Group Health Insurance

Group health insurance is a collective health insurance policy offered to a group of individuals. This plan allows companies, organisations, banks, and even housing societies to procure health insurance for their entire staff or members. The employer pays the premium of this policy while all employees and their families can avail the benefits. A group health insurance plan is beneficial for both the employers as well as the employees. While the employees get health coverage benefits, the employers get the increased chances of an employee staying in the company. In addition, the employer also gets tax benefits for providing such policies to its employees

Features and Benefits

Here are the key features and benefits of Group Health Insurance Policy:

  • Comprehensive coverage

    The policy provides comprehensive coverage for medical expenses, including the cost of specialists, ambulance, medicines, and more.

  • Medical benefits

    The policy offers comprehensive coverage against medical expenses incurred due to a wide range of health problems, including accidental hospitalisation and daily hospital benefits.

  • Cover dependents

    Cover dependents

    Group/employee health insurance policy offers an option of covering the employee’s spouse and children under the plan at a reasonable additional cost.

  • Save time and money

    Group health insurance plans are perfect for saving time and money. It is one of the best options for the employees working in the same organisation. In this kind of insurance, the insured group also gets discounts and waivers.

  • Cashless claims

    Avail cashless claims facility for medical treatments at all network hospitals.

  • Flexible terms

    Choose a policy term according to your needs and group size.

  • Education loan scheme

    Apply online

    You can apply for the group/employee health insurance online with a few easy steps.

  • Extended benefits

    Get a medical cover for pre-existing diseases or maternity expenses with an add-on cover.

Inclusions in a Group Health Insurance

A group health insurance covers the following things:

  • Group health insurance covers a group of members under the policy.
  • It covers medical expenses related to illnesses, diseases, and accidents. Additionally, it also covers pre-and post-hospitalisation charges.
  • Group health insurance policy can also add a member’s spouse and up to three children, aged between three months to 25 years, or other dependents for an extra cost.
  • The policy provides cashless facilities and direct settlement of expenses with the hospital.
  • Domiciliary expenses can also be availed.
  • The pricing of employee health insurance or corporate health insurance plans differs from company to company as every company has different employee strength.

Exclusions in a Group Health Insurance

Here are the exclusions under the group health insurance policy:

  • Pre-existing illnesses are not covered under group health insurance policies.
  • Mandatory medical procedures or tests are not included.
  • Age groups except those mentioned above are not included in employer health insurance or corporate health insurance plans.
  • Injury or illness from war is also not considered.
  • Companies health insurance policies do not include external durable items like a wheelchair, lenses, etc., even if doctors recommend it.
  • Dental and pregnancy-related treatments are also not included.

Why Choose Group Health Insurance from Bajaj Finance

Bajaj Finance is the most diversified non-banking institute in the country, with multiple product lines across consumer, commercial and SME finance, making it one of the most profitable companies in the category.

How to Raise a Claim

Cashless Claim

  • You can avail of the benefit of cashless treatment at partner network hospitals anywhere in the country. The procedure to file a claim is as follows:
  • First, search for the partners network hospital (For Eg: Aditya Birla) in the city where you want to get cashless treatment.
  • Intimate the insurer within 48 hours (emergency hospitalisation) and 3 days before admission in case of planned hospitalisation.
  • While visiting the hospital, carry the patient’s insurance cashless card or the policy details.
  • Show the Health Insurance cashless card and valid ID proof at the insurance desk of the hospital.
  • Fill in the pre-authorization request form correctly available at the hospital and submit it to the hospital.
  • For quicker action, fill the request form on the official website and intimate the insurer. Wait for the decision as your request will be reviewed.
  • The insurer may take up to 2 hours after receiving the request and will inform you about the decision via an e-mail and an SMS.
  • You can also check the status online. The claim will be processed as per the terms and conditions of the policy after all the formalities are completed.

Reimbursement claim:

  • In case of an emergency admission, you need to notify the insurer within 48 hours and pay the charges to the hospital directly unless a pre-authorization has been issued by us.
  • Collection and submission of claim documents- send the list of the documents mentioned below within 15 days of discharge from the hospital.
  • After reviewing the documents, the insurer will approve or reject the same as per the terms and policy.
  • If the request is approved, the insurer will send the reimbursement amount via NEFT to your registered bank account.
  • If the request is rejected, the same will be communicated to your registered contact phone number and email id.

How to Apply for Group Health Insurance

Here are the steps to apply for group health insurance online:

Step1: Click the ‘Apply Now button at the top

Step2: Fill in the online application form with your personal and click on the ‘Submit’ button

Step3: A Bajaj Finance representative will get in touch with you to discuss the available policies and receive necessary documents

Steps4: Receive your group health insurance within few hours.

Frequently Asked Questions (FAQs) for Group Health Insurance

1. What is Group Health Insurance?

Group health insurance is offered by organisations, banks, business groups, housing societies, and employers to their employees, and the organisation itself bears the cost of the premium. It is also known as a corporate health insurance policy. When the employer provides the group health insurance policy, both the employer and employee are the beneficiary. The premium will vary from one insurance policy to the other. Similarly, insurance coverage, payment, and premiums will also be different for every employee.

2. What are the benefits of group health insurance?

The main benefit of group health insurance is that the premiums paid towards these insurances are cost-effective. Plus, the policyholder gets access to the best medical facilities and quality healthcare at times of emergency.

Group Health Insurance acts as an incentive that employers can offer to their team. Employees are guaranteed financial aid in the event of an unfortunate hospitalisation. It also helps in tax deductions under the income tax act if you have corporate health insurance.

3. Why is group health insurance important?

Group health insurance is important as it provides safety and protection to the employees and their dependents. The security of group insurance results in better productivity and creativity.

Moreover, by offering coverage to the employees, the employers get tax deductions under the Income Tax Act. Group insurance policy is beneficial for both the employer and employees.

4. Are group health insurance premiums tax-deductible?

Yes, the premium paid towards group health insurance is eligible for tax exemption under section 80D of the Income Tax Act. Employers can claim a tax deduction. Employees are only entitled to the benefits offered under the group health insurance policy. Employees cannot claim the tax benefit if the premium amount of the group health insurance policy is paid by their employer. However, if the premium amount is deducted from the employee’s salary, then the employee can claim for a tax rebate.