Many corporates offer group health insurance to their employees to secure their well-being. If associated with any organisation as an employee, you are by default covered if the employer is offering group health cover. Many of the group policies cover not just employees but also their family members. Here are a few benefits of a group health insurance plan:
Advantages:
No waiting period: Unlike a personal health policy, most group health insurance plans do not have waiting period. Waiting period is the time span after the purchase of policy during which an insured cannot claim any hospitalisation expense from the insurer. In group health cover though, you and your family are covered from day 1 of the policy.
Quick claims: You do not have to face much hassle in settlement. Your claims are given priority and are looked after and settled by the third-party administrator (TPA) and the insurance company.
Low Cost: While many companies offer health cover for free, few also charge for them. In many cases, group health cover may be free for employees but they have to bear the premium for their family members. It is cost effective though vis-à-vis individual plans since the premium is shared among large number of employees under a group cover.
There are also a few drawbacks of group health insurance plans though. These are:
Drawbacks:
No customisation: Group insurance covers have limits in terms of customising the needs and medical history of you and your family members. It won’t provide adequate sum assured for all your family’s health care expenses.
No tax benefit: You are not eligible for tax benefits to claim insurance premium under Section 80D as an employee. This is in cases where the employer bears the premium and not you.
Risk of losing cover in job change: Once you switch jobs or even leave your corporate job, you lose the corporate health cover. The risk increases as you age and hence you cannot lifelong be dependent on your employer policy for health insurance needs.
What should you do once you are covered under a group health insurance policy? Here are a few pointers to bear in mind
Get an E-card or TPA card: Ensure to follow-up on the E-card or TPA card once you are covered under group cover. This will help you to avail cashless hospitalisation and seamless settlement. Once you receive it, confirm that all your basic details like name, date of birth, contact details, etc are correct. Also maintain a soft copy of the same.
Go through the policy document: When we buy a personal independent health cover, we make efforts to understand all the features of the product and its suitability before buying. That is not the case with group insurance cover because the corporate makes a deal with the insurance company. While employees are happy about receiving insurance benefit from their employer, majority do not bother to check the policy document of the product. It is important to at least go through the list of diseases covered and not covered and other terms & conditions under the group policy. This would ensure that you at least know what you can expect from the group cover and do not receive any rude surprises.
Inform your family about the policy: In Covid times, there have been countless cases where family members except the earning member are not aware about health insurance cover. It is very likely that once you get a new job and are busy settling in your new role, you easily miss to share important information about group policy with your family members. Ensure to share details of the plan with your family as soon as possible – including the TPA card, inclusions, exclusions, benefits and processes.
Although an independent personal health policy is a must, a group insurance policy can come in handy and further supplement your health insurance needs. Ensure you bear in mind the pointers above to get a clear view on what you could expect from your employer group policy.