Group Health

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Group Health Insurance Advantage

Better Benefits
Group Health insurance provides significantly better benefits than individual health insurance. For example, employees or group members do not require a medical checkup, waiting periods for existing diseases can be waived off, premiums are lower, maternity expenses or corporate floaters can be added to the cover. Group Health Insurance is an excellent tool to attract and retain talent for organisations.
Lower Cost
In group insurance policies, the risk is spread over a large group of individuals and that helps reduce the premium cost due to the economies of scale. However, the premium can be highly variable for group health insurance due to claim ratio and number of employees/members added to or removed from the cover.
Customised Cover
You can customise the policy according to your needs. You can add more benefits apart from the basic policy provisions already available in any mediclaim policy. For example, parents can be covered, day care treatments can be increased, accidental cover rider and maternity benefits can be increased. This flexibility allows the group health insurance to be tailored to your budget with your specific requirements.
Guaranteed Issue
As there is no medical checkup prior to the issuance of the policy and no waiting period clause for pre-existing ailments, the issue of group health insurance is assured. Group mediclaim is administratively much easier to place and you need not spend time in medical checks or in dealing with the aftermath of insurance getting rejected.

Benefits Overview of Group Health Insurance

Pre-existing Diseases Covered

  • Our group insurance waives of the waiting period for pre-existing diseases
  • Each individual is fully covered irrespective of their personal medical history
  • Medical history of an individual has no bearing on their future coverage
  • No medical check-up done for individuals to determine eligibility for coverage
  • Coverage applicable for chronic ailments such as diabetes

Maternity benefits With ZERO Waiting Period

  • Our group health insurance policies cover maternity benefit for employees and their spouse
  • Maternity benefits are covered immediately with no waiting period
  • Avail pre and post natal expenses along with delivery expenses
  • New born baby will also be covered immediately without the standard 90 day waiting period
  • Internal congenital diseases are covered

No disease Wise restrictions

  • All diseases are covered from day one, without standard waiting period of one to four years
  • Common surgeries like Cataract, Hernia, Piles, Knee Replacement are covered from day 1
  • No waiting period on critical ailments
  • Full sum assured available for all diseases
  • No copay on specific ailments

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We manage all aspects of your claim - from preparing documentation to follow-up with the insurer.

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In general, the period of coverage for each policy is 1 (one) year.
Yes, hospitalization costs are covered from day 1. A standard waiting period of 30 days is waived in our policy. However claims need to be submitted as per set guidelines.
No, in a Group Medical Policy, medical underwriting is not done for each individual separately; hence there is no need to undergo any medical test.
Reimbursement is not provided beyond the sum insured specified in the Group Health Insurance Policy. You could consider an additional benefit called, Corporate Buffer, which could be utilized by an employee if his or her sum assured gets exhausted.
Yes. Cashless claims service will be available at all network hospitals of the respective insurer. Typically, each insurer has more than 3000 hospitals on their network.
Yes, insurance company reimburses expenses even if the insured member does not use the network hospital. To get your reimbursement, you need to submit your medical bills along with other documents as specified by the insurance company.
Country’s insurance regulator, IRDA in an exposure draft issued on January 19, 2016, specified that the minimum number of persons in the group should be 20 for the purpose of a group health insurance policy. However, micro insurance policies can be issued to a group with as small as 5 members.
Yes, startups can always opt for a group plan which covers both the employees’ and their immediate family members to reach the minimum limits required by the insurer.
Only employer can claim the premium paid for the group insurance policy as a tax deduction., An employee is not entitled to IT exemption under the health cover provided by an employer.
Complete hospitalisation expenses incurred by an employee on self and dependents like spouse, family, and parents, are covered under a group health insurance.
There is no waiting period for group health insurance. Emergency ambulance service, pre, and post hospitalization expense is also included.

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