Many working professionals may avoid buying a personal health insurance policy as their employers provide group policies. Especially during the pandemic, maximum employers have rolled out health insurance for their workforce. In this context, it’s important to understand two key terms – Group Medical Coverage (GMC) and Group Personal Accident (GPA). Let’s understand the difference between the these terms to give you better perspective on the same.
A group personal accident policy is a part of the group insurance policy offered by most employers in India. This policy intends to provide financial support against unexpected and unforeseen circumstances like an accident that causes temporary/partial disability or fatal injury to the employer. This policy offers predefined in-built features that apply to all employees irrespective of their requirements and personal needs. The downside here however, is lack of customisation options for specific needs.
Premium amount for such policies is usually less than a standalone cover for personal accidents. It’s either paid by the organisation or from a fraction of the salary. Now, the GPA offers insurance coverage even if the concerned employee is not on duty or is outside the country.
Some important features of this policy include financial aid for accidental death cover, partial or permanent disability cover, disablement cover for loss of limbs, education fund for two dependent children per employee and ambulance charges as well as transportation cover.
As per PolicyBazaar,com, certain insurers also provide the option of add-on covers wherein the policyholders can avail personal accident cover of up to 40% and a daily allowance of Rs 500 for a maximum of 30 days while the policyholder is hospitalised.
While GPA insurance had little room for customisation, a group medical cover is a customisable health insurance plan. It’s often custom-made for organisations and corporations to suit their requirements and needs. In this type of health insurance plan, the risk cover is saturated on many people and therefore the premium amount that policyholders pay is lower than individual health insurance covers. While some employers pay the entire premium cost from their end, some charge a specific amount from the salaries of their respective employees.
GMC is dependent on many factors like organisation size, demographic components such as income, age and occupation of the employees. It also includes add-on covers as per the insurance policy. Certain important features of this policy include the option to cover for hospitalisation expenses, post and pre-hospitalisation coverage, OPD expenses, maternity and infant health and the expenses of daycare procedures.
Both these insurance policies come with exclusions like death clauses, engaging in criminal activities, sexually transmitted diseases, etc. Rememeber that you always have the option to choose a separate health insurance plan for your family and yourself in addition to these group health plans according to your health and financial conditions. If you’re someone solely dependent on a company health insurance, you must be extra vigilant about completing the formalities.
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