Manis.garg@gmail.com
Process Consultant
Rajat Joshi
Hr Consulting ,trainer -creative Thinking
HR_MyPassion
Hr Professional
Ttajveer
Soft Skills
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Hi,
Can anybody throw some light on the group Mediclaim Policies that are taken up by BPO's?
What could be the premium? Which is the best insurance package etc.,
Or even if somebody can helpme out with the kind of policy that are taken by the companies in Chennai, that would be of great help.
Thanks in advance.
Looking forward to ur inputs.
--Poorna

From India, Madras
Hi Poorna,
Since your query wasn't answered , morever am not from BPO industry please allow me to share my views..
Don;t think it would be much different from Manufacturing Industry..
Depends on the strength of the employees and amount assured..best is take the family floating cover as it proves to be a good retention tool..
For a company of 100 employees with a min of One lac coverage upto Rs 5 lacs coverage for senior management we managed to get the competitive premium at Rs 1.8 lacs..
This was achieved by tough negotiations and number crunching..
Well can;t answer this question as am from Mumbai..however it wouldn;t be much different..
Members from Chennai are requested to provide inputs please.
Cheers,
Rajat

From India, Pune
Hi Poorna,

One of my colleague sent this info..it may help..

In case you still don't have one and are keen on shopping around for a cover, here's what you need to look for.

Let age work in your favour

The premium is what you pay every year to the insurance company. This is the cost of the cover. The cover is the actual amount that you are insured for.

You can pick your cover and the insurance company will pick its premium.

The premium will depend on your age and the cover. The older you are, the more expensive the premium.

Let's say you take a Rs 1,00,000 medical insurance cover from the National Insurance Company Ltd.

Age (years)

Annual premium



Till 35

Rs 1,310



36

Rs 1,425



46

Rs 2,039



56

Rs 2,322



66

Rs 2,598



71

Rs 2,784



76

Rs 3,445



However, the above premiums are before service tax and education cess. So this is what the premium will work out to.

Basic Premium

Rs 1,310



Service tax (12.24%)

Rs 160.34



Education cess

Rs 3.21



Net premium

Rs 1,473.55088



So, whatever age you are, the premium is fixed.

If you buy the policy when you are 25 and pay Rs 1,310, then, when you turn 36, it goes up to Rs 1,425.

If you look at it from this point of view, then it does not make a difference when you take it. Because, when you grow older, you will pay a higher premium. The benefit lies in the fact that the younger you are, the lesser the illnesses or sicknesses you have so everything is covered.

When you take a medical insurance policy, your pre-existing illnesses (the illnesses you currently have) are not included. So it is best to take it when you are totally healthy.

Get your family insured too

Just married? Then take a cover for yourself and your spouse.

Have a child? Cover your child too. These days, doctors often ask that the children be admitted into hospital for observation when sick.

Let's say you are a family of three. And each of you gets insured for Rs 1,00,000. Then you will get a 5% or 10% discount on the premium you are paying for all these policies. For more than one cover, the insurance companies give a discount.

But, if you fall ill and your expenses come up to Rs 1,25,000, you will not be covered for Rs 25,000 since your individual limit is Rs 1,00,000.

Know what is not included

Everything and anything is not covered. Please do your due diligence before opting for a policy.

Go through the list of exclusions in detail. You don't want any rude shocks later.

Any sickness or disease that you had before you took the policy will not be covered. These are known as pre-existing illnesses.

Some insurers specify they will not cover obesity related illnesses, expenses related to terrorist acts or war or riots.

Expenses arising from HIV or AIDS, use of alcohol or drugs, or a suicide attempt are never covered.

Certain ailments like sinusitis, ulcers or cataract may not be covered initially -- say, in the first year or so of the policy. While in the first month or so, nothing may be covered except accidents.

Be clear on repayment

You will get an identity card when you take the policy. The insurance company will have a tie-up with a number of hospitals. If you use the card there, you will not have to make any payment; the insurance company will directly pay the hospital. This is known as the cashless benefit.

If you do not check into one of these hospitals, then you will have to make the payment yourself, produce bills to the insurance company and then get reimbursed.

Look at other aspects

There is a personal accident cover which only covers accidents and disabilities arising from accidents.

There is also a critical illness cover which only covers major illnesses. This time, the insurance company will pay you a lump-sum amount (whatever you are insured for) when the illness is diagnosed

These can be added to your Mediclaim.

There is also the cash benefit. This is the allowance the insurance company gives you and is a cash amount for the time you spend in the hospital. You can take this in addition to your normal insurance policy.

For instance, Bajaj Allianz refers to this as Hospital Cash. In addition to your normal premium, you will have to pay an additional premium if you want this benefit. Let's say you are 28 years old, you want a cash allowance of Rs 1,000 per day when you are hospitalised and you want this benefit for 30 days; the annual premium you need to pay may just be around Rs 600. So, during a year, a total of 30 days will be covered.

