Group Health Insurance Policy

A Group Health Insurance policy provides health insurance coverage to a group of people with some commonality. For example, employee-employer, bank-customers, and society-members. So, group health insurance policies let organisations, banks, housing societies and companies provide health insurance for their members or staff so that in the event of a medical emergency they have the financial support that is required.

When it comes to group medical insurance plans between employees and the employer, it’s a two-way street that is beneficial for employees as well as employers. Employees can get the benefits of a health insurance policy while employers are able to strengthen their employee retention plan and also avail of tax benefits.

Key features of group health insurance policies

Here are some of the key features of our group health insurance policies:

Features	Specifications
Cashless claim settlement	Across 8,000+ network hospitals
Expenses coverage	Up to Rs. 50 lakh
Ambulance charges	Included
Tax benefit	Included
Daycare procedures	Covered
Domiciliary treatment	Covered
Pre- and post-hospitalisation	Covered

Key benefits of group health insurance

Here are the key benefits of a group health insurance policy:

Comprehensive coverage

A group medical insurance policy provides comprehensive coverage for medical expenses, and includes the cost of ambulances, medicines, specialists, and more.

Comprehensive medical benefits

Group health insurance plans offer comprehensive coverage against medical expenses caused due to several health conditions, including hospitalisation (for accidents) and regular hospital benefits.

Cashless claims

Insurers have tie-ups with hospitals to create a network where one can get the advantage of cashless mediclaim. To avail of cashless treatment, you need to get hospitalised with a network hospital and you have access to the best healthcare without any out-of-pocket expenses. The insurer settles the bills with the hospital directly.

Flexible terms

Group health insurance plans allow the owner of the group to choose the policy term as per the group size and needs.

Added benefits

Exhaustive rider options with group health insurance provide maternity coverage along with coverage for several pre-existing health conditions with a rider plan.

Why is group health insurance essential for you?

Health insurance has become quite necessary to care for your and your family's health (check family health insurance), due to changing scenarios. Health-related problems can arise at any point in life and can cause a substantial financial burden and dig into savings for many. This is where group health insurance and group medical insurance come in handy.

Here are some of the reasons group health insurance is important:

• Provides health coverage to a group of employees under one policy
• Offers more affordable premiums due to the larger risk pool
• Enables employers to attract and retain talent
• Helps promote a healthy workforce and reduce absenteeism
• Covers pre-existing conditions for employees
• Provides financial protection for unexpected medical expenses
• Offers a variety of coverage options to fit the needs of the group.

Group insurance plans provide comprehensive coverage to ensure employees and their families are protected against unforeseen medical expenses. Overall, it is crucial for businesses and their employees to ensure access to quality healthcare and financial stability.

What makes group health insurance policy popular

Tax deductions

A group insurance plan has several health insurance tax benefits for an employer as well as the employees. Therefore, opting for this policy is a win-win situation for both.

Lower premiums

This insurance plan has comparatively lower premiums and several lucrative benefits. One can add various rider covers and customise them as per their preferences and needs.

Key inclusions of a group health insurance policy

A group insurance for employees offers the following coverages:

• Coverage for a group of people

• Covers the medical expenses related to diseases, accidents, and illnesses

• Pre- and post-hospitalisation charges that take care of expenses before being hospitalised and after discharge in the recovery phase

• Flexibility to add spouse, up to three children (provided they belong to the age group of three months to 25 years) and other dependents at an extra cost

• Direct settlements of the expenses and cashless facilities are also offered

Key exclusions of a group health insurance policy

The following are a few exclusions in a group medical insurance policy:

• Pre-existing health conditions

• Tests and mandatory medical processes

• No coverage for those who do not belong to the specified age group

• Illness or injury from war

• No coverage for external durable items, such as lenses, wheelchairs, etc.

How to apply for group health insurance policies

Group insurance policies available on Bajaj Finance Insurance Mall are exclusively available for Bajaj Finance customers. The application process is fast and simple and only requires a few basic information.

Step 1
Click here to open the online application form.

Step 2
Fill in the application form with basic details such as name, gender, mobile number, date of birth, and residential PIN code for you or the person you want to insure.

Step 3
Now click on ‘Get Quote’ to proceed.

Step 4
Enter the One Time Password (OTP) received on your registered mobile number for verification.

Step 5
Choose your preferred group health insurance policy from the list of health insurance policies and click on ‘Buy Now’.

Step 6
Your personal details, based on our records, will be pre-filled. All you need to do is check if the details are correct and click ‘Next’.

Step 7
Enter your address and nominee details.

Step 8
Answer a few questions about your health and lifestyle by clicking the relevant checkboxes. Click on the ‘Next’ button to proceed.

