Group health insurance is a type of health insurance plan that provides coverage to a specific group of people such as employees of a company or members of an organization. Also referred to as corporate health insurance, this insurance policy comes with multiple benefits such as accidental hospitalisation, COVID insurance, daily hospital benefit, critical illness cover, maternity cover etc.
A Group Mediclaim policy is the best way to protect your employees and their families, especially with the constant rise in medical expenses. This is because the Group Mediclaim policy covers the expensive medical treatment costs incurred by the employee if hospitalized due to an illness or an accidental injury.
When the group health insurance is provided by the employer, then both employee and employer are supposed to be the beneficiary. This is because; the plan addresses both the parties of a group.
Advantages of Group Health Insurance Policies
Employees are the treasured part of any organization. These days more and more companies are becoming employee-centric and corporate health insurance has emerged as one of the most preferred benefits to lure new talent. It plays a crucial role in influencing the psychology of an employee. It makes him feel part of a company and thus, it curtails employee attrition rate and unrest in labor unions. Moreover, it increases their productivity which increases profitability of a business. Special insurance schemes where families are also covered for benefits make employees faithful towards their employers. Moreover, by offering coverage to your employees, you become eligible to get tax deductions under Income Tax Act. So group or Corporate health insurance policy is a win-win situation for both employees and employers.
Advantages for Employers:
Helps in Employee Retention: In this modern era when there are a lot of jobs in all the fields, employee retention has become a difficult task. However, if the employer provides benefits like health insurance coverage to all its employees and his/her families as well, then the chances of an employee staying in the company increase.
Tax Benefits: As mentioned above both employer and employees are the beneficiaries in a health insurance plan for the group, thus the employer also gets tax benefits for providing such policies to its employees.
Motivated Employees: Today, when the medical costs are at its peak, having a corporate health insurance plan, motivates employees.
Better Benefits in Low Cost: Health insurance for employees provide better benefits in comparatively lesser cost than individual health insurance policy.
Advantages for Employees:
Pre-Existing Disease is Covered from Day 1: Unlike any individual health plan, a group health insurance policy starts covering pre-existing diseases from the day an employee joins the organization. In this way, there is no waiting period for any pre-existing disease.
An Extensive Range of Coverage with No Limited on Diseases: Apart from covering pre-existing diseases, a group health insurance plan for employees provides a wider coverage with no limit on diseases.
Larger Maternity Coverage: A wider maternity cover is one of the best advantages given to young employees. Most of these plans provide coverage for both C-section and normal deliveries. Some plans as well cover the newborn babies without a standard 90 days of maternity cover.
Companies Offering Group Health Insurance Policy in India
In the below grid, find the highlights of the different insurance companies providing group health insurance policy
Claim Settlement Ratio
Bajaj Allianz General Insurance Co. Ltd
Bharti AXA General Insurance Co. Ltd.
Edelweiss General Insurance Co. Ltd.
ICICI LOMBARD General Insurance Co. Ltd.
Max Bupa Health Insurance Co. Ltd
Reliance General Insurance Co.Ltd
Care Health Insurance (Religare)
SBI General Insurance Co. Ltd.
Manipal Cigna Health Insurance Company Limited
Star Health & Allied Insurance Co.Ltd.
IFFCO TOKIO General Insurance Co. Ltd.
HDFC ERGO General Insurance Co.Ltd.
Cholamandalam MS General Insurance Co. Ltd.
Universal Sompo General Insurance Co. Ltd.
The New India Assurance Co. Ltd
National Insurance Co. Ltd.
The Oriental Insurance Co. Ltd.
DHFL General Insurance Ltd.
Royal Sundaram General Insurance Co. Ltd.
See More Plans
Features of Group Health Insurance Plans
There are several group or corporate health insurance policies available in the market. Listed below are some common features present in all employee health insurance plans.
Employee health insurance companies typically cover medical benefits for insured (self), spouse, children and dependent parents
Some health insurance providers cover pre-existing illness and maternity as well
Employee health insurance offers cashless hospitalization at network hospitals
Group health insurance can cover ancillary charges such as ambulance costs too.
