Group health insurance policy

Group health insurance policy

Know about key features, benefits, and coverage details of a group health insurance policy

3 Mins

You must have probably heard about Group Insurance as part of the benefits offered by your organisation. Essentially, a Group Health Insurance policy provides health insurance coverage to a group of people with some commonality. For example, employee-employer, bank-customers, and society-members. So, group health insurance policies let organisations, banks, housing societies and companies provide health insurance for their members or staff so that in the event of a medical emergency they have the financial support that is required.

When it comes to group medical insurance plans between employees and the employer, it’s a two-way street that is beneficial for employees as well as employers. Employees can get the benefits of a health insurance policy while employers are able to strengthen their employee retention plan and also avail of tax benefits.

Features and benefits of group health insurance policies

Here are the key features and benefits of a group health insurance policy:

Comprehensive coverage

A group health insurance policy provides comprehensive coverage for medical expenses, and includes the cost of ambulances, medicines, specialists, and more.

Comprehensive medical benefits

Group health insurance plans offer comprehensive coverage against medical expenses caused due to several health conditions, including hospitalisation (for accidents) and regular hospital benefits.

Cashless claims

Insurers have tie-ups with hospitals to create a network where one can get the advantage of cashless mediclaim. To avail of cashless treatment, you need to get hospitalised with a network hospital and you have access to the best healthcare without any out-of-pocket expenses. The insurer settles the bills with the hospital directly.

Flexible terms

Group health insurance plans allow the owner of the group to choose the policy term as per the group size and needs.

Added benefits

Exhaustive rider options with group health insurance provide maternity coverage along with coverage for several pre-existing health conditions with a rider plan.

Why is group health insurance essential for you?

It has become quite necessary to care for your and your family's health, due to changing scenarios. Health-related problems can arise at any point in life and can cause a substantial financial burden and dig into savings for many. This is where a group insurance policy comes in handy.

What makes group health insurance policy popular

Tax deductions

A group insurance plan has several tax benefits for an employer as well as the employees. Therefore, opting for this policy is a win-win situation for both.

Lower premiums

This insurance plan has comparatively lower premiums and several lucrative benefits. One can add various rider covers and customise them as per their preferences and needs.

Key inclusions of a group health insurance policy

The following are covered under a group insurance policy:

  • Coverage for a group of people

  • Covers the medical expenses related to diseases, accidents, and illnesses

  • Pre- and post-hospitalisation charges that take care of expenses before being hospitalised and after discharge in the recovery phase

  • Flexibility to add spouse, up to three children (provided they belong to the age group of three months to 25 years) and other dependents at an extra cost

  • Direct settlements of the expenses and cashless facilities are also offered

Key exclusions of a group health insurance policy

The following are a few exclusions in a group medical insurance policy:

  • Pre-existing health conditions

  • Tests and mandatory medical processes

  • No coverage for those who do not belong to the specified age group

  • Illness or injury from war

  • No coverage for external durable items, such as lenses, wheelchairs, etc.

How to apply for group health insurance policies

Group insurance policies available on Bajaj Finance Insurance Mall are exclusively available for Bajaj Finance customers. The application process is fast and simple and only requires a few basic information.

Step 1
Click here to open the online application form.

Step 2
Fill in the application form with basic details such as name, gender, mobile number, date of birth, and residential PIN code for you or the person you want to insure.

Step 3
Now click on ‘Get Quote’ to proceed.

Step 4
Enter the One Time Password (OTP) received on your registered mobile number for verification.

Step 5
Choose your preferred group health insurance policy from the list of health insurance policies and click on ‘Buy Now’.

Step 6
Your personal details, based on our records, will be pre-filled. All you need to do is check if the details are correct and click ‘Next’.

Step 7
Enter your address and nominee details.

Step 8
Answer a few questions about your health and lifestyle by clicking the relevant checkboxes. Click on the ‘Next’ button to proceed.

Step 9
Verify if the previously filled details are correct and click on the ‘Proceed’ button to visit the payment page.

Step 10
Make the payment through net banking, UPI, debit or credit card to buy the policy.

Raising cashless claims: Simple process

You can reap the benefits of cashless treatment at any of the network hospitals. The procedure to raise a claim is as follows:

Step 1: Search for a network hospital in your city and inform the insurance provider at least within 48 hours of hospitalisation (for emergency situations) or at least three days prior to admission (for planned hospitalisation).

Step 2: Make sure to carry the policy details or the patient’s policy cashless card when you visit the network hospital.

Step 3: Produce a valid ID proof and insurance cashless card at the insurance desk of the hospital.

Step 4: Fill up all the details in the pre-authorisation form and submit it at the hospital.

Step 5: To expedite the procedure, fill up a request form on the official portal and inform your insurer about the same.

Step 6: Your group health insurance provider might take up to two hours to review an application and inform you accordingly via SMS and e-mail.

Step 7: You can even check the status of the claim online.

The insurer will process the claim as per the terms and conditions after the completion of all the formalities.

Raising reimbursement claims: What you should have handy

You can also opt for a reimbursement claim by following these simple steps:

Step 1: In case of emergency situations, you will have to notify the group health insurance provider within two days and pay the expenses to the hospital if you do not have a pre-authorisation.

Step 2: Submit all the necessary documents within fifteen days after the discharge.

Step 3: The insurance provider will accept or reject the claim after reviewing all the documents.

Step 4: Once approved, the insurer will transfer the amount to your registered bank account via NEFT.

Step 5: In case of rejection, you will receive a message regarding the same to your registered e-mail address and phone number.

Health Insurance from Bajaj Finance: What makes it a good decision

Bajaj Finance is one of the non-banking institutions with a diversified range of products across commercial, SME, consumer finance, and insurance. With various product offerings and a wide network, makes Bajaj Finance a dependable brand when it comes to your financial needs.


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