Group Mediclaim Insurance

About Group Mediclaim Insurance

The ‘Group Mediclaim Insurance’ policy or plan provides coverage to a registered group of members, such as of a professional association, society or an organization. Availing group insurance is advantageous as it permits the insurance companies to offer lower rates to an organization.  As a result, the insurance companies get large business giving the companies greater power to bargain for their client and thereby offering them with cheap group rates.

Importance of Group Mediclaim Insurance

Employee’s group health insurance plan is important for boosting their morale. It ensures them that the organization they work for cares about their well-being and health and is willing to extend the financial help in the case of a medical emergency. By offering this type of insurance coverage to the employees, an organization earns a good reputation for itself.

From an employee’s perspective, the policy offers financial help in the case of a medical crisis. This type of cover is available with low underwriting formalities. As the employer pays the premium of this insurance policy, the employees do not have to bear any financial burden of this policy.

Best Group Mediclaim Insurance Policies in India by Top Insurance Company
  • HDFC Ergo Group Mediclaim Insurance Policy
  • Reliance Group Mediclaim Insurance Policy

Types of Group Mediclaim Insurance Policies or Plans

  • Group Term Life Cover: This insurance policy offers cover to each of the members working in an organization. The premium that is collected from a group owner is deducted from the employee’s salary on monthly basis.

  • Group Health Cover: This insurance policy has been designed for meeting the unpredictable medical requirements of each of the group members. This plan covers the pre-existing diseases as well as the diagnosis costs. In certain cases,the group health insurance policy covers the visionary treatment, maternity expenses as well as the dental check-ups. You can use this policy in the form of a cashless card or medical expense reimbursement up to the particular limit.

  • Group Personal Accident Insurance Cover: This insurance policy is beneficial for a large workforce which has to travel often. The policy covers all the members of the group and compensates for the loss incurred for each of the members in an unfortunate event of an accident. It covers the permanent total, permanent partial and the temporary ‘total disability as well as the medical expenses in the case of an accident.

  • Workers Compensation Insurance: This insurance policy covers the liabilities of the employees under ‘Workers’ Compensation Act’ of 1987. The employer should have this policy for his workers as they are prone to accidents that may bring about complete or partial disablement.

  • Group Pension/Superannuation Plans: This is one of the best insurance covers as it promises security and safety to the senior citizens. There are different types of pension plans such as Gratuity, Provident Fund, and Superannuation.

  • Public Liability Insurance: This insurance policy is ideal for the groups that offer professional service to the customers. While offering professional service this group may face penalties or legal scrutiny as they are responsible for their decisions and acts while rendering professional service. This insurance policy covers the expenses that are incurred by any insured group along with its members.

  • Group Travel Insurance: This insurance policy covers all the hazards travellers face including the theft of the luggage and important documents. This insurance even includes a group of member’s health cover.

Group Mediclaim Insurance Buying Tips

For buying the group mediclaim insurance policy an array of factors need to be considered, such as follows:

  • Workforce Strength: While buying a group mediclaim policy for a small organization you have to consider the strength of the employees. For a small organization or start up it is essential to extend medical emergency cover for the employees. This group insurance is recommended where there are 25 to 100 employees. With the growth of an organization, it is essential to extend the medical benefits to the family members of the employees as well. Family means children and spouse and this policy is recommended when the workforce strength is 100 to 500 employees. A large organization whose workforce strength is more than 500 employees can provide medical benefits to the parents of the employees apart from the employees and their families.

  • Insured Sum: There are two methods for deciding the amount to be insured, that is the graded and the flat method. By the graded method, the insured sum is given to the employees on the basis of their management, whereas by the flat method a flat sum of money is given to the organization in different grades. It is beneficial where the employees belong to similar grades and have the same living standard. The minimum sum insured for the employees should be at least Rs. 2 lakhs. Sometimes depending on the lifestyle of the employees, the insured sum is fixed.