Some employee health insurance policies provide fee reimbursements of specialists and other medical practitioners for follow checkups
Why Is Group Health Insurance Required?
These days organizations are becoming more employee-centric than before and hence they offer health insurance plans to its employees. Some of the reasons why group health insurance plans are required and beneficial for both employers and employees are:
Wide Coverage and Better Benefits: Most of the group health insurance plans provide wide coverage and elaborated benefits to the policyholders.
Option to Get Customize Cover: The health insurance policies for groups and corporate give the option to customize coverage. For example, an employer can take a plan that provides maternity cover or OPD coverage.
Affordable Premiums: Comparing individual health insurance plans with group health insurance in terms of premiums shows groups health plan as affordable. This is because the premiums that one has to pay in respect of coverage that one gets is always higher in group health plans.
Group Health Insurance Inclusions
The common inclusions that most of the group health insurance plans provide to its policyholders are:
Pre-existing diseases are covered from day one.
Maternity cover is provided in all the group health insurance plans; however, some has a waiting period of 9 months whereas some do not.
The infant is covered from the day of his/her delivery.
Some plans also cover ambulance charges.
Pre and post-hospitalization expenses.
Domiciliary and daycare expenses.
Fees of a medical practitioner and specialists.
Room rent and nursing charges.
Anesthesia, oxygen, blood, OT charges, medicines, drugs, and cost of diagnostic such as x-ray, etc.
Some plans also cover radiotherapy, chemotherapy, pacemaker cost, etc.
Group Health Insurance Exclusions
The common exclusions that all the plans under this category have been:
Some policies do not cover the parents of the employee.
Non-allopathic treatments like homeopathy, Ayurveda, etc. are not covered.
The validity of a corporate health insurance policy for employees is always limited and is valid only until the employee works with the organization.
Congenital diseases and all the expenses incurred in the treatment of AIDS and other related alignments.
Alignment or complications arising out of the use or abuse of alcohol or drug.
How to Claim for Group Health Insurance?
The common steps that most of the health insurance providers follow in order to file a claim are:
Contact the health insurance provider in order to file a claim as soon as possible by calling the toll-free number.
The customer care representative guides on the claim process and all the documents required.
An insured can download the claim form from the website of the insurance provider or can ask for the same to the customer care representative of the company.
Duly fill and sign the claim form.
Attach all the required documents with the form.
Send the claim form with all the documents to the specific address of the insurance provider.
Note: The policyholder is suggested to keep the copy of all the documents and claim form with him/her.
Documents Required for Making a Claim
Documents always play a major role in the approval of the claim. The list of documents required in this case while making a claim are:
Duly filled claim form with the sign of concerned doctor or hospital.
Final investigation report.
Final bill with the breakup.
In case of accident, police report.
Cash memos and itemized bills.
Discharge summary with a suggested line of treatment.
Any other document required by the health insurance provider.
Note: The policyholder has to submit the original copies of all the documents.
Buy Group Health Insurance Policy at PolicyBazaar
Group health insurance is a medical insurance that covers a group of people, who are usually the members of family, employees of a common company, or professionals in a common group. Group health insurance helps companies identify and mitigate the risks faced by their employees. Rising costs of healthcare have made it necessary for every employer to cover their employees and their families from financial instability that may arise in case of hospitalization. Also, corporate health insurance helps companies in attracting talented staff. Whether you are a small group or a company, you can easily retain best talent in the industry by offering comprehensive health insurance coverage.
Almost all health insurance companies offer flexible covers at affordable premium rates, which depend on conglomeration of factors, like size of the group, profile of members, etc. It works under certain terms & conditions, which are applicable to all insured members.
At PolicyBazaar, we strive to use highly innovative approach to help you in comparing best health plans. Compare and choose the right health plan, which provides coverage to all members in a single policy.
Want a Healthy Workforce? We can Help!
