Also known as: Group Mediclaim Policy
Medical cover for employees and, where extended, their families — arranged by the employer under a single policy.
Group Health Insurance, also called Group Mediclaim, covers hospitalisation costs for a defined group of employees under one policy held by the employer. Because risk is pooled across the group, pricing is materially lower than equivalent individual cover and underwriting is simplified — pre-existing conditions are typically covered from day one, and medical tests are usually waived. For most employees it is the most tangible benefit their employer provides.
Any organisation with employees. In several Indian states and under specific labour codes, employers above defined headcount thresholds carry statutory obligations around employee medical provision. Beyond compliance, group medical has become an expected part of the package in competitive hiring markets, particularly in technology, professional services and financial services.
Sum insured is typically set per employee, ranging from one to ten lakh rupees depending on the organisation and seniority bands. Family floater options extend the same sum across spouse, children and sometimes parents. The critical variable is not the headline sum insured but the room rent sub-limit, which quietly caps the entire claim.
The difference between a policy that responds and one that disappoints usually sits in details that are easy to overlook at purchase.
Not sure which combination fits your business?
Speak to an AdviserRequirements vary by state and by headcount. Many employers provide it voluntarily as a retention measure regardless of statutory position. We can advise on the specific obligation for your organisation.
Under most group policies, yes, and usually from day one. This is one of the main advantages of group cover over individual cover.
Most policies allow extension to spouse and children, and often parents. The employer may fund this fully, partially, or pass the cost to the employee.
A cap on the daily room charge the insurer will pay. If the employee takes a room above the limit, the insurer often reduces all associated charges proportionally — surgery, consultation and diagnostics included.
Cover ceases on exit. Some insurers offer portability to an individual policy, which is worth confirming at placement rather than at the point of exit.
Primarily on group size, age profile, sum insured, coverage extensions and prior claims experience. Groups with favourable claims history negotiate better renewal terms.