IRDAI License Number: IRDAI/INT/ISNP/2022/250
This policy comes under the Employee Benefit Insurance schemes which are meant for welfare and wellbeing of employees. This policy provides social security benefits which include compensation for hospitalization, untimely death, disabilities, occupational diseases and injuries.
Group Health Insurance Policy (GHI) is taken by employers to cover their employees and family members. The coverage under the policy is uniform for all employees/ members of the group except when sum insured vary for employees. Fabulous benefits are available in the policy at very competitive premium rates.
An organization can take this policy for their onroll employees.
Coverage under Group Health Insurance Policy are as follows:
Add-on covers under Group Health Insurance Policy are as follows:
Sum insured of INR 50,000 - 10 Lac per employee/family member can be taken.
Exclusions under Group Health Insurance Policy are as follows:
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.
The insurance company held the view and conveyed via TPA that Cashless serviced will not be extended to the claimant under these circumstances.
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.
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.
After retirement the individual did not have any Health Insurance Policy
The Individual was left without cover and if he was taking any policy from the market, it had a waiting period
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.
We advised him to take continuity benefit from his Corporate Group Policy by porting it
Important rating factor includes:
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