How Do I Draft a Medical Insurance Policy with a 2 Lakh Coverage Limit for Employees?

Twishika Agarwal
Hi, I have to frame the medical insurance policy for the employees of our company. Our coverage limit is 2 lakh per family, and the sum insured is INR 2 lakh per employee. Please help me draft it.
vmlakshminarayanan
Hi, you can start with the objective of the policy. Briefly describe the scope of the policy, including whether all employees are eligible or only confirmed employees. Specify the coverage limit per employee and whether the coverage is applicable only for the employee or also for the employee's family. For unmarried employees, include coverage for the father and mother. For married employees, cover the spouse and two or three children. Ensure there is a zero waiting period, meaning coverage starts from day one, and clarify whether it is an individual cover or a floater cover. Mention any disease-wise sublimits if applicable.

Claiming Options
Describe cashless and reimbursement options, and provide a brief about network and non-network hospitals. Specify the upper limit for per day bed and ICU charges.

In case of resignation in the middle of the policy tenure, the employee cannot avail of the benefit.

You can consolidate the above information and present it as a policy.
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