Group 

MediClaim

Insurance.

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Needless to mention, the health of employees is the top priority of a corporation. Group insurance also called as Group Mediclaim in India is primarily a cashless hospitalization coverage for your employees and their families. This can be often offered as a valuable benefit for workers because the premium for the same is borne by the employer. However, the value for this is relatively plenty lesser than compared to individual insurance plans, and also benefits employers in tax reductions, therefore making it beneficial for both the employer and their families. 

How Group Health Insurance Works?

Group insurance plans are purchased by companies and organizations then offered to its members or employees. Plans can only be purchased by groups, which implies that individuals cannot purchase coverage through these plans. Plans usually require a minimum of 70% participation in this to be valid. Thanks to the numerous differences—insurers, plan types, costs, and terms and conditions—between plans, no two are ever identical. Once the organization chooses a plan, group members are given the choice to simply accept or decline coverage. In certain areas, plans are available in tiers, where insured parties have the option of taking basic coverage or advanced insurance with add-ons. The premiums are split between the organization and its members supported the plan. Insurance coverage can also be extended to the immediate family and/or other dependents of group members for an additional cost. The price of group insurance is typically much not up to individual plans because the danger is spread across a better number of individuals. Simply put, this kind of insurance is cheaper and more cost-effective than individual plans available on the market because there are more those that put the plan. 

What Does This Policy Cover?

  • Individual cover for your worker

  • Pre-existing disease covered

  • Workers aged 18-60 years can be covered

  • Maternity benefit

  • Room rent charges covered

  • Pre-30 days & post 60 days hospitalization

  • Road ambulance charges covered

  • Daycare procedure.

Benefits

1. Hospitalisation cover: 

Employees are covered for all in-patient hospitalization expenses, just in case of accidents/illness covered under the policy up to the quantity of the sum insured that you simply choose. The stay within the hospital should be for minimum of 48 hours.

1. Pre and post hospitalization expenses:

All relevant medical expenses incurred 30 days before hospitalization and expenses incurred during 60 days after hospitalization are considered a part of the claim. Pre and post hospitalization expenses: All relevant medical expenses incurred 30 days before hospitalization and expenses incurred during 60 days after hospitalization are considered a part of the claim.

3. Out-patient care:

In certain cases like Nephrolith removal, tonsillectomy, eye surgery and D & C, outpatient treatment expenses also are covered.

4. A Higher Number of People Increase The Plan Advantages: 

A large number of individuals are covered under group insurance plans, its advantages increase for the policyholders. They get a better value with added benefits like protecting pre-existing diseases, hospitalization expenses, etc.

5. Family Protection:

It may depend upon a policy to policy, but group insurance plans often cover your members of the family too. These plans protect the dependents of the workers by offering them financial help within the time of need. If not this, the relations may purchase another family floater insurance plan and pay the premium out of their own pocket.

Exclusions

1. A group health insurance policy may offer limited coverage owing to sub-limits. An employee, therefore, may not be fully covered.
2. A master policy offered by companies covers all employees in the organization under the same umbrella and therefore lacks customization.
3. The policy is valid only for a certain period during which an employee is working in a company.
4. Companies may reduce the health insurance cover at their discretion.
5. An employee and his family are not covered in case of any interval between jobs.
6. The policy may become invalid if a company does not pay the required premium or if an insurer backs out of the contract with the company.
7. Many companies may not provide health cover to the employee’s parents.

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