Endorsement Process in Group Health Insurance

Many of us may rely on the group health plan provided by the employer. With different needs and expectations, the group health plan is no longer considered a one-size-fits-all approach. An endorsement can be an inclusion, exclusion, or change in the original terms of an insurance policy. Let us look at the endorsement process in group health insurance.

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What Is An Endorsement Or A Rider?

An endorsement, commonly known as a rider, is used to add, delete, or make changes to the original insurance cover. The employer can also use endorsement in a group health insurance to increase the existing coverage limits.

Group health insurance endorsement is an excellent solution for employers seeking additional employee benefits. An endorsement can also help customize the group health insurance plan per employees' needs.

Purpose Of Endorsement In Group Health Cover

The primary purpose of an endorsement is to provide extra protection to the insured, especially if the scope of the original policy is limited. An endorsement in a group health plan helps boost the basic coverage. The following are the main purposes of an endorsement:

Addition of a Cover: Endorsements are often used to add coverage that has not been provided in the original policy. It gives an option to broaden the coverage. For example, a critical illness cover is added to a standard group health insurance plan.

Eliminating a Cover: Endorsements may also serve as exclusions or eliminate coverage for certain types of claims.

Modification of a Cover: Some endorsements may modify the policy's scope of coverage rather than adding or removing it. For example, an endorsement may include a specific clause that may affect the amount the employees may receive at the time of the claim.

Administrative Changes: The name, address or contact details of the insured are changed or updated and may be done through an endorsement.

In group health insurance, employees or employers might want to increase the policy coverage and opt for an additional benefit. This might lead to an increase in the premium amount. 

For example, an employer offers his employees a standard group health plan. He then wishes to add personal accident cover to the basic policy. Due to this financial endorsement, the premium amount is now higher than earlier.

Endorsement Process in Group Health Insurance

Endorsements are crucial because they address issues or items, not in the primary contract or policy. The process is straightforward and can be carried out by the policyholder. Let us now look at the endorsement process in group insurance:

Endorsement Process in Group Health Insurance

Step 1: As an employer and the policyholder of the group insurance plan, you can make endorsements in your group health insurance policy at the time of purchase, during the term and while renewing the policy.

Step 2: The policyholder (the employer in this case) must submit a request letter, supporting documents, and an endorsement form to implement the required changes in the original policy.

Step 3: The insurance company officially records the endorsement through an endorsement certificate.

Step 4: The insurance company then analyses the request by checking the accuracy of the request (if needed) and gets the required approval before taking necessary action. A new policy document is shared with the insured after making the changes.

Things To Remember While Opting For Endorsement In Group Health Insurance

Since we have learned about the endorsement process in group health insurance, we share some pointers you should keep in mind while opting for the same.

  • Once the endorsement is done, it forms a part of a legal agreement
  • Only if the endorsement mentions a specific period does it remain valid till that period, or else it stays valid till the expiration of the contract
  • Endorsements are thus renewed under the same terms and conditions as the rest of your policy
  • Financial endorsements have an impact on your premium.

Conclusion

An endorsement can help attain higher coverage at competitive rates and saves you from the worry of buying a new policy. The hassle-free endorsement process in group health insurance is widely used as it skips the administrative process and lengthy paperwork that might be needed for a separate insurance policy.

Written By: PolicyBazaar - Updated: 30 August 2022

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