The Indian health insurance market is witnessing a rise in demand for more comprehensive and customized health coverage plans. This has led to expansion in the private health insurance products available which has unveiled newer avenues of growth for the insurance industry. In the last ten years, it has grown at a CAGR of 23%, […]
How does the e-claim process work for group health insurance policy?
Insurers required policyholders to submit original claim documents for processing reimbursement claims. Policyholders used to courier claim documents to insurers/ TPAs for processing. However, this has changed since the Covid-19 pandemic hit the world. It has brought all transportation and logistics to a standstill due to government-imposed lockdown throughout the country. Courier services were not […]
Disease-wise capping: How can it help GMC to manage price?
With disease-wise capping, an insurer can reduce claims out-go and hence its risk for the GMC. Though you can select the list of diseases and respective capping for a group policy insurers have pre-defined slabs of lower limits, default limits, and higher limits. Below is an illustration of these slabs – Disease-wise capping can be […]
How can a maternity claim be shared between 2 health insurance policies?
It is common for insurers to cover maternity-related expenses in a health insurance policy. However since maternity claims are frequent, insurers cover them for a restricted policy sub-limit which is commonly between INR 50K – INR 1L. Can you claim maternity expenses from multiple health insurance policies? The total expenses incurred in maternity far exceed […]
Filing a claim under group health insurance policy
The process for filing a claim under a group health insurance policy depends on the hospital and the type of treatment. Claiming health insurance in-network hospitals A network hospital is one that has a tie-up with an insurer. Members covered under group health insurance can get cashless hospitalization from network hospitals. This means that the […]
Claim process of Group Health Insurance – Infographic
Group health insurance offers protection to employees of an organization against any medical emergencies by covering them for hospitalization costs. To file a claim under a group medical insurance policy, you will need to follow the steps outlined by your insurance company. Below is a general outline of the process you can expect: Consult your […]
Subrogation and Group Health Insurance
Does your employer offer corporate health insurance? Has the term ‘subrogation’ come up in the context of this employee insurance scheme? If you would like to understand what it means and how it affects you, this post is for you. What is subrogation in Group Health Insurance? Have you ever been accidentally injured, visited the […]
How to file reimbursement claim under a Group Health Insurance Policy?
If you are covered by a group health insurance plan, you might have to claim reimbursement for medical expenses if you go to a hospital that is non-empanelled (or not a network hospital). You cannot avail of cashless hospitalisation at non-empanelled hospitals. Another reason for claiming reimbursement could be that the insurer takes time to […]
Co-pay in group health insurance
For many young establishments, the costs associated with group health insurance might be daunting. So, if you want to provide your employees with the security of medical insurance without a considerable cost burden, you might want to consider a co-pay. This post attempts to help you better understand co-pay in group mediclaim insurance. What does […]
Know about the Group health plan claim settlement when capping is breached
A group health insurance scheme specifies an amount or limit for different medical expenses for claim settlement which is called capping. What is capping? Capping refers to the maximum amount that the insured can claim for a specific medical expense under a group health insurance plan. If the amount paid for a particular medical expense […]