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Stormy Beach

Group Personal Accident & Group Mediclaim Cover

Group health insurance is a type of medical insurance that covers your employees as well as their families against unforeseen healthcare expenses. Also known as corporate health insurance or employee health insurance, these plans protect your workforce & their dependents against illnesses, injuries, and other such medical conditions.

What is a Group?
According to IRDAI, a group means a group of members who assemble together with a purpose of engaging in a common economic activity and not formed with the main purpose of availing insurance cover.

A group can be majorly divided into two:
Non-employer- employee groups
They may include members of registered welfare associations, holders of credit cards issued by a specific company/ banks, customers of a particular business where insurance is offered as an add on benefit.
Employer- employee groups
They may include employees of any specific registered organisation.

Benefits of Group Health Insurance for Employer
As an employer, it is important to make your workforce feel important, appreciated & safe. One way to do this is to get a group mediclaim policy. These plans help your employees pay for healthcare expenses and give them an added sense of reassurance on the job. Here are some good reasons why it is important to get a group insurance policy for your organisation.

  • It is one of the biggest job perks!

  • Retention of talent

  • The feel good factor

  • Tax benefits


Benefits of Group Health Insurance for Employees
Today’s workforce is also on the lookout for employment opportunities that offer the best on-job perks, one of which is health insurance. Some of the benefits your employees can enjoy with group mediclaim insurance are highlighted below.

  • No waiting period

  • No health check-ups required

  • No premium

  • Cover for family members

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In the forest
Group Discussion

What is not covered by a group health insurance policy?

Few of the major exclusions are mentioned below but since Group Mediclaim is a Tailor-Made policy, the same can be covered on account of additional premium

  • Costs incurred by you if you opt for naturopathy treatment that is not covered by our group insurance policy.

  • The charges for spectacles, hearing aids, and contact lenses are to be borne by you only.

  • Inoculation and vaccination are also not covered under our group mediclaim policy.

  • Circumcision, vaccination, cosmetic surgery or procedures, inoculation or any other procedure of the same kind will not be covered under our policy unless these procedures are absolutely necessary or required for the treatment of the diseases or illnesses covered under our policies.

  • Our policy does not cover the costs incurred for the treatment of any sterility, fertility or assisted conception procedure, self-harm, suicide, convalescence, psychosomatic disorders, and diseases or accidents, injuries caused due to intoxication or abuse of substances, etc. related matters.

  • Costs incurred by you for diagnostic purposes which are not followed up by hospitalization or active treatment.

  • Expenses incurred by you for procedures or investigation for things that are not related or irrelevant to the disease that caused the hospitalization.

  • Costs of non-medical nature, such as costs for telephones and other services will not be covered by our policies.

  • Treatment for conditions and illnesses arising out of obesity, weight management problems, supplies, etc. will not be offered by us.

  • Stay in hospitals for domestic reasons where no active treatment has been provided by the hospital to the insured person or persons will not be covered by us.

  • Costs incurred for sex-change operations, out-patient diagnostic operations, use of non-prescribed drugs and medicines, hormone replacement therapy, etc. will not be covered by us.

  • Pre-hospitalization or post-hospitalization charges for doctor’s home visits. Costs incurred by private nurses and attendants etc. will not be covered under our group insurance policy either.

  • Treatment and costs incurred by you, which is not related to the disease or illness that caused the hospitalization will not be covered by us.

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Group health insurance is offered by the employer to its employees.

✓ Employees can choose to include their family members like spouse, dependent children, parents, and parent in-laws.

✓ Group Health Insurance can be issued with or without co-pay for covering elderly parents and in-laws.

✓ The policy would provide a floater/individual sum insured to cover the medical expenses of 24 hour in-patient hospitalization due to an illness or an accident and daycare procedures.

✓ The employee can opt an additional top-up cover to suit his/her requirements.

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Whom do we recommend to buy Group Health Insurance?

Employees are invaluable assets of any company, and employers are undertaking several initiatives to promote a healthy workforce ensuring their excellent mental and physical health that sets them up to perform well.
In the current scenario, there is a growing trend among organisations considering Health insurance as an employee benefit.
Health Insurance is the key factor in recognising and rewarding the employees. Health insurance can also be used a retention tool where the employees are obliged to work with company for a longer period.
When the needs of the employee are taken care like the hospitalisation for his aged parents, therefore it brings satisfaction to give his best to the employer.

COMMON QUESTIONS:
Q.Does Group Health Insurance plan require a minimum number of employees?
Q.What is the minimum number of employees I need for Group Health Insurance plan?
Q.We are a small company with less than 20 employees, are we still eligible for group health insurance policy?

SME’s and start-ups:
Group health insurance for startups with a small team size consisting of minimum 7 members can be provided with a group medical policy. For instance, you are a new company with a count of 7 members, you could still sign up for a group health insurance plan. Employers can take advantage of investing in group health insurance policy on two fronts. Not only can they provide benefits to your employees but, can also help in your tax exemption under Section 37(1) of Income Tax Act.

Large organisations:
Corporate Social Responsibility is the continuing commitment by business to behave ethically and contribute to the welfare of the employees and their families and contribute to the welfare of the local community and society by and large.

Construction Work

Group personal accident insurance, as the name suggests, is a group insurance policy that covers accident mainly for the employees under corporate group insurance. It is available for both, the employees and board or owner of a company.Group Personal Accident policy assures that the claim gets settled quickly, in case any employee dies or injured and suffers a permanent disablement, temporary total disability or any other medical expenses. The claim of the policy is paid to the policyholder or his/her nominee.

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Accidents, many times, create serious financial issues for the injured and their dependents. In order to cover such mishaps, Group Personal Accident Insurance Policy is used. This policy provides complete cover in the event of death or disablement of the insured due to accidents occurring anywhere in the world.

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Accidental Death
100 per cent of the sum insured on accidental death of the insured person

Permanent Total Disability
100 per cent payment of sum insured on permanent total disablement
100 per cent payment of sum insured in the event of loss of two limbs/ two eyes or one limb and one eye
50 per cent payment of sum insured in the event of loss of one limb or one eye

Permanent Partial Disability
Specified percentage of the sum insured will be paid in case of permanent partial disability

Temporary Total Disability
One per cent of capital sum insured will be paid per week in case of total disability (sum not exceeding Rs. 5,000 per week, for a maximum of 100 weeks)

Group personal accident insurance, as the name suggests, is a group insurance policy that covers accident mainly for the employees under corporate group insurance. It is available for both, the employees and board or owner of a company.
A group personal accident insurance has the following characteristics-

It is issued to the group of people with a similar risk profile.
This group can be formed by an employer for his/her employees, organization, travel company, banks and other service providers for customers.
The policy covers the expenses and gives compensation to the group members insured for any injury mentioned in the causes occurred in their lives.   
It is applicable to the entire world.

The general benefits included are-
 

  • Accidental death

  • Medical expenses incurred due to accidents

  • Permanent total disability due to the accident

  • Permanent partial disability caused by an accident


The key benefits that are provided under the group accident insurance plan is that it safeguards you against any financial liability that can arise because of disability or death due to an accident. This policy is designed keeping in mind that the sole bread earner of a family has individuals who are dependent upon him both financially and emotionally and it is the responsibility of the bread earner to safeguard their interest and future.

What All Does Personal Group Accident Insurance Cover?

  • An accidental death

  • Permanent total disability

  • Permanent partial disability

  • Mortal remains charges

  • Broken bones

  • Education benefits

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