It is no secret that employees’ value benefits of group health insurance. However, as premium costs escalate and claim procedure being stringent; employee health insurance has become a tight rope walk in India. We at PolicyBazaar introduce a wide gamut of group health insurance policy products to help you in choosing best corporate insurance plans that will suit both parties i.e. employers and employees. Blending the entire service right from expert advisory, purchase assistance and policy renewal in one package, PolicyBazaar works towards making insurance process easy and convenient.
All the employees who are more than 18 years old and below 70 years and are employed with a company are eligible to get cover for Group Health Insurance policy. In addition to that, they can as well add their dependent children who are between 3 months to 25 years, spouse, and sometimes even parents.
A standard individual health insurance policy has several waiting periods for specific reasons and diseases. One of the biggest advantages of having a group insurance (or group mediclaim) policy is that these waiting periods can be waived off. Also, it is important to understand the implications of these waiting periods. The different waiting period in a Group Health Insurance policy are:
Waiting Period of 30 Days: This is put by the Insurer to make sure that the policy was not taken for a planned surgery immediately after the policy. Hence, emergency hospitalization and accident cases are covered in this period. All other hospitalization cases are not covered for the first 30 days of the inception of the policy. This condition can be waived off (if desired).
Waiting Period of One Year: Group health or medical insurance policies exclude certain high incidence diseases, including Cataract, Kidney Stone, Gallbladder, etc. The list of such ailments varies from one Insurer to another. Because of this condition, the members cannot claim this benefit until the expiry of 1 year in the plan. However, under Group Health Insurance policy, this condition can be waived off, if desired.
Waiting Period of 2 Years and 4 Years: Several insurers have a waiting period of 2 to 4 years for many pre-existing diseases. The list of such pre-existing ailments may vary with the insurer. So, you have to go through your policy documents for getting to know about the waiting period of 2 to 4 years.
Waiting Period of ‘9-months’: Group health insurance policies that provide maternity benefits have a 9-months waiting period before the person can claim the benefit. However, if the company so desires, this waiting period can also be waived off, essentially making the member eligible to claim maternity benefit from Day 1.
Hospital costs are dependent upon the type of room selected, e.g. fees for doctor consultation in a single A.C. room would be higher when compared to the shared room in the hospital. Hence, insurance companies put conditions on room eligibility. All costs thereafter are payable as per the eligible room rent. Typical eligibility is 1% of the sum assured as room rent cap.
Below figures, shows the cost of a Single AC room and Shared Room, along with are mentioned the package cost of Heart By-pass surgery for these rooms respectively. These are actual costs for a leading hospital in Delhi. Room rent per day: 1. Single AC Room: 9900 2. Shared Room: 4000 Cost of heart surgery by room type: 1. Single AC Room: 292,000 2. Shared Room: 200,000
In case the policyholder selects a room with a higher rent than the one mentioned in the policy document, the charges to be paid shall be limited to the charges applicable to the entitled category. So, if for instance, one had a health policy with a sum assured of Rs. 4 Lakhs, and room eligibility of up to Rs. 4000, then the claim payable would be limited to Rs. 2 Lakhs. So, despite the sum assured being much higher, the Insured would have to pay 92,000 out of pocket.
Fortunately, one can customize the Group Health policy to choose the room rent type. The following options are available: 1. As proportion of Sum Assured (1%, 1.5%, & 2%) 2. Single AC room (irrespective of the costs) 3. No room rent capping at all
The primary advantage of group health insurance is that one can enhance the coverage over a standard policy. One such benefit that most companies take while buying Group Insurance is the pre-existing diseases. Let us discuss the pre-existing disease concerning Group Health Insurance extensively:
Pre-Existing Disease: A pre-existing disease is an ailment or sign of an ailment present before the inception of the insurance policy. For instance, many cardiovascular diseases are classified as pre-existing diseases, in case one has a heart attack. The same is valid in case one has a problem with severe blood pressure abnormalities, which can also be classified as a pre-existing disease in the name of cardiovascular issue.
Pre-existing Disease Coverage: Many insurance companies have started providing coverage for pre-existing diseases after a waiting period of 4 years. Some other insurers would have a lower criterion of 3 years. Pre-existing medical conditions are permanently excluded before policy issuance. This is to prevent any fraud or misuse so that people do not buy insurance to cover pre-existing diseases.
