Page 185 - IC38 GENERAL INSURANCE
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P. Group health cover
1. GROUP POLICIES
As explained earlier in the chapter a group policy is taken by a group owner who
could be an employer, an association, a bank‟s credit card division, where a
single policy covers the entire group of individuals.
Group Health Insurance Policies may be offered by any insurance company,
provided that all such products shall only be one year renewable contracts.
Features of group policies- Hospitalisation benefit covers.
1. Scope of coverage
The most common form of group health insurance is the policy taken by
employers covering employees and their families including dependent spouse,
children and parents / parents in law.
2. Tailor-made cover
Group policies are often tailor-made covers to suit the requirements of the
group. Thus, in group policies, one will find several standard exclusions of the
individual policy being covered under the group policy.
3. Maternity cover
One of the most common extensions in a group policy is the maternity cover.
This is now being offered by some insurers under individual policies, but with a
waiting period of two to three years. In a group policy, it normally has a waiting
period of nine months only and in some cases, even this is waived. Maternity
cover would provide for the expenses incurred in hospitalization for delivery of
child and includes C- section delivery. This cover is generally restricted to Rs.
25,000 to Rs. 50,000 within the overall sum insured of the family.
4. Child cover
Children are normally covered from the age of three months only in individual
health policies. In group policies, coverage is given to babies from day one,
sometimes restricted to the maternity cover limit and sometimes extended to
include the full sum insured of the family.
5. Pre-existing diseases covered, waiting period waived off
Several exclusions such as the pre-existing disease exclusion, thirty days waiting
period, two years waiting period, congenital diseases may be covered in a
tailor-made group policy.
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