Insurance Advisory Newsletter: Group Mediclaim Insurance Policy – March 2023
Group Mediclaim Insurance Policy
A Group Mediclaim Insurance policy (“GMC”) is a group insurance scheme specifically curated to cover and provide health insurance benefits to a group of people, usually, employees of a company, organisation or association that have been identified in the insurance policy. In India, GMC is a popular form of health insurance, for organizations or entities (“Policyholder”) who want to provide effective health insurance coverage for their employees (“Insured Persons”). GMC can evoke a sense of financial security in the Insured Person and fuel better employee-employer relationships, becoming a factor leading to enhanced performance.
Under a GMC policy, the premium is paid by the Policyholder entity and, at times some benefits can be paid on co- sharing or co-pay basis with the Insured Persons. The premium and amount of sum insured of a GMC is calculated on the basis of the risk involved and also takes into consideration parameters like the job profile, industry type, average age of an Insured Person and the amount of sum insured.
Standard Coverages and Exclusions under GMC
A GMC is a tailor-made policy typically providing the following hospitalisation coverages:
However, a GMC comes with certain standard exclusions such as:
Benefits and Limitations of GMC
Employer/ Policyholder Perspective:
Employee/ Insured Person Perspective:
Characteristics of a robust GMC