MEDICLAIM POLICY BENEFITS - me and my spouse are in the same company - if I can demand the company to take policy for both?

I would like to inform you that my spouse and I are working for the same company. Our company provides a mediclaim policy that includes coverage for spouses. However, the company only takes out one policy for both of us and issues only one medi health card, which is given to me and my spouse. This situation implies that the company should procure policies for both of us, just as they do for other employees. This way, I can benefit from being an employee, and my spouse can benefit as a spouse.

I would like to know if it is reasonable for me to request the company to obtain policies for both of us so that we can access benefits from both perspectives. It is essential to consider that we are employees first and foremost, and then our relationship status comes into play. Please advise.

Husband and Wife are considered as one. If both of you are working in different companies, it is a different ball game altogether. If you get two mediclaim policies, the limit is enhanced. In one policy, the limit is half. HR is the final decision-making authority.

Pon

What exactly is the benefit you are looking for? The company must have decided on a mediclaim policy considering the amount of coverage a family needs. Just because both of you are working, do you need double the limit? Is the existing limit inadequate? You should not be looking at that expenditure as an entitlement but as a security benefit. If you fall sick and have two policies, you can claim the bills only from one of them, not from both.

Thank you, Mr. Sawant. I want to clarify that our company only provides mediclaim for self and spouse, not for the entire family. In our case, the company has taken out a policy in my name, so my spouse is also included in this. However, I would like the company to provide separate policies for both myself and my spouse. This way, my spouse will be covered under their own policy, and I will be covered under mine. Currently, the company has a policy of Rs. 1 lakh for me, and my spouse can also claim up to Rs. 1 lakh.

If the company decides to issue separate policies for both of us, I could potentially claim Rs. 1 lakh from my policy and another Rs. 1 lakh from my spouse's policy. Alternatively, the company could opt for a combined policy totaling Rs. 2 lakhs for both of us. I am unsure which option would be more beneficial for us. In other companies, when both spouses work for the same employer, they are usually provided mediclaim benefits for each individual to ensure equal coverage and benefits.

Which option do you think I should request from the company?

Dear Pulq,

It is entirely your company's discretion whether to avail mediclaim policies for both you and your spouse. However, the premium will be paid by either you or your spouse. Therefore, I would suggest that you raise a query with the HR department regarding the additional benefits that you could receive if a separate policy is also availed for your spouse.

Moreover, nowadays, mediclaim policies typically include coverage for Self, Spouse, and a maximum of 2 children.

The company very clearly intends to insure each person and their spouse only once. It is a welfare measure and not an encashable perquisite from their perception. Unless it is included in both your CTC, you cannot demand it as a right.

Then there is a concept of insurable interest and double insurance. Under that doctrine, if you have 2 covers for the same item, you can use only one of them in the end. So, having yourself covered for both you and your spouse would not have any meaning.

Correct me if I am wrong, but if the mediclaim premium is a part of your CTC (cost to company), then clearly the company is saving one premium. They should pay one of you equivalent to the premium (either you or your spouse, where the policy is not taken).

A.S. Bhat

Hi,

Please check if the sum insured remains the same or is doubled. For example, a 2 lakh policy for you and your spouse can be utilized up to 2 lakh. On the other hand, two 2 lakh policies will amount to 4 lakh. This means that each of you can benefit in full. Kindly ask the authorities to add a rider to your policy.

Thank you all for your support. This mediclaim premium is part of CTC, but my company only takes one policy for me and my spouse for Rs.1 lakh. Does this mean the company should take two policies for both of us separately for Rs.1 lakh each, or should they take one policy for Rs.2 lakh covering both of us? Please suggest what I should demand.