6 Reasons Why Your Employees are Not Using The GMC and What to Do About It

To keep all the employees happy and satisfied, the companies offer employee benefit schemes like group health insurance. The purpose of offering group health insurance is to support employees to make them feel secure and in a way, it enhances their productivity. However, several employees might be underutilising the benefit.

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*Premium starting from ₹105/Employee/Month for ₹1 Lac Sum Insured covering Health & Wellness Needs (excluding GST)
#Premium may vary on the basis of coverage type & add-ons
**All savings are provided by the insurer as per the IRDAI approved insurance plan. Standard T&C Apply

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Top 6 Reasons Why Employees Underutilise the Benefits of Group Health Insurance Plan

Group insurance comes with  comprehensive wellness benefits along with a hassle-free experience. A company offers a health insurance plan to maintain the productivity of the employees, and also give them a healthy lifestyle to promote a healthy working culture. All these factors lead to enhanced performance of the employees and positive goodwill of the organisation.

Some employees find it difficult to utilise the benefits of group insurance plans offered by their employers. Here are the top 5 reasons for not utilising the healthcare plans-

1. Lack of Awareness

Lack of awareness about the group healthcare benefits is one of the common reasons for the underutilisation of the healthcare benefits offered by the organisation. It is not that they are not aware of being covered under a group medical cover but how to utilise it. Sometimes, employees are not aware of the coverage, inclusion & exclusions, the sum insured or the illnesses covered in a particular plan.

Moreover, the amount spent on medical expenses is relatively lower than the mentioned amount in the policy. That is why it creates confusion in the mind of the employees, and they end up choosing not to avail the benefits of the healthcare plans.

2. Inadequate Coverage

Coverage refers to the sum insured, eligibility for the claims, types of illnesses, inclusions & exclusions associated with incidental expenses, etc. Not having adequate knowledge about the GHI coverage leads employees towards ignoring its utilisation. At times, the sum insured mentioned in the policy is low, and employees end up not raising the claims, anticipating the benefits of the plan is not up to the expectations.

3. Exclusion of the Dependent Family Members

Generally, companies offer group health insurance that is limited only to employees. A company does not find benefit in including the employees’ immediate family members in the GHI.

However, employees look for plans that reduce their medical and financial stress by adding their immediate dependent family members to the policy. Hence, they end up choosing an individual or family floater health plan to cover their family members and ignore the benefits of the group health insurance plans. 

4. Not Sharing the Correct Personal Information

Another reason for the underutilization of group insurance is the employees not sharing their personal information about their medical history and condition with the organisation due to the fear of being judged.

Some employees do not find it right to share the nature of the type of illness with their employer. In the process of keeping their medical history private, they are unable to raise claims against certain illnesses that are not disclosed to the company.

5. Non-participation in Decision-making Process

Generally, the top management of the organisation takes the insurance company, the coverage, and some other factors for choosing the group health insurance plans. The inputs from the actual beneficiaries of the plan are not considered. Due to non-participative behaviour in the decision-making process, the employees lose interest in group health insurance.

6. Lack of Flexibility

An individual plan or family floater plan tends to be more flexible than a group insurance plan for the coverage and complimentary services. Therefore, employees might prefer choosing an individual health insurance plan over the GHI plan due to the flexibility of customising a plan.

Tips to Increase the Utilisation of Group Health Insurance Plan

Here are a few tips to ensure employees are actively using a comprehensive healthcare plan offered by the company-

1. Increase Awareness About GHI

An employer can provide all the information about the group health insurance plan to their employees during orientation and induction training. Moreover, they should organise workshops and regular training sessions to recall the features and benefits of a group insurance plan.

Furthermore, a representative from the organisation facilitates by explaining the claim process and addressing all the employee queries. The HR of the company should circulate emails regarding the plan features.

2. Enhance the Plan Coverage

Through the participation of the employees in the decision-making process, the companies can enhance the plan coverage, sum insured, cover more illnesses, and increase the number of beneficiaries in a plan. Moreover, an employer should take steps to flexible the plans, and allow customising them according to the individual’s need.

Companies should offer add-on covers and increase their coverage amount via top-up plans. Under the add-on covers, they should cover healthcare expenses that are not covered in a basic plan, including daily cash allowance, cost of consumables, critical illnesses expenses, etc.

3. Make a Hassle-free Claim Process

In any organisation, the claim process is too lengthy and involves a lot of paperwork. In such cases, employees may not want to get involved. They do not want to register claims and pay expenses from their own pocket. Therefore, the employees should partner with an insurer that allows an easy claim settlement process via a mobile app.

A group health insurance mobile app by Policybazaar.com allows the employers to directly settle their claims within 5 minutes from WhatsApp. Thus, a claim process becomes digital and simple, and employees do raise their claims without any hesitation.

Final Thoughts

Several digital group health insurers offer a value-based and affordable GHI. Therefore, an employer should have a plan that satisfies all the needs of employees, and the claim settlement process should be seamless, quick, and efficient. Moreover, to enhance the utilisation of group insurance, employees should also be a part of the decision-making process for choosing a plan.

Written By: PolicyBazaar - Updated: 05 May 2022
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