You have a wide choice

You have many insurance companies offering medical insurance.

According to the Insurance Regulatory and Development Authority, here are some of the players listed in alphabetical order.

Bajaj Allianz General Insurance Co. Ltd

ICICI Lombard General Insurance Co. Ltd

IFFCO Tokio General Insurance Co. Ltd

National Insurance Co.Ltd

The New India Assurance Co. Ltd

The Oriental Insurance Co. Ltd

Reliance General Insurance Co. Ltd

Royal Sundaram Alliance Insurance Co. Ltd

Tata AIG General Insurance Co. Ltd

United India Insurance Co. Ltd

Cholamandalam MS General Insurance Co. Ltd

HDFC-Chubb General Insurance Co. Ltd

From India, Pune
Hi Poorna,

There are standard clauses in the detailed policy, issued by an Insurance Company. You can view and add certain conditions as per the requirement of your Company in terms of services, data of addition and deletion, settlement of claims etc. It is however, general clauses you may include in the agreement, which is as follows: -



1 Start and end of the agreement and review/revision thereof.

2 Services of the TPA (Third party Administrator), an agency, taking care of employees claims, in terms of documentation, submission with the insurance authority, cashless benefit, follow-up of claims and settlement thereof. An additional premium is chargeable to engage TPA, as per IRDA guidelines.

3 You can set the norms of services, provided by Insurance Company, ie.time line for submission, of employees’ claim, processing and settlement of claim ie. Disbursement of mediclaim reimbursement payment etc.

4 It is very important to register the claim ie. Providing initial information about the employees to be hospitalized, failure of which claims are not payable. The attitude of insurance authorities is bit reluctant in case claim is not registered. You should convince the insurance authorities concerned while preparing the agreement but max. time limit should be defined.

5 Another important clause is when to submit the detailed expenses and documents along with claim form to insurance company. It has been noticed that employees are bit slow to collect the proper documents from the hospital and nursing home concerned and provide dealing person very late so you need to decide the time at least 15 days time is sufficient, which should be maintained by the claimant. But the organisation level there should be mutual understand between the two parties in case of any delays.

6 It is very important to make it clear through policy or inter circular to the employees concerned that preparation of documents, submission thereof in true copies is their responsibility, If it is not contributory policy, it should not taken as a matter of right on the part of employees. In that case it is additional benefit being provided to employees without any contribution on their part.

7 There are certain diseases, which are not covered under the mediclaim policy, or which has some medical history, which is pre-existing in nature are excluded for reimbursement. You must discuss in details, if you want to cover those diseases then an extra premium will be chargeable depending upon the size of the policy. As HR department lots have to be listen on such cases where the claims is rejected by the insurance company on account of pre-existing diseases to the claimant.

8 Coverage of the individual alongwith the other family members, in case you take floater coverage is very important. As per practice and definition of family: Self, spouse dependant parents and children only.

9 There should be scope of review or revise the policy with mutual understand between the two parties in case it is felt to amend the policy as per the requirement.

10 It is very important to get the employees declaration regarding their dependant family member due to addition (birth in the family, marriage) and deletion (due to death) update the records, and send it to the insurance company on the monthly basis, time line to this effect should be standardized. There are chances when due to error an employee addition information not submitted in time. There should be a provisions to provide subsequent information.



You can add more clauses as per the requirement or benefits to be provided to employees. But try to make it employees’ oriented.

Regards,

Rajat

From India, Pune
Hi,
Myself is working in one reputed Pharma Company as a Manager - P&A. We want to take a Mediclaim Policy for our employees, which includes
Employee + his wife+ two dependants below 18 years. The age of employee & his wife will be between 35 - 45 years.
For this, we are required a comparitive table or quotations from the Insurance Companies which are approved by Insurance Regulatory and Development Authority.
Regards,
ANAND POKHARKAR

From India, Pune
Hi,
Most of the group insurance policies are same, You have to see what exactly the requirement is. for more refer to
Health Insurance
Pls let me know if you wanna go for health insurance, Send me the details I will do it for you,
a) Comany name and Address
b) No of employees
c) Amount to be insured for
take care

From India, New Delhi
Hi Rajat,
Thanks 4 the valuable inputs...i am just new,am a trainee Hr now...would be very grateful if you just guide me as to how to start my R&D and grow....now i am just doing a bit of research on various hr policies....Regards.amitkujur@hotmail.com

From India, Delhi
hii poorna,
I am working as a procees trainer in insurance process i.e. Royal Sundaram (India 1st private insurance company, chennai based.) if u r interested in buying a mediclaim policy. feel free to call me @ 09811933848. i will arrange the call for you from sales department fro more clarity.
Thanks
Tajveer Singh

From India, New Delhi
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