Understanding Mediclaim: Can Someone Explain GPA and GMC Policies?

Dear all,

Can any one of you please explain to me what GPA and GMC policies are in mediclaim?

G.P.A. stands for Group Personal Accident.
G.M.C. stands for Group Medical Coverage.

The GPA Policy covers employees who are on duty, i.e., from the time they leave their residence until they return, provided it is for official duties. In case of an accident during this period resulting in death or injury, policy benefits can be claimed. However, if an accident occurs during a non-duty period, such as after reaching home or during leave, policy benefits cannot be claimed.

GMC is essentially a Mediclaim policy. Individuals can avail the benefits of this policy at any time in case of an accident. It is important to note that no death benefit is available under this policy.

If you have any doubts, feel free to reach out.

Regards,
KARAN

The explanation of GPA is incorrect. All accidents are covered irrespective of the person being at work or not. However, accidents due to adventure sports (paragliding, mountaineering, etc.), or if a person is involved in an illegal activity e.g. driving without a license, under the influence of alcohol are not covered.

The GPA pays for disability or death due to an accident as a percentage of the Cover amount. There is also a weekly compensation for loss of pay (away from work) due to an accident. This is a lump sum payout.

The GMC reimburses expenses towards hospitalization and covered medical expenses related to hospitalization.

Hi Tina,

Please find below the details about GPA - GROUP PERSONAL ACCIDENT AND GMC - GROUP MEDICLAIM POLICY.

GPA

The Group Personal Accident Insurance Scheme is a welfare measure formulated to insure the employees against the consequences of personal accidents and provide appropriate relief to the affected employee or the nominees through an Insurance Cover.

Policy

The Scheme is framed entirely as a welfare measure and does not confer any right or benefit on the employees, nor impose any obligation or liability whatsoever on the Company. It shall not be deemed to be any contract or condition of service between the Company and its employees.

Benefits

The Insurance Policy will provide coverage by way of payment of compensation to the extent specified in this Scheme to the covered employees round the clock, whether he is on Company's duty or not, on any location in India or abroad; against bodily injury resulting solely and directly from accidents caused by violent, external, and visible means which shall solely, and independently of any cause, result in death or disablement (as per the provision/Schedule in the Policy).

GROUP MEDICLAIM POLICY

Any Group/Association/Institution/Corporate body of more than 50 persons can take a group Mediclaim policy. The institution should have a central administrative point. This Policy contains names of persons covered and provides cover to all eligible members.

What is covered?

This Policy covers the following critical ailments:

1. This Policy covers hospitalization expenses incurred within the country, due to illness/disease and/or due to an accident during the Policy period.

2. Room, Boarding expenses as provided by the Hospitalization/Nursing Home, and Nursing Expenses. Surgeon, Anesthetist, Medical Practitioner, Consultants, Specialist Fees, Anesthesia, Blood, Oxygen, Operation Theater Charges, Surgical Appliances, Medicines and Drugs, Diagnostic Materials and x-ray, Dialysis, Chemotherapy, Radiotherapy, Cost of Pacemaker, Artificial Limbs, Cost of Organs, and similar expenses.

I HOPE THAT THE BASIC DIFFERENCE BETWEEN THESE TWO IS CLEAR NOW.

KATYANA

Hi Tina,

Please find below the details about GPA - GROUP PERSONAL ACCIDENT AND GMC - GROUP MEDICLAIM POLICY.

GPA

The Group Personal Accident Insurance Scheme is a welfare measure formulated to insure the employees against the consequences of personal accidents and provide appropriate relief to the affected employee or the nominees through an Insurance Cover.

Policy

The Scheme is framed entirely as a welfare measure and does not confer any right or benefit on the employees, nor imposes any obligation or liability whatsoever on the Company. It shall not be deemed to be any contract or condition of service between the Company and its employees.

Benefits

The Insurance Policy will provide coverage by way of payment of compensation to the extent specified in this Scheme to the covered employees round the clock, whether he is on Company's duty or not, on any location in India or abroad; against bodily injury resulting solely and directly from accidents caused by violent, external, and visible means which shall solely, and independent of any cause, result in death or disablement (as per the provision/Schedule in the Policy).

GROUP MEDICLAIM POLICY

Any Group/Association/Institution/Corporate body of more than 50 persons can take a group Mediclaim policy. The institution should have a central administrative point. This Policy contains names of persons covered and provides cover to all eligible members.

What is covered?

This Policy covers the following critical ailments:

1. This Policy covers hospitalization expenses incurred within the country, due to illness/disease and/or due to an accident during the Policy period.

2. Room, Boarding expenses as provided by the Hospitalization/Nursing Home, and Nursing Expenses. Surgeon, Anesthetist, Medical Practitioner, Consultants, Specialist Fees Anesthesia, Blood, Oxygen, Operation Theater Charges, Surgical Appliances, Medicines and Drugs, Diagnostic Materials and x-ray, Dialysis, Chemotherapy, Radiotherapy, Cost of Pacemaker, Artificial Limbs and Cost of Organs, and similar expenses.

I HOPE THAT THE BASIC DIFFERENCE BETWEEN THESE TWO IS CLEAR NOW.

KATYANA