What is Corporate Buffer in Group Health Insurance?



A group health insurance policy can be availed by companies for their employees. It is one of the most common benefits offered by corporates to their staff.

Availing of a group policy has several benefits and advantages which are not available in an individual or family policy. The corporate buffer is one such benefit.

In this article, we w` cover everything that you need to know about corporate buffers in health insurance.

What is Corporate Buffer?

A corporate buffer in a group mediclaim policy is a common pool of sum insured offered by the insurance provider to the company. In case of a critical illness of an employee of the company, the costs of which exceed the sum insured of the individual employee, the employee can avail additional funds from the common pool.

The corporate buffer is essentially a safety net offered by the company to its employees. The release of funds from the corporate buffer to an employee is at the discretion of the company.

A corporate buffer is a great way for a company to ensure that all the medical needs of all its employees are met, regardless of the financial severity of the illness.

Funds from the corporate buffer can be released to the employee or any of their dependents covered under the policy, as the case may be. The corporate buffer covers almost all critical illnesses and can be a life-saver under dire circumstances.

The exact coverage of the corporate buffer will differ from insurance provider to insurance provider.  

In order for an employee or member to be able to avail of funds from the corporate buffer, the family floater coverage must be completed first.

How to Avail Funds from a Corporate Buffer?

Funds from the corporate buffer in health insurance can be availed by an employee by making an application to the company.

This is because the corporate buffer is held by the employer and can be used at its discretion only. The company will determine whether additional funds should and can be released to the employee or the employee’s family. The company will also determine the amount of the funds to be released.  

This decision to release the corporate buffer can be taken on a case-to-case basis depending on the policy of the company.

The employee can make a request to the company by providing certain supporting documents.

These documents can be the medical reports of the patient, a doctor’s certificate showing the course of treatment, an estimate of the cost of the treatment, along with proof that the insured’s existing family floater has been completely exhausted.

The company can then proceed to disburse the funds from the corporate buffer at its discretion.

Possible Exclusions of a Corporate Buffer

The corporate buffer in group mediclaim policy is only available in cases of critical illnesses. Hence, in cases in which the family floater amount of the employee has been exhausted but the medical condition of the patient is not critical, funds from the corporate buffer cannot be claimed.

The company can enforce further limitations and exclusions towards how funds from the corporate buffer are to be used:

Maternity costs – Several companies choose to exclude maternity costs and related medical conditions from their corporate buffer policy.

Excessive costs – Once the company has determined an amount to be released to the employee depending on the case, the company may refuse to release further funds in case the cost of treatment exceeds the initial estimate. This cost needs to be borne by the employee.

Room charges – The company can decide the sub-limit for the room charges of the hospitalization of the patient. In case the room charges exceed this sub-limit, the excess cost may need to be borne by the employee.

Wrapping Up

The corporate buffer is an excellent feature of group health insurance policies that ensures that the needs of companies are met. The employees of the company can rest assured that they will receive financial help in case of any critical illness in their family (covered by the insurance policy).

The use of the corporate buffer is at the discretion of the company and can be determined on a case-to-case basis.

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Susheel Agarwal

Susheel is the CEO of Ethika Insurance Broking P Ltd. This company, which has a current value of 10 million dollars, was bootstrapped by him and two of his friends. He attributes his success to his ability to inspire others to seek happiness at work.