Step 9
Verify if the previously filled details are correct and click on the ‘Proceed’ button to visit the payment page.

Step 10
Make the payment through net banking, UPI, debit or credit card to buy the policy.

How to raise cashless claims for group health insurance

You can reap the benefits of cashless treatment at any of the network hospitals. The procedure to raise a claim is as follows:

Step 1: Search for a network hospital in your city and inform the insurance provider at least within 48 hours of hospitalisation (for emergency situations) or at least three days prior to admission (for planned hospitalisation).

Step 2: Make sure to carry the policy details or the patient’s policy cashless card when you visit the network hospital.

Step 3: Produce a valid ID proof and insurance cashless card at the insurance desk of the hospital.

Step 4: Fill up all the details in the pre-authorisation form and submit it at the hospital.

Step 5: To expedite the procedure, fill up a request form on the official portal and inform your insurer about the same.

Step 6: Your group health insurance provider might take up to two hours to review an application and inform you accordingly via SMS and e-mail.

Step 7: You can even check the status of the claim online.

The insurer will process the claim as per the terms and conditions after the completion of all the formalities.

Also, read: Senior Citizen Health Insurance

How to raise reimbursement claims for group health insurance

You can also opt for a reimbursement claim by following these simple steps:

Step 1: In case of emergency situations, you will have to notify the group health insurance provider within two days and pay the expenses to the hospital if you do not have a pre-authorisation.

Step 2: Submit all the necessary documents within fifteen days after the discharge.

Step 3: The insurance provider will accept or reject the claim after reviewing all the documents.

Step 4: Once approved, the insurer will transfer the amount to your registered bank account via NEFT.

Step 5: In case of rejection, you will receive a message regarding the same to your registered e-mail address and phone number.

Documents required for making a claim

Here is the list of documents that you need to raise a claim request against your group health insurance policies.

• Claim form (part A and B)
• Cashless card or health card issued by the insurer
• Valid ID proof (PAN, voter ID, passport)
• Original discharge summary
• Original hospital bills and payment receipts
• All doctor consultation papers
• FIR copy or post-mortem report in case of an accident or death

What is a health card in a Group Health Plan?

A health card in a group health plan is an identification card provided to members of the plan. It grants access to healthcare services under the group insurance coverage. The card typically includes the member's details, policy number, and insurance provider information, enabling cashless treatment and direct settlements at network hospitals and clinics.

Who should purchase Group Health Insurance?

Employers and organisations should purchase a group insurance policy to provide health coverage for their employees. This policy benefits companies by enhancing employee satisfaction and retention, while also offering comprehensive medical coverage. Small businesses, startups, and large corporations alike can ensure their workforce is protected against medical expenses, promoting a healthier and more productive work environment.

Important points to keep in mind while comparing Group Health Insurance

When comparing corporate medical insurance plans, consider the following important points:

• Coverage: Ensure the plan covers a wide range of medical expenses, including hospitalisation, surgeries, and maternity benefits.
• Network hospitals: Check the list of network hospitals for cashless treatments.
• Premium costs: Compare premium rates and the benefits offered.
• Add-on benefits: Look for additional features like wellness programs, preventive care, and critical illness cover.
• Claim process: Evaluate the ease and efficiency of the claim process.

Choosing the right corporate medical insurance ensures comprehensive healthcare for employees.

How is Group Health Insurance different from Individual Health Insurance?

Given below are the key points of difference between Group Health and Individual Health Insurance:

Feature	Group Medical Insurance	Individual Health Insurance
Coverage	Covers a group of people, typically employees of a company	Covers a single individual or family
Cost	Generally lower premium rates due to bulk purchase	Higher premium rates based on individual risk factors
Eligibility	Provided by employer; employees and sometimes their dependents are eligible	Available to anyone willing to purchase a policy
Customisation	Limited customisation as it is designed to meet general needs of the group	Highly customisable to suit individual needs
Claim process	Often simpler with direct settlements and cashless options at network hospitals	Individual must file claims and manage reimbursements
Policy tenure	Active as long as the individual is employed with the company	Chosen by the policyholder, typically ranging from 1 to 3 years
Benefits	May include additional wellness programs and preventive care	Varies based on the chosen plan, often including more comprehensive coverage

Given below are the key points of difference between Group Health and Individual Health Insurance:

Group medical insurance provides coverage for employees at a lower cost, while individual health insurance offers personalised coverage with more customisation options

Health Insurance from Bajaj Finance: What makes it a good decision

Bajaj Finance is one of the non-banking institutions with a diversified range of products across commercial, SME, consumer finance, and insurance. With various product offerings and a wide network, makes Bajaj Finance a dependable brand when it comes to your financial needs.