Health Insurance - employees are requesting us to add their family members also within this policy to be paid by them - CiteHR
Vmlakshminarayanan
Sr.manager - Hr&admin
Dhiliban
Senior Accounts Executive

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Dear Seniors, Our company has taken a Group Health Insurance Policy (including Pre-Existing Disease, 30 days / 1 year / 2 years waiting period waiver, etc) as a first time only for our company employees.
But, our company employees are requesting us to add their family members also within this policy and the entire premium of their family members will be paid by our employees only.
In this case, our company is accepting this request. But, they wants to check and confirm, is there any legal issue, if company will liable to pay to employee's family members, if insurance company is not accept or not give claim against company employees family member claim.
Hence, i request you to kindly guide me in this regards.
Thanks in advance.
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Hi,
In general there will be no legality involved. However you need to safeguard the interest of your employer.
Make a Policy 'addition of family members in Group Mediclaim Insurance "
Policy should brief about
1) The validity of the medi claim policy till employees are in services of the Company
2) Employees willingness and agreement to pay premium for the family members.
3) No addition /deletion in the middle of the policy tenure ( else it would become tough for you to handle)
4) Company has no liability on any front in case of any dispute arise out of any non settlement by the insurance company.
Also please collect a self declaration from all employees requesting for addition of their family members with names and dob details with the assurance to pay premium and also with a assurance and acceptance that Company has no responsibility in case of any dispute between them and the insurance company.
Addition or deletion you may have it on yearly basis. Company may pay the whole premium up front and recover it in say 6 months EMI. In case of resignation balance EMI to be recovered in FFS. After the cancellation of employment employee cannot use the mediclaim card.
All benefits like in medi claim reimbursement cases the payment has to be routed through employer. So Company will be having some hold.
Dear Sir,
Thanks for your valuable reply and time spent for my question.
I understood, your points are very clear and more effective in this case.
But, can we ask to insurance company to underwrite the same in our group health insurance policy? Can insurance company do the same based on our request?
Kindly clarify me the above doubts.
Thanks in advance.
Hi,
If you are covering employees under the same corporate GHI, underwriting may not be required.
The crux of covering employee's family under Group GHI is that they can cover their elderly parents with the existing illness. If you go for underwriting, the number of employees opting for addition of parents option will go down.
Sir,
Our employees were already cover under Corporate GHI. Now, we are planning to add their family member in the same Corporate GHI policy.
And i can't understand your reply clearly "If you go for underwriting, the number of employees opting for addition of parents options will go down".
Kindly clarify me again and sorry for the inconvenience. If possible, kindly give me a notes or documents copy for understanding purpose.
Thanks in advance.
Hi,
What I meant is if you go for underwriting for Parents addition (wherein they will exclude per-existing illness or will charge more premium) number of employees showing interest to opt for the parents addition will come down.
If number goes down insurance company will charge higher premium for the employees who are willing to add their parents.
Sir,
Thank you sir.
If we request our insurance company to incorporate these points (the above 4 points mentioned by you in your 1st reply), they can do underwrite or not? Will insurance company accept these type of request?
Thanks in advance.
Hi,
The above points are for your internal Policy. Create a Policy with points like above and get it signed by the concerned employees.
Insurance company will not impose these points. They will provide quote based on your requirement based on number of lives to be covered.
Underwrite in Mediclaim insurance is different terminology.
Dear Sir,
Thank you very much for sharing your valuable time with me.
Had a very good discussion with you.
I understood, what we do next.
Thanks again.
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