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Dear Community Members,

I have a doubt regarding Group Medical Cover. My company provides Group Medical Cover to employees and dependents (Spouse + 2 children). The cover provided to each employee is dependent on his grade.

The current policy, when it was purchased, covered 153 members (71 employees and 82 dependents) for which the premium was Rs. 5.8 lakhs. An amount of Rs. 6 Lakh was claimed in 11 claims in this policy.

Now when we approached the same provider for a quote for a fresh policy covering 128 members (60 employees + 68 dependents) the quoted amount is in excess of Rs. 8 Lakh.

My basic questions are:-

(a) How is the premium for a Group Medical Policy calculated?

(b) Does the claims during the ongoing policy have any impact on the new premium?

(c) In my appreciation the premium should have been somewhere in the range of Rs. 2 to 3 lakh. However, in the present quote a major portion of the claims during current policy seems to have been loaded on the new premium. Am I right in my assumptions?

Would appreciate some clarification on these issues from the experienced members of this community.

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