Health Insurance 5558 views February 2, 2020

Group Mediclaim Policy

A group mediclaim policy is a type of health plan where all the employees of a firm are covered under a common health insurance cover. It is a very common type of health insurance offered by practically every organization in India. Group plans are also offered to members of large clubs, associations, etc, though it is more commonly seen in the corporate world. Take a look at this article to know more about the group mediclaim policy.

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How does a group mediclaim policy work?

A group plan works in a simple and logical manner. The employer buys the cover for all his employees. He pays a common and single premium for all the policyholders. The insurance provider spreads out the risk over various people, assuming that while some employees will raise claims frequently, others will hardly ever do so. Group plans, therefore, are very affordable. A small percentage of the employees’ salaries are deducted towards the premium payment costs. This is an employee benefit that employees enjoy. Any organization that has over 20 employees can start a group health insurance scheme.

Features of a group mediclaim policy

After understanding what is group mediclaim policy, let us now proceed towards the features of these medical insurance covers:

1. Wholesome cover – A group health insurance plan is like any other comprehensive health insurance policy that offers a wholesome health cover. You get facilities such as in-patient care, home health care, cover for daycare procedures, cover for domiciliary care, OPD cover, cover for diagnostic tests and so on. This is a very handy form of health insurance that allows you to stay fit by seeking treatment whenever there is a requirement.

2. Cover for dependents too – Group health plans offer coverage for the dependents of employees as well. Parents, children and wife/husband of the employee stand to get a health cover too when the employee is enrolled in a group health plan. This is a great advantage of the employee health insurance plans as, under this coverage, all the members of the family remain protected.

3. Affordable – The group health policies are very affordable. This is useful because the health insurance costs of individual health plans are not always affordable for the common man. As a result, many people stay away from buying health insurance, which is a crucial requirement. But when they get employed, they get health insurance at a very nominal cost and have the opportunity to stay covered at all times.

4. Automatically available with employment – There is no separate procedure to follow to get enrolled in a group health plan. As soon as a person gets employed, his health cover commences too. In some cases, employees need to be confirmed in the organization to get employee health plan. This is very encouraging and also an employment benefit that many people look forward to. Getting a regular health insurance plan is more complicated as it requires research, comparisons, health screenings, etc. But here, the policy is already in force and a new employee is simply added to it.

5. Valid till employment – It is important to note that a group health insurance plan is only valid till the time a person remains employed. If the employment ends due to dismissal, resignation or retirement, the health insurance cover will instantly end as well. This is a drawback of group insurance as someone who relies on this type of health cover solely, may lose his entire medical insurance cover overnight without any backup plan in place.

6. No need to self-renew – Employees covered under group insurance do not have to worry about renewals and policy lapses. The employer renews the health cover when needed and the insured enjoys an uninterrupted cover for as long as he/she is employed in the firm. This makes it easy for him/her to have the health cover.

7. Cannot customise – A group health insurance plan is a type of health insurance that cannot be customised by the employees. The employer chooses the features and covers and enters into an agreement with the insurance provider. The employee is simply given the cover and can only make claims for conditions stated within the policy. No customizations are permitted.

8. No tax benefits – As the policyholder does not directly pay the health insurance premium to the health insurance company, he/she cannot get a tax benefit against a group health plan. The premium paid towards an individual health cover is tax-exempted.

These are the main features that define a group mediclaim policy.


As you can see, a group mediclaim policy is very helpful and many Indians benefit from this health insurance coverage. If you too are employed, make sure you get the benefits of a health insurance cover from your employer in the form of group health insurance. It is one of the best and most useful employment benefits that everyone deserves.

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