Page 313 - Ebook health insurance IC27

Sashi Publications

Section 4
Features of Medical Insurance

Individual versus group medical insurance

It is very important to distinguish between individual and group medical insurance. Each
has its own features and should be clearly understood. The following table shows a
comparison between characteristics of individual and group medical insurance contracts:

A Comparison of Individual & Group Medical Insurance

Individual Group
It provides coverage to a number of
It provides coverage to an individual who persons under a single contract (known
owns the contract of insurance as the master contract).
The policy owner is an employer or any
Insured person is the policyowner other organization
It provides benefits to a group of
It often includes the policyholder's family individuals who have a specific
members relationship (for example, employment)
to the policy owner
It is usually owned by the insured. There Someone other than the person insured
are some cases where an individual owns it
purchases the insurance for spouse or
dependent children only To avoid anti-selection, most of policies
It covers any individual who legally usually cover full-time employees
qualify for contracting and his spouse and
eligible dependents Usually a minimum number of
No limitation on the number of participants is required
participants The underwriting is focused on the
Acceptance for coverage is determined characteristics of the group, rather than
by the characteristics of a person being those of the individual members
insured, rather than those of the
policyowner

Website : www.bimabazaar.com, PH: 033 22184184/40078428 317