Group health insurance policies offer coverage for pre-existing diseases right from day one. Since group insurance is purchased for numerous families together, the chances and the impact on frauds are considerably reduced. Hence this benefit can be offered by Insurance companies.
It depends on the demographic to be covered and the benefits you want to offer to your group members. For instance, if the group includes youngsters who don't have a medical history, including coverage for a single person, the benefits of the policy are comparatively less important. On the other hand, if the group has an average age of 40 with parents covered, then the significance of this benefit is much more. Also, it is dependent on the group's policy as well as on the cost it wishes to include. Some group members might be entitled to the benefits of the policy only after they have been with the system for 4+ years. At the same time, this benefit comes only at an additional cost.
One of the key benefits that young employees value in the Group Health Insurance (Group Mediclaim) provided by the company is the Maternity Benefit. There are several aspects to the Maternity benefit that should be considered while designing and purchasing the group health insurance plan. These aspects are covered below:
Amount of Maternity Coverage: The maternity sum assured is different from the overall sum assured of the group mediclaim policy. This sum assured is fixed differently for Normal and Caesarean delivery. Generally, companies provide a higher sum assured for Caesarean delivery. The market average is to provide 25,000 as the sum assured for Normal and 35,000 for C-Sec delivery. While most Insurance companies limit the benefit to 50,000, some would provide as high as 100,000. Group insurance plans for young group offers maternity benefits. Hence HR managers have to evaluate the extent of benefit to be offered carefully.
Co-Pay in Maternity Cover: In case your policy has co-pay, it is generally not applicable for maternity claims. The rationale being that benefit is already capped. However, your Insurance Broker needs to specify this in the policy terms since ambiguity later can lead to claim disputes and employee dissatisfaction.
Coverage for Abortion in Maternity Cover: Group Health Insurance generally does not cover self-inflicted, or fertility-related treatments. Similarly, voluntary abortion is not covered under Group Health Insurance by most Insurance companies. However, emergency abortion, i.e. for the life-saving purpose is covered by most insurance companies. It is important to note that each company has its view on this, so it is important to get it clarified through your insurance broker.
Coverage for a Newborn Baby Under Maternity Cover: In a standard policy, a newborn is not covered under the health insurance policy unless it is at least 90 days old (some companies increase the restriction to make it 150 days). However, one can get it customized to cover a newborn from Day 1. Within this, the employer has a choice to fix the sum assured for the newborn for the period between 0-90 days. It can be either the maternity sum assured or the sum assured available to the employee. It is highly recommended that the higher sum assured should be chosen since if any complication arises to the newborn, the maternity sum assured would be highly inadequate.
Waiting Period for Maternity: Some of the individual policies that offer maternity benefits have a waiting period of 3-4 years. However, in a Group Health Insurance (or Group mediclaim) the waiting period comes down to 9 months i.e., the member should at least be enrolled in the policy for nine months. This condition for 9 months waiting period can also be waived if desired by the company. This would mean that from Day 1 of the policy, the enrolled members can claim the maternity benefit.
It is a standard exclusion with most insurers. Again, this exclusion can be waived off and get it covered in the group insurance policy. Do note that all companies do exclude external congenital diseases.
Some health insurance plans pay for the expenses of general health check-ups at-least once in some years. Generally, this facility is available once every four years and is provided as a value-added service for corporate customers.
Written By: PolicyBazaar - Updated: 14 January 2021
Though I am not upset with the services of the policybazaar but I felt that sometimes they delay in providing with the services from the customer care. But day by day their work is going good and I feel they are improving a lot. I had taken the group medical cover from them.
Babhleshwar, August 18, 2020
Online buying of the policy
We recently bought the group accidental insurance for our employees. It is an amazing plan with great safety features and the premium rate is less. Not so costly at all. Even, we bought the policy online. It is very easy and hassle free to buy the policy online. Thank you so much team policybazaar for giving the best plans at low premium rates and the prices.
