Group Mediclaim Policy and Its Primary Benefits

Employee benefits are a core area for the consideration of the HR department of any organization. The policies that an organization's HR department makes for its staff are a reflection of the organization's attitude towards its employees. In the present scenario, employees are quite curious about the medical benefits that an organization provides.

While other benefits are mostly under the control of an organization, the mediclaim benefits are dependent upon a third party service provider, i.e., the insurance company. Hence, the medical benefits got by employees depend upon the HR department's understanding of the various insurance plans available in the market.

Lipika Verma, Head - Compensation and Benefits, Nokia India Pvt. Ltd., says "Medical security is the key thing while assessing insurance coverage and a seamless benefit on the medical side is something which an employee expects these days". In the present times, Group Mediclaim Policy provides the best option for providing a medical cover to the employee and his/her family.

This policy comes under the category of non-life insurance and takes care of an individual's hospitalization expenses up to a certain limit that is based upon the policy. Hospitalization may occur owing to ill health or on account of injuries sustained due to an accident, so long as it is for a period more than 24 hours. Hospitalization expenses generally include:

• Doctor's fees and nursing expenses.

• Surgical fees and operation theatre expenses.

• Expenses on medication.

• Room and boarding - subject to limits.

Following are some primary benefits of group mediclaim policy:

Covers Pre-existing Diseases: Group mediclaim policy provides complete cover even for pre-existing diseases while the individual policies offer no or limited cover for such diseases. Maternity benefits are an added advantage in the group policy, which were never included in individual policies.

Floater Option: This option allows a company to choose to insure an employee along with his dependents (parents and children) under a single cumulative amount. For instance, if the floater amount for an employee in an organization is Rs. 3,00,000/-, then the employee can avail hospitalization up to maximum three lakh rupees for himself and his family.

Corporate Buffer: Organizations usually choose to opt for a corporate buffer over and above the maximum limit fixed for each employee. This buffer proves very helpful for employees. Suppose, the maximum limit for an employee is Rs. 3 lakh while his hospitalization cost comes to Rs. 4 lakh; in such a scenario, the organization may provide the remaining one lakh from the buffer amount it has fixed with the insurance provider.