  • Additional Waivers: The group mediclaim insurance policy is an insurance product that can be tailored according to the requirement of an organization unlike the individual ‘Mediclaim Policy’ which is not customizable. For the benefit of the employees, an organization should choose additional covers such as pre-existing diseases, maternity etc.

  • TPA: Most of the insurance companies settle the claim process with the help of TPA. It is mandatory for checking the reputation, the hospital network as well as evaluating the TPA services. The group mediclaim insurance policy offers the insurance company the flexibility of appointing the TPA of insured’s choice. It is important to evaluate the TPA more than the insurance company before purchasing the group mediclaim insurance policy.

  • Insurance Company: While choosing the insurance company from the endless options available in the market, the buyer should take into account the premium charged for the group mediclaim insurance policy, reputation, policy conditions and terms, flexibility and the service levels of the insurance company. This is of prime importance as the insurance company cannot be changed till the expiry of the insurance. The relationships of the company with the intermediaries also can decide what support you may get from an insurance company.

  • Renewal Premium:In the case of individual policies, premium rates are based on the insured’s age and sum insured but not so in the case of the group policies. Renewal premium in the case of the group mediclaim insurance policies is based on past claims that are experienced on a policy. The claims in the present policy year would have a direct relationship with premium renewal in the forthcoming year. A high insured sum given to few members compared to a complete group can distort the claim ratio. Thus the directors of a company should be given an individual separate policy with a large cover.

  • Anti-selection: Group policies are developed on the basis that the parents and family members of all the employees of an organization are included as the insurance is based on the probability of huge numbers. The parents and the family members should not be covered selectively as that is against the insurance principles. Thus it is recommended to cover the complete beneficiary category other than selectively covering them under this group mediclaim insurance policy.

Key Advantage and Features of Group Mediclaim Insurance

  • It improves the overall employee satisfaction. Companies that offer group mediclaim insurance policies are able to retain their employees effectively. The ‘group health insurance,’ ‘group term,’ and the ‘group personal accident’ are some of the effective insurance policies that are purchased by organizations for employee retention.

  • This type of insurance policies especially the ‘group superannuation’ and the ‘group gratuity’ helps in managing the funds efficiently. It offers a greater probability of receiving improved returns on funds.

  • Overseas travel insurance involves a lot of paperwork that is difficult to manage for a couple of employees traveling frequently. In such cases, the group travel insurance policy proves to be beneficial as it offers 24/7 cover to all employees traveling in a single insurance.

  • In the case of group mediclain insurance ‘one policy’ known as the ‘Master Policy’ is issued for covering the group members for a year. The policy is renewed every year.

  • The sum insured under the ‘group mediclaim policy’ is of a limited nature and may be different for each of the members or could be a flat overall cover for all its members. It could even be uniform at a specific group level across all the members.

  • The group mediclaim insurance policies offer low premium rates as compared to the individual health plans.

  • In order to enjoy the coverage under the group mediclain insurance plan you have to remain a group member, otherwise, you would not be entitled to the coverage.

Which is the Most Popular Group Mediclaim Insurance Policy?

The ‘employee health insurance’ policy is undeniably a popular ‘group mediclaim insurance ‘policy. It covers the organization’s all employees under a single health plan. In many of the policies, the coverage is extended to the immediate employee’s family (children, dependent parents, and spouse). The sum insured in the employee health policy is uniform either for all the organization’s employees or varies on the basis of the hierarchy of the company. At one hierarchical level, the insured sum is same for all the employees.

The employer of an organization pays the premium for the employees’ group mediclaim insurance policy and the coverage exists till the employee works in that organization. As soon as the employee leaves the organization, his policy terminates.

Eligibility Criteria

A group interested in the group mediclaim insurance policy should be recognized and registered. Some of the widely accepted groups that can buy the ‘group mediclaim insurance’ policy are

  • Clubs
  • Employer-employee groups
  • Societies
  • Trade Unions