Baarod, August 17, 2020
Documentation to be required
We provided the group accidental cover to our employees for the safety and security of them. As nowadays the life has become quite risky. So, while the policy was been issued all the documents were duly checked. And it is much required so the policybazaar does their work properly. Thank you
N.paravur, August 17, 2020
I have received a great number of support and the benefits from the policybazaar at the time of buying of the group medical cover. But recently I faced the delay in issuance of the policy copy. But that was little delay which was resolved in few hours. It’s good that Policybazaar helps their customer at each and every step
Vadali, August 14, 2020
Helps in employee retention
The group health insurance plans are really good as it helps in the retention of the employees into the organization. If the employer provides the health benefits schemes to the employees then there are chances that the employee will stay in the organization. It is a good plan and I really love it.
Vadali, August 14, 2020
Gets medical expenses covered
We have taken the group medical insurance policy for our office employees as it is much needed thing for the now time. So, it provides the medical support to our employees and helps them to get the medically treated well. It brings the positive thing into the mind of the employees. Thank you team Policybazaar.
B.khajuripada, August 05, 2020
Compare plans easily
I recently took the personal accident cover insurance for my employees and it was suggested by many people and for the happiness of our employees we have taken such great plan. Along with that I search the website of policybazaar and got to know about various plans. I compared all kind of plans and finally choose the best one for our employees.
Vadali, August 05, 2020
Maternity coverage included :
The group health insurance plan which we have taken for our employees of the organization is well good. It is also good for the females as it covers the maternity insurance and services of the customers. It gives 90 days of assistance to pregnant females. A good plan.
Fakirsahi, July 30, 2020
Better benefits with low premium
We have taken the group health insurance plan for the employees of the organization. It is a good plan which have the best benefits and the add on covers for the employees. Also, the premium rate of the policy is very good and not so costly. To help the employees for their health this is really good package we came across. Thanks team.
Hadol, July 29, 2020
I have come across various better plans and policies for the group health insurance policy. The policybazaar team has diversified form of plans and policies and you can choose out of them easily. A great place where you can choose the secured and safer plan.
Nabadwip, July 29, 2020
It gives motivation to employees
We, as a company has taken the group health insurance for our employees. It is a good plan and helps our employees to stay motivated. It is a best plan for our all employees and we believe in the safety and the security for everyone. In this policybazaar sales team helped us a lot to get the latest and useful group health plans.
Jabalpur, July 29, 2020
Tax Benefits to be given
We have provided the group health insurance to our employees of our organization. It is a good plan which helps each and every one provides with the tax benefits. In this both the employee and the employer gets the ultimate amount of tax benefits. It helps in securing the health and the money.
Gorakhpur, February 17, 2020
I feel that policybazaar is such a nice cpmpany who actually thinks about customer. They provide good customer assistance.
Kallara, February 06, 2020
I got the best and perfect group policy for my team and I am happy that my employees are getting a good benefits out of it.
**IMPORTANT NOTICE: We have received in-principle approval from IRDAI for our insurance broking business. In accordance with the in principle approval, since 24th January 2020 we have changed our name from Policybazaar Insurance Web Aggregator Private Limited to Policybazaar Insurance Brokers Private Limited. We thank our customers for their continued support and assure that our customers remain our priority.
**Discount is offered by the Insurance company as approved by IRDAI for the product under File & Use guidelines #On the basis of your profile
CIN: U74999HR2014PTC053454 Policybazaar Insurance Brokers Private Limited (formerly known as Policybazaar Insurance Web Aggregator Private Limited) Policybazaar is currently registered as a Web aggregator by IRDAI. Approval for registration as an Insurance Broker is pending with the IRDAI. Registered Office - Plot No.119, Sector - 44, Gurgaon, Haryana - 122001
Insurance is the subject matter of solicitation.Visitors are hereby informed that their information submitted on the website may be shared with insurers.
*The information provided on this website/page is only for information sake. Policybazaar does not in any form or manner endorse the information so provided on the website and strives to provide factual and unbiased information to customers to assist in making informed insurance choices.
The product information for comparison displayed on this website is of the insurers with whom our company has an agreement.