These are some of the queries I have received over the past one month. I have made it a point to answer every query received at support@ssamiti.org.
Here’s a copy-paste of some of the questions along with my answers. I have only made some amendments to hide the identity of the member.
Query – I want to add my mother to my policy as a beneficiary . Ho can I do that ?
or
Query :- I’M A RETIRED AIR FORCE OFFICER. LIKE TO JOIN THE ORGANISATION FOR MEDICAL PURPOSES. I HAVE A WIFE, MOTHER AND MOTHER-IN-LAW. I HAVE TRIED JOINING ON LINE BUT IT IS NOT WORKING. PL REVERT.
or
Query :- I paid the membership and registration fees today. I wish to take a medical cover policy for Rs 5 lacs cover for myself only/ The premium rates are for family coverage(1+3) . kindly advise the premium payable for a single person. .
or
Query – Does my wife also need to register ?
Answer – A family , for insurance , is defined as 1+3 meaning Self, Spouse and two children below 25.
In a group policy , a family of 1 or 4 members are charged the same premium amount. If you want to reduce the premium, the only way is to reduce the sum insured.
For mother , mother in law or siblings (and for anyone not coming under spouse and children below 25 years),
……there is a need to take separate membership and take a separate policy. Their spouse and their children below 25 years will become beneficiaries of their families.
For joining , go to ssamiti.org click on membership
Only the Policy holder needs to register. Spouse become a beneficiary . Spouse need not register separately.
Query
Sir,
Please wait for e card ,policy documents etc. 15 days TAT is normal in group policies for receiving documents.
Query
I deposited rs xxxxx/- for policy yesterday?
When will I get my e card?
How long will it take to ‘correct’ the status on dashboard?
Answer
As a group policy, Turn around Time ( TAT )from the time of deposit by the member with SSS to receiving all documents would be about 15 days.
The health cover, however starts the day after deposit of amount with insurer by SSS. This may take 2 – 10 days depending on the making up of lots.
There is no manual update of website..once the lot wise list is published , the members dashboard is automatically updated.
So if it is shown as policy not active ,it just means your money is yet to be deposited with the insurers.
There is an escalation matrix that can be used to contact ODIN or raksha TPA for pre approval or admission in an emergency.
Along with medical reports please send a copy of the old card and the receipt for this year to the mail ids shown above in escalation matrix.
New members may send just the receipts from SSS.
Whatever be, the health cover has started and speaking from personal experience, Raksha TPA is approving treatments based on old card and receipts
The escalation matrix and other instructions/ information can also be accessed from ssamiti.org/sss_blog/
Please quote your sss id in all correspondence
Query
Query :- Am trying to go through the Policy for 2023-24, but cannot read or download???
Query
Query :-Where can I find escalation matrix ?
Query
can I have a list of networked hospitals in xyz place ?
Query
How do I ascertain that My card is a valid one ?
Note
I am not at all comfortable with Whatsapp Groups . Will help if further queries if any can be posted here in comments. For individual queries, that may not be of interst to all, you can write to my personal email id colmurali@gmail.com
Thanks
for an associate member the following info is very useful.
—Their spouse and their children below 25 years will become beneficiaries of their families.—
i thought in-the case of sister and b in law two policies are to be taken.
thank you
Sir
I was going through the list of network hospitals in Alwar Rajasthan(My residence place). Some of these hospitals have closed. Hence, I believe this list of network hospitals need to be updated by the insurer and we need to ask for the same.
I am aware it’s a dynamic list.
Raksha TPA site / app will have an updated list.
What I have given is only indicative.
For final confirmation, one should identify local hospitals and contact the corporate desk of these hospitals that they cover RakshaTPA members.