What are GMC and GPA insurance policies?

GMC (Group Medical Coverage) is also known as Corporate Health Insurance, Group Health Insurance, or Employer-Employee Insurance. GPA (Group Personal Accident) is called Personal Accident Cover or a 24-Hour Worldwide Accident Policy.
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What are GMC and GPA insurance policies?
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3 min
01-June-2023

Most employers today offer policies to ensure their employees’ well-being. There are two types of plans that employers provide, a Group Medical Coverage (GMC) and a Group Personal Accident (GPA) insurance policy.

What is a GPA insurance policy?

Here is what you need to know about GPA insurance plan:

  • A group personal accident policy or GPA provides financial assistance during unforeseen circumstances.
  • You get coverage for treatments in case of an accident that leads to disability or fatal injury.
  • The employer pays the premium for the group personal accident policies. In some cases, a certain amount gets deducted from the employee’s salary and the employer pays the remaining amount.

What is a GMC insurance policy?

Here is what you need to know about the GMC insurance plan:

  • A group medical coverage or GMC is a health insurance policy that covers a group of employees. The policy offers financial coverage to take care of medical expenses when needed.
  • GMC policies are cheaper than individual health policies as the coverage amount and risks get divided among the employees.
  • The employer either pays the entire premium amount or the premium gets divided between the employee and employer.

Differences between GMC and GPA insurance policies

GMC and GPA insurance policies may sound similar but have different features and benefits. The following table shows the differences between these two policies:

Parameters

GMC Insurance

GPA Insurance

Full Form

GMC full form -  Group medical coverage

GPA full form - Group personal accident

Other Names

This policy is also known as Corporate Insurance, Group Health Insurance and Employer-Employee Insurance.

This policy is also referred to as Personal Accident Cover for Employees and 24-Hour Worldwide Accident Policy.

Type of coverage

It is an indemnity-based plan, which means the policy will cover the exact amount an employee incurs if covered under the sum assured limit.

It is a fixed benefit plan, which means the policy will provide a lump sum amount as per the terms and conditions of the insurance. The employee will receive the amount based on the nature of the injury suffered.

Scope of coverage

Covers hospitalisation, medicine, diagnosis, maternity care, and OPD treatment expenses of the covered employees.

Covers accidental death and treatments for disability (total or partial) caused due to accidental injury.

Customisation

You can customise the GMC insurance policies, depending on the number of employees, type of occupation, industry of the employer, etc.

You cannot customise the GPA insurance policies, as these work as a fixed benefit plan.

People covered

The GMC policy provides coverage to the employees as well as their spouses, children, and parents in some cases.

The GPA policy covers only employees under the plan.

Range of Coverage

GMC offers broader coverage compared to GPA. Additionally, GPA can be added as an extra cover within a GMC policy.

GPA offers limited coverage as it only covers accident-related incidents.

Inclusion

The specific inclusions vary based on the chosen policy coverage, additional options selected, and the terms and conditions. Common inclusions in GMC typically encompass hospitalization expenses (pre, during, and post), maternity coverage, daycare expenses, and outpatient department (OPD) expenses (either included or available as an add-on).

The specific inclusions vary based on the policy coverage, optional add-ons (if selected), and the terms and conditions. Here are typical inclusions in GPA coverage: accidental death, permanent total disability, permanent partial disability, temporary total disability, child education cover, and repatriation of mortal remains.

Exclusion

Here are common exclusions typically found in GMC policies. The specific details will be outlined in the Policy Wordings: treatments not covered by the policy, drug and alcohol abuse, and self-inflicted injuries.

Here are typical exclusions often found in GPA policies. Specific details will be specified in the Policy Wordings: attempted suicide, participation in adventure sports, and engagement in illegal activities.


What does a GMC policy cover?

A group medical policy covers the following expenses incurred by employees:

  • Covers pre-and post-hospitalisation charges including medicines, medical reports, X-rays, and other expenses. Also, hospitalisation if admitted for more than 24 hours.
  • Covers pre-existing and critical illnesses/diseases, such as diabetes, cancer, hypertension, and more. However, check with the insurer if you have any waiting period before availing of the benefits.
  • It also covers maternity care expenses and medical expenses for newborn children.

