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Group Health Insurance Policy

Group health insurance plans provide coverage for a group of people – usually employees of a company or members of an organization, which can also extend to their families. Medical expenses incurred by the insured during hospitalization and any illnesses or injuries they may suffer will be covered by their insurance policy. Having these benefits will enable your employees to cover their unexpected and potentially expensive medical expenses caused by illness or accidents.

Key features

  • Accidental and Illness Hospitalization Cover

  • Day-care procedures

  • Pre-Hospitalization Medical Expenses

  • Post-Hospitalization Medical Expenses

  • Domiciliary treatment

  • Road ambulance expenses

  • Congenital internal diseases.

  • No medical screening is required.

  • Health ID Cards.

  • Cashless network of hospitals.

  • Employee deletion and addition flexibility.

Insureds can extend coverage by:-

  • Insurance coverage for employees’ dependents.

  • Maternity benefits, including prenatal and postnatal care

  • Cover for a new-born baby

  • Outpatient special cover

  • Corporate buffer

  • Restoration benefits.

  • Ayush Treatments

  • Medical opinion service

  • Hospital cash cover.

  • Wellness Program.

  • Organ Donor Expenses

  • Air ambulance cover

  • IVF and infertility treatment

  • Mental illness and disorders

  • Consumable expenses

  • Non-medical expenses

  • Modern treatments, stem cell surgery, gamma knife/cyber knife surgery, oral chemotherapy, Robotic surgery, Septoplasty, RFQMR Device – Cryotron, C3R, balloon sinuplasty, bariatric surgery, injection of Avastin/Lucentis/Macugen, and Ozone Therapy.EECP, rejuvenation therapy, etc.

You can take advantage of the following waivers.

  • Pre-existing disease exclusion.

  • Specific illness waiting period.

  • Waiting period for the first 30 days.

  • Disease wise Sub Limits

  • Co-Payments.

Employer benefits

  • Effective employer-employee relations

  • Reduced tax burden

  • Cost-effectiveness

  • Promoting goodwill

  • Attracting and retaining quality employees

  • An effective motivational tool

Exclusion, claim arising therefrom

  • Any medical treatment not involving hospitalization, other than day procedures.

  • Hospitalization is in the absence of an active line of treatment

  • Cosmetic treatment, except in specific situations like accidents or injuries.

  • Standalone Investigation & Evaluation

  • Attracting and retaining quality employees

  • Self-inflicted injury

  • Congenital disorders, external.

  • The cost of spectacles and contact lenses, hearing aids.

  • Hazardous or adventure sports

  • Voluntary medical termination of pregnancy.

  • The treatment of alcoholism, drug abuse, and other addictive conditions, and the consequences thereof

  • Dietary supplements and substances including but not limited to vitamins, minerals, and organic substances.

  • Correction of eyesight caused by a refractive error of less than 7.5 diopters-related expenses

  • Unproven treatments

  • Naturopathy treatment

  • Obesity/ Weight Control

  • Gender treatments

  • Sexually transmitted diseases

Group Health Insurance VS Employee State Insurance Scheme (ESIC)

ESI is available to employees whose salaries are below Rs.21,000/- per month. Both the employer and the employee contribute to the future treatment cost premium. All expenses are predefined, and the state government operates hospitals where beneficiaries can receive treatment.

GHI (Group Health Insurance) can be purchased based on individual requirements. It can be customized according to desired terms (like Maternity Benefit, No Room Rent Capping, Free Health Check-ups, No Sub-limits, Ambulance Charges, and Additional Personal Accident Coverage). Day-care and inpatient hospitalizations can be obtained from any hospital or clinic in India that is registered to provide care.