Difference Between Group Mediclaim Policy And Group Personal Accident Insurance

With employee satisfaction become a priority for most business owners these days, many companies have started providing extensive perks to their team members. Often confused with each other, group personal accident insurance and group mediclaim policy are among the most commonly provided employee benefit programs. Both of these help employees with any unexpected health emergencies and related financial burdens. Read on to know more about these plans.

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What Is Group Mediclaim Policy and Group Personal Accident Insurance?

As the name indicates, a group medical coverage policy is a customized program offered to a set of people with the same benefits to all its members. This plan offers assistance with hospitalization expenses, reimbursements of out-patient expenses, maternity care, and also covers families in many cases.

Group personal accident is specifically tailored for any damages caused due to accidents, injuries, or such. This plan covers you even if the employee is off duty or not, in the country or outside. It also has options for benefits like ambulance charges, education cover for two dependents, and other add-ons.

While both plans are made for a group of employees, there are some distinct differences. Here’s a table to help you understand these better:

Categories

Group Mediclaim Policy

Group Personal Accident Insurance

Purpose

A broad plan covering the health needs and medical expenses of all the employees

A plan tailored to protect employees mostly from sudden accidents or injuries that may render them disabled or deceased

Family Cover

Extended to employee’s family

Covers only several accident-related bodily injuries or the death of the employee

Limitations

Treatments carried outside the policy’s geographical limits are not covered

Treatments will be covered irrespective of the geographical area

Benefits

Helps with financial expenses incurred due to diseases, injuries, non-fatal accidents, maternity, and child care expenses, etc.

Provides reimbursements only in cases of juries or death caused by accidents and other consequent expenses as per the policy.

Understanding Group Mediclaim Policy

Like explained previously, this policy provides help with the treatment and hospitalization expenses of usual health concerns as covered by the policy. The premium paid is significantly lower than individual plans and hence very affordable for everyone. Here are some of its benefits offered:

  • Hospitalization Expenses: In cases when an employee is hospitalized, the cost of their stay, medical expenses, and other charges cost by the medical institute will be covered.
  • Pre & Post Hospitalization Expenses: The expenses incurred in consultation, testing, and other post-hospitalization costs are also covered under the group medical cover.
  • Maternity and Child Care Benefits: Female employees can avail reimbursement for their in-patient and out-patient expenses that may occur during their maternity leave. They can avail of many benefits including prenatal, infant, and post-delivery medical benefits.
  • Family Floater: More and more companies are offering extended coverage to their employee's family members. This usually includes spouses and children as well as parents and in-laws in many plans. The whole family can avail of benefits from the single sum insured for a year.
  • Cashless Hospitalization: Most network hospitals under the insurer offer this facility where employees can avail themselves of the cashless treatment facility.
  • Day Care Procedures: Employees who avail of treatment at specialized daycare centers and are discharged the same day can also get cover under this policy

Understanding Group Personal Accident Insurance

This plan is tailored to assist employees who may face unfortunate accidents that are fatal or render them injured or disabled. Because of its huge coverage, it is also known as 24- hour worldwide accident policy. Here are its benefits:

  • Accidental Death: In case of the unexpected death of an individual, it covers all medical expenses that were incurred for the treatment of the employee's injury. The expenses are covered as per the sum insured stated in the policy.
  • Dismemberment: Any accident leading to an employee's dismemberment (loss of limbs/eyes etc) is covered under the policy.
  • Disability (Permanent, Total & Partial):Compensation will be provided to an employee who may face any partial or total disablement depending on the terms of the policy provider.
  • Additional Benefits: Many group personal accident plans offer benefits like ambulance charges, transportation costs of carrying the deceased person's remains, cost of damaged clothing, etc
  • Optional Covers: The plan also offers several add-ons at additional premium including daily allowance etc.

When Are These Not Applicable?

As it is with most group insurance plans, there are some circumstances where these plans will not provide any compensation or benefits. A few of them are:

  • Diseases/accidents caused due to drug or alcohol abuse
  • Self-inflicted injuries, suicide attempts, intentional self-injuries
  • Damage caused by engaging in criminal or illegal activities
  • The loss suffered due to war, military action, mutiny, etc.
  • Expenses because of alternative or experimental treatments
  • HIV and other sexually transmitted diseases

Benefits Of Including Group Health Insurance Plans In Your Company

Other than the benefits and safety that a group health insurance plan offers, here are a few reasons why they are good for both the employer and their teams:

  • Motivates Employees: These plans help the employees with the financial burden of medical costs and motivates them. It also improves employee retention.
  • Tax Benefits: There are many tax benefits if opted for these insurance plans.
  • Affordable Premiums: These group plans are mostly cheaper than individual plans as the premium is higher for a group of individuals.
  • Quick Settlements: The company ensures that any unfortunate incidents with the employees are settled as soon as possible so that they can get the needed help/compensation for their losses.

To Conclude

Both group health insurance and group personal accident insurance are plans made to suit the different needs of employees. The plans can be customized depending on the requirements of the group as well as with other add-ons which the employee can purchase. In case of unfortunate accidents or sickness, corporate group health insurance can be very helpful for the employer and the employee, along with their family.

Written By: PolicyBazaar - Updated: 02 September 2021

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