Importance of Group Health Insurance for Manufacturing Industries

Workers of a manufacturing firm are one of the most important assets. Since these workers produce finished goods using tools, raw materials, equipment after going through a particular process and play their role in the growth of the firm. Hence, it becomes a responsibility of the owner of the manufacturing firm to give something in return such as group health plan to the workers to keep them motivated stay in the firm for a longer time.

Coverage under Group Medical Insurance for Manufacturing Company

Group health insurance for manufacturing company covers the following:

• Pre-existing Diseases: The insurance plan covers pre-existing diseases from day 1.
• Infant Cover: This insurance plan provides coverage to the new born baby of the insured worker from the day of his/her delivery.
• Pre & post Hospitalisation: This insurance plan provides coverage for pre and post hospitalisation expenses.
• Doctor’s Fee: The plan covers the doctor’s fee.
• Maternity Cover: The insurance plan provides maternity cover. Several plans have 9 months of waiting period.
• Ambulance charges: The insurance plan provides coverage for ambulance charges.
• Room rent charges: This plan provides cover for room rent as per amount specified in the policy.
• Day care & Domiciliary charges: The plan provides cover for day care and domiciliary charges as well.
• Medical Test Cover: Some of the plans cover chemotherapy, radiotherapy and pacemaker cost, etc.
• Extended Cover: Some of the plans provide coverage for oxygen, blood, Anesthesia, Medicines, drugs, x-rays, diagnostics costs, etc.

Group Insurance for Manufacturing Company does not Covers

Group health insurance for manufacturing firms does not provide coverage for the following:

• Non-allopathic Treatments: This plan does not provide coverage for the Ayurveda and Homeopathy treatments.
• Parents: There are several plans that cover parents but some of the insurers do not provide coverage for parents.
• Alcohol & Drug Abuse: If the health related complications and ailment are caused due to alcohol or drug abuse then the insurer will not provide coverage for it.
• Congenital Diseases: Diseases present from the birth of the insured will not be covered.
• AIDS: The insurance plan does not provide coverage for the expenses incurred in the treatment of disease like AIDS or any other related ailments.

Claiming Process under Group Medical Insurance for Manufacturing Company

Follow the below mentioned steps to raise your cashless claim in case of third-party administrator under group health insurance for manufacturing firms:

• Fill-in Form: Fill-in the pre-authorisation form once you reach the hospital at the TPA desk.
• Pre-approval: TPA informs the insurance company for pre-approval.
• Approval Received: Insurer sends the approval with an initial amount.
• Final Settlement: After the treatment, the insurer settles the final payment as per T&C.

For re-imbursement, follow the steps mentioned below:

• Within 24 hours of hospitalisation, inform the insurer.
• Collect original bills reports and discharge documents.
• Within the 7 days of the discharge, submit the claim form and required documents.
• After checking the T&C of the policy the insurer will process the claim.
• Also provide a cancelled cheque to process the amount.
• The insurance company will reimburse the amount within 15 days.

Group Medical Cover for Manufacturing Company: Required Documents:

In order to raise a claim, following documents are required:

• Filled claim from with concerned Doctor’s sign
• FIR, if any
• Prescription of the Doctor
• Final bill
• Police report in case of accident
• Cash memo
• Discharge summary with the treatments listed
• Any other document that the insurer wants.