Difference between Group Mediclaim Policy and Group Personal Accident Insurance

Dear Seniors,

Could u please help me to understand the differene between Group Mediclaim policy and Group Accident Insurance policy and the importance of it.

Kindly reply

Miss Rath,

To understand in simple terms:-

Group Medicalim Policy - It is the insurance policy taken by the Employer to cover the medical expenses of the employee & the dependents of his/her choice. It is at the discretion of the employer what is the coverage amount that the employer is opting for. In this kind of policy employee can cover himself/herself & his family members who are dependent on him. It depends on the policy taken that how many members can be covered, whether is its 1+3 or 1+ 4 or 1+5.

Along with himself /herself the employee can cover his/her Mother /Father, OR Wife /Kids Or a combination of his/her choice covering the above members.

While taking a Group Medicalim Policy there are certain clauses which are attached to it & depends on what kind of policy has been taken by the Employer :-

• Pre –existing diseases are covered or not.
• Only Employer will bear the premium cost or some amount needs to be borne by Employee also.
• After spending how many years one can have those diseases covered which were not covered at the time of taking the policy.
• Maternity Cost is Covered or not.
• Whether the policy has both Cashless and Reimbursement option Or either of these two.
• Does the policy get applicable only on the condition of 24 hours hospitalization or OPD is also covered.

Group Personal Accident Insurance- It is another part of Group Insurance Policy which covers all the expenses related to the accident of the employee. Out here no other dependent is covered.

The amount again depends on what kind of policy has been taken by the employer.
Also if in an unfortunate incident there is a loss of employee life then after doing the paper work the nominee or dependents gets the amount of the policy.

In a uncertain world like today it holds a lot of importance both for Employer & employee.

For employer it works as way to take care of a very big personal need of an employee & the employee feels more connected to the organization and also sometimes it works as a good retention tool.

For Employee it is something which gives them a monetary safeguard against the big amounts that needs to be spend in the event of illness of his/her near & dear ones.

-Prashant

Dear Mr Prasant,

Thanks a lot for your reply.

One more thing i wanted to ask in a manufacturing unit what kind of policy would be more beneficial for employer as well as employee.

kindly reply

Miss Rath,
Frankly speaking I will not be able to recommend you any specific policy. It all depends on your Company's decision that how much they want to invest in Insurance Policy, whether they will like to make it a joint contribution policy where both employee & employer contribute or they would like to make just the employer contribution, whether your company would like to make it a Group Policy or just one like (Accident Policy OR Mediclaim Policy OR both ), employees interest to contribute in the policy premium, total headcount etc.
All I can suggest is that if you are asking for a policy in Manufacturing concern i will suggest that you can take the policy which have amount more in the Personal Accident Clause as usually employees in manufacturing concern work extensively on machines so there is a greater risk of accidents also , so this kind of policy will help them to get the coverage.