Group Health Insurance Policy

At Your Chosen Price

Different Companies have different needs depending on Employee profile We have Great Offers for all your needs.

Minimum 7 Employees Required.

Pre-Existing Diseases.

Mother & Father In Law Can Be Consider To Opt For This Policy Cover.

Option Of Selecting Sum Insured & Limits Etc. Create Number Of Options Instantly.

Get Comparative Quotes From Leading Public Sector And Private Insurance Companion.

Health Cover of ₹1 Lakh
Just ₹105/employee*

Coverage under Group Health Insurance Policy are as follows:

Self, Spouse, 2 children and Parents can be covered with or without Family Floater.
Room Rent and ICU expenses
Ambulance Charges
Maternity Benefit up to Rs.50,000 per claim with or without 9 month waiting period
Newborn Baby Coverage from Day One within Maternity Sum Insured
Pre-existing diseases
Waiver of 30 day waiting period
Waiver of 1st, 2nd & 4th year exclusions
Corporate Floater for major illness
Domiciliary benefit
OPD charges
Expenses incurred 30 days before and 60 days after hospitalization

Why Choose PolicyLo. com

Professional and Experienced Team

Customized Solutions

Strong Relationship With Insurance Companies

Service Commitment Ontime Everytime

Technological Edge

Additional Services Offered

Competitive Premium

Single Window Solution

Key Documents At The Time Of Claims

General Claim Intimation Format

Immediate Action Client Should Take

Indicative General Documents for Settlement of Claims

Important Points To Remember While Buying The Policy

Group policy sync with individual policy to get the continuation benefit of exit employees

A Clause can be added in Group Policy wherein the group benefit can be synchronized with Individual Policy for the employees exiting the organization and taking the individual policy from the same Insurer

Corporate Floater can be covered

Corporate Floater provides facility to cover the medical expenses incase of individual family sum insured exhausted.

Parents can be covered along with employees

GMC Policy provides an option to cover employee's parents as well by charging additional premium.
This option nulify the requirement of separate health policy for parents.

Claim Case Study 1

Situation

In a GMC policy of a fast growing IT company, there were frequent joining`s of the employees due to which the employees did not get the coverage from day one.

Challenge

The insurance company held the view and conveyed via TPA that Cashless serviced will not be extended to the claimant under these circumstances.

Solution

We were able to convey to the Insurance company that the CD deposit so maintained takes care of such exigencies and claims were paid accordingly.

Advisory/Conclusion

Complete reconciliation of data was done to ensure all the existing members are covered. Monthly details of addition and deletion of members was comprehensively done for future.

Claim Case Study 2

Situation

After retirement the individual did not have any Health Insurance Policy

Challenge

The Individual was left without cover and if he was taking any policy from the market, it had a waiting period

Solution

Health insurance policy should continue and there should not be any break to avail the accrued benefits. Even in case of portability, accrued benefits will continue with the new insurer.

Advisory/Conclusion

We advised him to take continuity benefit from his Corporate Group Policy by porting it

Frequently Asked Questions

Premium

Coverages

Claims

Others

Which are the important rating factors for GMC Policy?
Important rating factor includes:
- Family definition
- Average age of members
- Sum insured
- Add on covers
- Claim ratio of expiring policy (in renewal cases only)
Do i have to pay any amount on behalf of my employees?

The decision to pay the premium of the GMC policy, either partly or completely, rests solely on the employer. If the employer wants, he can pay the premiums in full on behalf of his employees. Contrary to this, the employer might also ask his employees to bear the entire premium themselves or pay the premium partly.
How does claim amount in the expiring policy impact the premium?

Claim history reveals the risk exposure of the group, whether the health of the lives in the group is standard or sub-standard.
Can i reduce my coverage to reduce the overall premium?

Yes, group health insurance policy are highly customizable. You can take the coverage based on your need and preference.
what is the impact of co-payment benefit on premium under the policy?

Co-payment benefit overall reduces the burden of premium on the employer. The claim amount is shared by the claimant upto the co-payment limit specified in the policy.

What is covered in GMC policy?

Hospitalization expenses such as room charges, nursing care, cost of medicines etc. is covered in the policy.
Who can buy GMC Policy?

GMC Policy is purchased by employers to cover medical expenses of their employees, dependents like spouse, children and parents.
What is the smallest size of group which qualifies to be benefitted by GMC policy?

As per exposure draft dated 19-1-2016 of IRDA, minimum number of persons required to form a group for purpose of a group health insurance policy is 20. However, group policy under micro insurance can be issued to 5 members.
What are additional benefits available under GMC Policy?

Pre-existing diseases and maternity expenses can be covered. Waiting period of 30 day & 1 year are also waived.
Can pre existing be covered from day one under Group Mediclaim Policy?

Yes, Pre existing disease can be covered from day one under Group Mediclaim Policy.

Is claim payable if treatment is not taken in network hospital?

Expenses are reimbursed subject to limits specified in the policy. The insured has to fill up claim form and produce allmedical bills along with prescriptions, test reports.
In case of a major operation if limit of expenditure of a group member gets exhausted, what should the member do?

Amount can be sanctioned from Corporate Buffer for named operations/procedures.
Can a group member claim beyond individual sum insured or floater sum insured?

No one individual or family can't claim beyond the Family Sum Insured.
How reimbursement claims are settled?

Under reimbursement claims all original documents duly signed by the doctor along with Claim Bill are required along with the reason why cashless was not opted.
Who decides whether Corporate buffer to be utilized at the time when limit of an employee exhausted in a policy year?

It is generally decided by Human Resource Department of the Company.

Are medical tests compulsory for GMC Policy?

No Medical test is conducted under Group Policy unless any insured member is of more age than the limit specified.
Are Group Health policies tax deductibles?

Only employer can claim the premium paid for the group insurance policy as a tax deduction., An employee is not entitled to IT exemption under the health cover provided by an employer.
What are the advantages of Group Health Insurance for an employee?
Advantages of Group Health Insurance for an Employee is as follows:
- Pre Existing Disease is covered from Day 1
- An Extensive range of coverage with no limit on diseases
- Larger Maternity Coverage
What are the advantages of Group Health Insurance for an employer?
Advantages of Group Health Insurance for an Employer is as follows:
- Helps in Employee Retention
- Tax Benefit
- Motivated Employees
- Better Benefits in Lower Costs

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CUSTOMIZED GROUP HEALTH INSURANCE

At Your Chosen Price

Health Cover of ₹1 Lakh
Just ₹105/employee*