What does a GPA policy cover?

GPA insurance covers the following expenses incurred by employees:

  • Covers treatment costs of accidental injuries and if it leads to total, permanent, or partial disabilities. You also get coverage for accidental death. In such a case, the nominee receives the sum insured.
  • The plan also provides coverage for ambulance transportation expenses and charges.
  • Covers room rent and daycare procedures expenses during the hospitalisation period.
  • The plan covers the dependent children in case of permanent disability or death of covered employees.

Overall, GMC, and GPA insurance policies are significant for employees' welfare. Both these provide multiple benefits to the employees.

Pro Tip

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What are Benefits of GMC Insurance Policy

  • Provides comprehensive health coverage for employees and their families.
  • Covers hospitalization, pre- and post-hospitalization expenses, and daycare treatments.
  • Offers cashless hospitalization at network hospitals, reducing financial burden.
  • May include maternity benefits and coverage for pre-existing conditions.

What are Benefits of GPA Insurance Policy

  • Offers financial protection in case of accidental death or disability.
  • Provides coverage for permanent total disability, permanent partial disability, and temporary total disability.
  • May include coverage for ambulance charges and funeral expenses.
  • Ensures financial security for the employee's family in unforeseen circumstances.

GMC vs. GPA: Which One is Best?

GMC and GPA serve distinct purposes. GMC focuses on health coverage, addressing illnesses and medical needs, while GPA covers accidents leading to disability or death. Ideally, both are beneficial. GMC is essential for healthcare costs, whereas GPA acts as a safety net against accidents. The "best" depends on your priorities; however, a comprehensive plan often includes both for complete protection.

Conclusion

GMC and GPA insurance policies are crucial components of a robust employee benefits package. GMC ensures health security, covering medical expenses, while GPA provides financial protection against accidents. Offering both demonstrates a commitment to employee well-being, enhancing satisfaction and loyalty.

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Frequently asked questions

What is GPA in insurance policy?

GPA stands for Group Personal Accident insurance. It's a type of insurance policy that provides financial compensation to employees or their beneficiaries in the event of an accident leading to injury, disability, or death.

Who owns GPA insurance?

GPA insurance is typically owned by an employer or an organization. They purchase the policy to cover their employees as a group.

What are the benefits of GPA?
  • Financial protection for employees and their families in case of accidental injury or death.
  • Coverage for disabilities resulting from accidents.
  • Peace of mind knowing that unforeseen accidents are financially covered.
  • May include coverage for ambulance charges and funeral expenses.
What is a GPA claim?

A GPA claim is a formal request for compensation from the insurance company when an employee experiences an accident covered under the GPA policy. This involves submitting necessary documentation to prove the accident and its consequences.

When should I get a GMC policy for my employees?

You should get a GMC (Group Medical Coverage) policy for your employees when you want to provide them with health insurance benefits. This is particularly important when:

  • You want to attract and retain top talent.
  • You want to improve employee morale and well-being.
  • You want to offer comprehensive benefits that include coverage for hospitalization, medical treatments, and other healthcare needs.
Is it mandatory to insure employees under a GPA?

No, it is not generally mandatory to insure employees under a Group Personal Accident (GPA) policy in India, except in specific industries or for certain types of employment where it might be mandated by law or regulations. However, it is highly recommended as a valuable employee benefit.

What does "off duty GPA" mean?

"Off-duty GPA" means that the Group Personal Accident policy covers employees for accidents that occur outside of their work hours and workplace. This provides 24/7 coverage, whether the accident happens at home, during travel, or leisure activities.

Can part-time employees be covered under a GMC or GPA?

Yes, part-time employees can be covered under both GMC and GPA policies. However, the specific terms and conditions, including eligibility and coverage amounts, will vary depending on the insurance provider and the policy chosen by the employer.

What is the gmc full form in insurance?

A: The GMC full form in insurance is Group Medical Coverage. It refers to a health insurance policy that provides medical coverage to a group of people, typically employees of an organization.

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