Mumbai: You may have faced hardships while procuring a mediclaim policy for your ageing parents. Even the agents must have quoted exorbitant premium rates for a policy to cover pre-existing diseases, if any.
The group insurance policy may be the right choice for you. Insurance companies, which deny taking patients altogether or bloat the premium figures for a person whose health profile is not good, easily agree to the same when you go for a group insurance cover.
Group insurance policies have easy norms as the insurance companies have to spend less to clinch one policyholder.
Insurers consider that the chances of claims in a group insurance policy are less. A policyholder can get additional cover and can even negotiate for the premium rate, depending on the group profile.
Also, as Ajit Singh Dhingra, managing director of Prudent Insurance Brokers said, “The same type of cover is cheaper when taken under group.” The premium on a group policy depends on the number of members, the age profile they all come under, the area in which they stay and the number of claims that the company has experienced for a similar group.
The most common group policy which the salaried employees come across is the ‘Employees Group Mediclaim’. These days, most of the companies are using this insurance tool to either retain employees by including insurance benefit in the package or as a gesture towards employee welfare. However, many other groups too can be insured.
Even all the residents of a building, any social club, school students or a union can be insured. But, one cannot create a group just to get insurance, says Dhingra. “That is unfair. Insurance is not the intention of a group. The employees, club or building members have something in common and hence they form a group, which in turn is insurable,” he says.
The age of a group member is not a matter of concern for issuing a group insurance. Dhingra said, “We have also insured a group where one of its members was 101 years old.”
Most of these policies are family floaters, wherein the entire family of the group member, i.e. spouse, children and often parents, are covered. If one goes hunting for a family floater cover as an individual, the chances are bleak.
The best part is that none of the group members will undergo medical tests or give any declaration for good health. One reason for dropping the medical test may be, unlike individual health policy, all the pre-existing diseases are covered under a group policy.
In addition, the exclusion period of 90 days to one year that applies in individual policies is absent in group mediclaim. So, all the hospital expenses made since day one of the policy coming into effect can be claimed. “Under individual policy, claims for operations linked to cataract, hernia, fistula, etc cannot be made if done within a year of taking a policy. But, under group policy, they are immediately covered,” Dhingra says.
Maternity expenses can be claimed under group scheme. “Another unique feature is that employees and their spouses are covered for maternity expenses upto Rs 50,000 per delivery from the date of the employee joining the company, thus waiving the nine-month waiting period,” states a group policy from United India Insurance.
Not just for health insurance, but group covers are available for accident as well as term life insurance policies. Anybody who sells individual health insurance policy — an agent, broker or an insurance company sales person — can also sell group policies.
Source:
Daily News & Analysis
Khyati Dharamsi
