Can Unused Mediclaim Insurance Be Cashed Out at Year-End? Seeking Guidance

Hi,

My employer provides Mediclaim of approximately Rs. 1000 per month. If, at the end of the year, I have not used that facility, can it be encashed by showing the bill? Can anyone guide me, please, regarding this?

Regards,
Pan

No, Mediclaim insurance premium is paid by the company to the insurance company for any unforeseen events happening to the employee, ensuring that no financial burden immediately falls on the employee. This amount is not claimable even if you have not made a claim under the company's Mediclaim insurance.

Regards,
Anand

Dear Pan,

When paying Rs 12,000 per annum, the Insurance Company settles a claim of Rs. 2,00,000. Where do you think they get the money from? It is from the premiums they collect from members like you who remain safe but have covered themselves for safety. This is the basic premise on which Insurance Companies conduct business.

Kind Regards,
SC

Hi all,

I am sorry, if you can shed light on it in a more vivid manner as I was not able to understand it, especially the relationship between the company and the insurance company.

I think how it works is the company pays the mediclaim premium ON BEHALF of the employee to the insurance company. This premium amount is a part of the employee's CTC, and he is not taxed on it.

If at the end of the year, the employee does not have need to claim the insurance, then it's OK. Otherwise, if he has an accident or something, then the insurance claim will pay the medical expenses under the mediclaim insurance. Either way, the employee does not have to pay anything for the insurance cover.

To make it simpler:

Your company takes on an insurance policy to cover medical expenses incurred by its employees (up to certain limits as laid down in the policy) by paying the Insurance Company premium for a Group Insurance Policy. If an employee incurs such medical expenses, then the INSURANCE COMPANY reimburses the employee for such expenses (through your company). If, at the end of the insured period, the employee has not incurred or claimed any medical expenses, the premium amount IS NOT REFUNDED TO YOUR COMPANY but used by the Insurance Company to set off reimbursements made to other employees under the Group Medical Policy. Since your Company does not get the premium amount refunded to it in any way, obviously you as an employee have no claim to it. I hope this is clear enough to settle all your doubts.

I still have a doubt on:

1) Medical Expense Reimbursement
2) Mediclaim Premium
3) Group Health Insurance
4) Hospitalization Insurance Premium

Could someone please provide me with clear information on these? Specifically, how do they benefit an employee, how can he claim for it, and is there a specific period for claiming?

Info provided by Devjit & Jeero should clear your doubts. All the terms you mentioned are one and the same. You can call it mediclaim insurance or GPA or GPI, but it is all related to health insurance for you and your family members.

Your company pays a small premium on your behalf to safeguard your finances in case of any unforeseen incidents that require significant expenditure. This will be taken care of by the insurance company at the cost of the premium paid by your company, which is non-refundable or claimable.

Regards, Sat.

Dear Member,

With reference to your mail, Mediclaim is an insurance policy. Few companies enter into group medical insurance policies for employees in addition to the existing ESI hospital facilities provided by governments. This aims to curtail immediate expenditures for serving employees who encounter unforeseen accidents.

Insurance companies have their terms and conditions for providing medical coverage, which will be discussed before entering into a policy with them. For example, a 15-bed hospital and a doctor's diagnosis statement are required for reimbursement of expenditures.

This saga continues.

Regards,
Yandamuri

How about the reimbursement limit? (Amount & Cut-off date) It depends on the company policy or is there any legal ceiling limit?

I came to know in our company that mediclaim premium is different from hospitalization and reimbursement.

Dear Anu840,

There are generally two health benefits in most of the companies:

1. Mediclaim
2. Medical Allowance

Mediclaim works as Jerry and others have outlined. However, to get a claim under mediclaim, it is a must to be hospitalized. Many companies and staff refer to this as hospitalization cover.

Medical Allowance, on the other hand, is an allowance that is a part of the salary structure or CTC. The income tax exempts tax on medical allowance up to Rs. 15,000 per year on submission of bills and prescriptions. This is paid to employees as reimbursements.

I hope this clears your doubts.

Cheers!
Faizal Haque