme 2021 stage 5

Step 3: Hit the Done button to be certain that your completed document may be exported to each gadget you end up picking or sent to an email you indicate.

Step 4: Make sure you keep away from upcoming difficulties by creating no less than a couple of copies of the file.

Watch Sbi Retired Employees Medical Benefit Video Instruction

If you believe this page is infringing on your copyright, please familiarize yourself with and follow our DMCA notice and takedown process - click here to proceed .