Five essential benefits of group health insurance policy for employees

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Five essential benefits of group health insurance policy for employees

An old adage used to float around in the Indian film industry – the profession of the protagonist of a commercial film could tell you about the industry in vogue in the country. Evolution of film makers and creative advertisers has brought us to a place where films have forfeited this ground to commercial ad space. When you see Ranbir Kapoor trying to sell your health insurance instead of a cola, the biggest take away is, this sunrise industry is finally coming of age.

Welcome to the world of neo health insurance. The traditional brick and mortar structure would soon pave way to the Alexa’s and Siri’s, who would either be selling health products or providing after sales service.

According to a Niti Aayog report published in October 2021, 30 percent of the middle class i.e. around 40 crore Indians remain uninsured. While that fact alone should explain the renewed thrust one witnesses in the industry of late, it is the discovery of technology by the industry that could prove to be the inflection point it has been groping for, over the last one decade. Technology seems to be eliminating the last mile problem, facilitating trade at finger tips. Advanced technology setups like PhonePe are eliminating redundancies and increasing efficiencies in the process. The entry of companies like Amazon – with their deep insights on Consumer Behavior – is set to disrupt the Industry that could change the way this push product is managed in the country; who knows, maybe the push-pull dynamic as well.

The concept of risk and ways to mitigate are not new to mankind. These have been around since the early cave dwellers decided to hunt and gather. While hunter-gatherers used to mitigate risks (mostly life threatening in their case like starving, freezing, predatory risk) by hunting in packs, one group sharing food with another when they had excess, so on and so forth, the traditional group health insurance extrapolates the same concept on the employees of a company, who form a closed group. A group health insurance (GHI) works on the assumption that not all the employees would need cover at one moment in time. While this has by far been one of the most creative solutions to the under-insurance problem in the country, the numbers are hardly encouraging. GHI covers around 7.3 crore individuals across the country, as per the Niti Aayog report.

Covid-19 outbreak has made us understand how disease affects individuals differently – while elderly folk in their eighties recovered, a lot of youngsters lost lives; while people with comorbidities recovered, some without any adverse medical history lost the battle. One lesson that has been common through this pandemic and the ones humanity has fought earlier, is how disease affects each one of us differently.

While we advocate taking an individual mediclaim policy tailor made to your needs, the benefits of a GHI are far from ordinary.

GHI’s cover common hospitalization, which could include Flu on one end of the spectrum to critical ones like heart attack, cancer on the other end. Think of your GHI as the foundation on top of which you can lay the brickwork that can mitigate risk, personally for you.

Every financial consultant on the block must have advised you about the amount of money you could save under Section 80 D. While we advocate looking at the premium payment for mediclaim as a means of hedging risk, here’s a list of five group health insurance policy benefits that make it an unbeatable product

  1. Pre-existing disease, the demon responsible for the highest number of rejections in the mediclaim portfolio. Most GHI policies give you and family (which could include your aging parents or inlaws) a day one coverage for pre-existing diseases. This gets extremely critical as age plays catch up. This one benefit could very well be the single most important benefit of enrolling for a GHI policy.
  2. Continuity of a mediclaim policy is another aspect that assumes critical importance, especially when one ports from one policy to another. Earlier when you switched jobs, all the continuity benefits you accrued with the current GHI policy would be lost, but today most Insurers reward you with continuity if you port from your GHI policy to an individual mediclaim policy with them. IRDAI also allows porting of individual mediclaim policies – this is an extremely powerful tool in the hands of a Consumer. This essentially means you can move, from an Insurer you aren’t happy with, but had to port into, to retain continuity benefits, to a different Insurer in a year.
  3. India’s health expenditure as a percentage of out of pocket expenditure is around 63% – despite the health penetration in the middle class, for every 100 bucks spent on health, it spends around 63, out of its pocket.

An analysis by Brookings India, based on National Sample Survey Office (NSSO) surveys, says 7% of India’s population is pushed into poverty because of healthcare costs. You might feel relatively isolated by that fact but its impact on your spending could leave a dent that could take years to recover.

One of the beauties of GHI policies is the breadth of hospitals they cover under cashless facility. With medical inflation outpacing salary hikes, a cashless facility is like the dessert you wanted but couldn’t ask for.

  1. The mediclaim portfolio under the general insurance umbrella is undoubtedly one that has witnessed the most developments over the years. Proactive regulatory interventions and a demanding consumer base have ensured regular upgrades on policy terms. One such upgrade has been the addition of modern and outpatient treatments. Most GHI policies now cover procedures like cataract, sinus corrections, ligament tear and many more, that do not require patients to stay hospitalized for more than twelve hours. These procedures can be a significant drain to ones resources and are normally not covered under individual mediclaim policies.
  2. We remember how it is to be young, devoid of responsibilities, but we also remember that first accident we had and the hospital bill and how we had to swallow our pride and ask our parents for financial help.

Life is unpredictable. It can and will hit you when you aren’t expecting it to. Understanding one’s medical needs takes time and deliberation. Till the time you figure out yours, relying on group wisdom (a GHI) can save you a lot of unwanted trouble, on the monetary and more importantly on the physical and emotional front.

While the insurance industry in general and the healthcare portfolio in particular has a long way to go, we feel we are now reaching the point after which developmental strides would be exponential as opposed to linear.

So the next time you see Katrina Kaif trying to sell you a health insurance policy, don’t just get bowled over her beauty or the creatives, jump the bandwagon and enrol into your group health insurance policy, if you haven’t already.

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