Group Health Insurance Policy

With the rising cost of healthcare, health insurance policies have become a need of the hour. By getting health insurance for employees, you can provide your staff and team with adequate financial support. This type of coverage also has many significant benefits for employers, which makes it essential to get it when the time is right. 

On Bajaj Markets, you can get health plans at affordable premiums starting at just ₹160/month. Choose a plan that best meets your requirements and manage your medical expenses effortlessly. 

Important Update (Dated May 30, 2024) – Good news for Health Insurance policyholders! According to the Master Circular on Health Insurance Business 29052024 rolled out on May 29, 2024 by IRDAI, insurers are to decide on the request for cashless claims within 1 hour of receiving the request. Also, the final claim is to be granted within 3 hours after the policyholder’s discharge from the hospital. Insurers have been directed by IRDAI to establish necessary systems and procedures for this process by July 31, 2024.

The Master Circular on Health Insurance Business 29052024 circular is available here - https://irdai.gov.in/document-detail?documentId=4942918

A group plan is more affordable than an individual plan, as there is a large number of people sharing similar coverage. Here are the features offered by a group health insurance.

• Employees can make cashless claims to get medical care at network hospitals 

• It does not have a waiting period, unlike individual health cover

• It also covers pre-existing medical conditions of the employee 

• It comes with pre- and post-hospitalisation coverage 

• The coverage also extends to family members of the employee 

• There is no pre-medical screening process to get insurance 

In the changing times, employee retention is a big factor for companies. Health insurance for employees gives them a sense of security, which allows them to prioritise their work. With more companies moving towards an employee-centric approach, it is a great way to boost their morale. 

Here are some other reasons why group health insurance is a great option for employees. 

• Tax Deductions

You can claim up to ₹25,000 annually as tax benefits with an additional ₹25,000 if living with parents.    

• Lower Premiums

Compared to the individual health insurance plan, a group plan has lower premiums despite its vast benefits. 

Here are the conditions included under group health insurance plans: 

• In-patient hospitalisation charges include doctors' fees, ICU coverage, room cost, etc.

• Pre- and post-hospitalisation expenses include diagnostic test consultation, medication, etc.

• Maternity care and postnatal care

• Pre-existing medical illnesses

• Medical cover for the spouse, children, and dependent parents 

Here are medical expenses that are not covered by group plans: 

• Any cosmetic procedure or treatment 

• Medical conditions caused by lifestyle, such as respiratory issues due to smoking 

• Any injury or medical care required due to self-harm 

• Treatment for dental vision or hearing-related issues 

• Infertility treatment and abortion cost 

• Treatment for any transmissible disease 

• Physiotherapy, ayurvedic, or homoeopathic treatment 

• Joint replacement surgeries due to old age

You need to choose an insurance company that gives you all the required benefits. For this, you can compare some of the options available on Bajaj Markets. After deciding on your preferred insurance company and plan, follow the steps to apply for health insurance online. 

1. Click on the ‘CHECK PLAN’ tab

2. Enter your details and click on ‘Get Quote’ 

3. Enter OTP for verification

4. Choose your preferred plan and click on ‘Buy Now’

5. Enter your company and employee details 

6. Answer a few lifestyle-related questions 

7. Submit the application 

8. Make payment to complete the process

The process for cashless claim settlement depends on whether it is a planned or unplanned hospitalisation. In case of a planned visit, you need to inform your network hospital 48 hours in advance by filling up the required form. 

On the day of admission, you need to provide your health card number and photo ID. Thereafter, you need to fill out the request form on the official website and wait for confirmation. Upon receiving confirmation, the insurance company will settle the claim with the hospital.

In case it is an emergency situation, you need to inform your relationship manager within 24 hours of hospitalisation. Here is a step-by-step process to get reimbursement for your medical expenses for group health plans. 

• Notify your insurance company or Third-Party Administrator (TPA)

• Get the required treatment in the hospital

• Pay the hospital bill in full

• Collect all documents after discharge, including bills, discharge summary, and diagnostic reports 

• Submit a claim on the insurance company's official website

• Submit all the required documents, including a blank cheque 

• Wait for document verification and claim approval 

• Receive the reimbursed amount in your bank account

Here is a list of documents to need to submit for claim settlement:

• Proof of Identity such as Aadhar card, voter's ID card, driving licence, passport, etc.

• Proof of age, including Aadhar card, PAN card, driver's licence, birth certificate, etc.

• Address proof such as ration card, passport, Aadhar card, rent agreement, utility bills etc. 

• Passport-size photograph 

• Duly filled claim settlement form

• All original medical documents and reports 

• A cancelled cheque for bank account details