Group health insurance is a type of health insurance policy that covers the hospitalization and other related expenses of the insured members of the policy in return for a premium amount. Most of the group health insurance policies are taken by the employers to cover their employees working in their organization. Organizations provide group health insurance cover as a part of employee benefits to their employees. Let us understand why someone should invest in group health insurance policy:-
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Benefits of Group Health Insurance: There are certain benefits to investing in a group health insurance policy in India which are mentioned below:
- No waiting period: The major advantage of group health insurance policy is the waiver of waiting periods which are otherwise applicable in retail health insurance policies. There are certain types of waiting periods in health insurance policies in which the insured can make a claim only after satisfying the waiting period under the policy.
Initial waiting period or 30 day waiting period is the time in which the insured customer has to wait for a period of 30 days after taking the policy to make any claim. This clause is applicable only for new retail health insurance policies taken and not for the renewal or group health insurance policies. Hospitalization due to accidents is exempted from the initial waiting period.
Specific waiting periods may vary from 1 year to 3 years during which the customer cannot claim for certain illnesses or diseases as specified in the policy period. There are certain illnesses such as knee replacement, cataract, kidney stone removal etc. which can be claimed only after satisfying the specific waiting period. This clause is not applicable in group health insurance policies and the customers can claim anytime after taking the group health insurance policy. Pre-existing waiting period is the period in which the customer cannot make a claim for any pre-existing diseases that were declared before the inception of the policy. The pre-existing waiting period varies from 1 year to 4 years. Any condition of the insured that existed prior to taking the health insurance policy is considered a pre-existing disease.
Maternity Waiting period is the time period in which the insurance company will not settle any maternity related claim under the health insurance policy. The maternity waiting period ranges from 9 months to 2 years in certain health insurance policies.
- Premium paid by Employer: The other benefit of availing group health insurance is that the premium would be paid by the employer in most of the cases. Organizations provide group health insurance as an employee benefit to the employees working in their organization. The premium for the same kind of coverage if available elsewhere would be on the higher end and most of the individuals may not be able to afford this. The group health insurance premium for self or self and family would be paid by the employer while there might be extra premium that is charged for parents or parents in law if added to the group health insurance that is to be paid by the employee.
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- Easy Claim Settlement: Claim settlement is of utmost importance in insurance. The value of service provided by the insurance company would come into picture at the time of claim settlement. The claim settlement process in group health insurance policies is very easy and is beneficial to the employee. There are more than one touch points to contact in case of any claim under the group health insurance policy. The organization/ employer would take care of the claim settlement for the employee and make sure the claim is settled hassle free. All the documentation and other processes would be taken care of by the organization/employer in a group health insurance policy.
- No medical tests required: The group health insurance policy does not require any medical tests when compared to the retail health insurance policy. Employees with any health condition can be added to the group health insurance policy without requirement for medical tests. Senior citizens more than 80 years of age can also be added in the group health insurance policy without requiring any medical tests. The group health insurance policy benefits the below category of employees:-
Employees whose parents are aged and cannot avail of retail health insurance due to certain health conditions. Insurance companies deny health insurance for people with certain health conditions such as Diagnosed and treated for Cancer, Heart attack etc.
Employees who cannot afford health insurance otherwise for themselves and their parents:
- Elder members covered with no extra premium: The other benefit of a group health insurance policy is that employees at any age can be covered under the policy without paying any extra premium. For example, Mr. Rak is aged 65 years with certain pre-existing conditions that can be covered under the group health insurance policy at no extra premium and also doesn’t require medical underwriting. Elder members without any age restriction can be covered under the group health insurance policy. The best benefit to invest in group health insurance is that the elder members are covered at no extra premium.
- Maternity and newborn coverage: The group health insurance policies cover the hospitalization costs for maternity and childbirth. All the delivery or pregnancy related expenses can be claimed under the group health insurance policy for up to a certain limit as mentioned in the policy. The other benefit of group health insurance policy is that there would be no waiting period for availing maternity and newborn claims. The maternity expenses include childbirth due to cesarean or normal delivery. Employees can add their spouses in the group health insurance policies and avail the of maternity benefit as per the limits set under the policy.
- OPD Coverage: OPD refers to the Out patient expenses that are incurred by a patient without the need for inpatient hospitalization. The outpatient or day care procedures are covered under the group health insurance policies. Day care treatment is when the treatment is done within a day and doesn’t need more than 24 hour hospitalization.
- Free check-up & other benefits: A group health insurance policy offers many benefits apart from hospitalization such as free health check-ups, free eye check-ups which are available to all the eligible members of the policy. Preventive health care measures are also taken up by the insurance companies for the employees of the group health insurance policies to reduce the severity of illness for the employee which also helps the employees maintain a healthy lifestyle. Many insurance companies provide apps to track the health of the employees at free of cost.
- Claim history doesn’t impact future retail policy purchase: The claim history under the group health insurance policy does not impact the prospects of taking retail health insurance as the retail health insurance policy only asks for existing health conditions at the time of taking the policy. The claims made in group health insurance policy would not affect the prospects of purchasing retail health insurance policy in future.
- Corporate Buffer: Corporate Buffer is the extra sum insured available in the group health insurance policy that can be distributed to the employees in case of need. Buffer would be allotted to the employees based on the decision of the employer as and when need arises. Corporate buffer increases the sum insured of the employee which can be utilized in case of need. In general the corporate buffer is assigned to the employee when the base sum insured is exhausted and there is need for extra sum insured for the treatment to be continued. Corporate buffers would otherwise not be available in the retail health insurance policies.
Group health insurance investment is the best financial investment in India as health insurance provides financial security to the families. Invest in group health insurance today and reap the benefits tomorrow, for more details on this please book a call with Ethika insurance to avail health insurance advice.