Importance of Group Health Insurance for IT/ITES Industries

Employees are one of the most important assets of an organisation. Since almost everything is done online using computers these days, IT professionals make sure that the company’s online data stay secured from external threats as well as keep fix the laptops of the other employees of the organisation in case they have to face any issue.

Hence, it becomes employer’s responsibility to give these IT professionals a reason to continue working in the organisation for a longer period of time and that is where the role of group medical cover for IT industry begins. It reflects the employer’s goodwill, helps in retaining good employees and standout in the market among other organisations.

Coverage under Group Medical Insurance for IT/ITES Industry

Group health insurance for IT/ITES firms covers the following:

• Pre-existing diseases are covered under this insurance from the 1st day of commencement of the policy.
• Pre & post hospitalisation charges are covered under this insurance policy.
• Insured employee’s new born baby is covered under the policy starting from the day of delivery.
• The Doctor’s fee is also covered under this plan
• Room rent charges as per specified in the policy copy is covered
• Maternity cover is provided however, some of the plans come with 9 months of waiting period
• Day care cover is provided
• Domiciliary charges are covered under this policy
• Medical tests such as radiotherapy, chemotherapy, etc. are covered
• Extended cover for supplies such as oxygen, medicine, drugs, etc. are covered

Group Medical Insurance for IT/ITES Industry does not Cover

Group health insurance for IT/ITES firms does not provide coverage for the following:

• There are several insurance plans that do not provide coverage for parents
• Congenital diseases are not covered under this plan
• Health-related complications due to over dose of drugs or alcohol abuse are not covered
• Non-allopathic treatments such as Homeopathy or Ayurveda are not covered
• Expenses incurred in the treatment of AIDS or other related diseases are not covered

Group Insurance for IT/ITES Industry: Claiming Process

Follow the steps to raise the claim through TPA under group health insurance for IT/ITES industry:

• Once you reach the hospital, fill in the form at the TPA desk
• Third-party administrator will inform the insurer for pre-approval
• The insurance company will send the approval with an initial amount to be paid
• Once the treatment is done, insurer settles the final amount according to the terms and conditions

For re-imbursement, follow these steps

• Inform the insurer within 24 hours of getting admitted in the hospital
• Collect all the documents such as bills and discharge documents
• Fill in and submit the claim form along with the required documents
• Then the insurer will process the claim
• Provide a cancelled cheque to initiate the process of getting the claim amount
• Then the insurance company will settle the claim within 15 days

Group Health Insurance for IT/ITES Company: Required Documents

Make sure to keep the following documents handy as you will have to submit these documents along with the claim form.

• Filled claim form with Doctor’s Signature
• Prescription made by the doctor
• Police report in case of accident
• FIR, if any
• Cash memo
• Discharge summary with the list of treatments done
• Any other document as per the insurer’s requirement