September 7, 2021

Life is unpredictable, unfortunate events like accident, disability, illness or may be death creates a huge vacuum in the life of the affected person and his family members. It is always prudent to get a protection against the financial losses occurred due to such untimely and unfortunate events. Now a days employers are also insuring their employees with GMC and GPA. Insurance Policy GMC and GPA against such events by purchasing a group insurance policy. Where the premium is paid by the employer or may be contributed partly by both employer and employee.

Let us have a look at GMC and GPA Insurance Policy. Which are offered by the employer to its employees or other such homogeneous or social groups.

Group Mediclaim Coverage (GMC)

In today’s world, getting a medical treatment has become highly expensive. There is a scarcity of government hospitals in the country. And getting health care services in a private hospital creates a big hole in the pocket. Group mediclaim coverage (GMC) is a medical health insurance plan offered to the group of people. Where the benefits offered are similar to all the members of the group. The policy takes care of the hospitalization expenses and other allied expenses as opted by the employer or the organization.

The premium of such policies is comparatively cost effective as compared to individual health insurance plans. Such policies are tailor made policies and can be customized completely. The parameters to determine the premium of GMC are:

  • Size of the group
  • Demographic factors like occupation, age of the members, income, etc.
  • Additional benefits opted under the policy

The following benefits are covered under the Group Mediclaim Coverage:

Hospitalization Expenses: The expenses which are incurred while the insured is hospitalized are covered like room rent, nursing, medical practitioner, anesthesia, blood, oxygen, surgical appliances, operation theater charges, medicines, drugs, consumables, and other devices required during a surgical procedure. To claim such expenses the insured must be hospitalized for more than 24 hours.

Pre & Post Hospitalization Expenses: The policy covers the expenses which occur a few days (usually it’s a 30 days time frame) prior to being admitted in the hospital like some pre medical screening tests, diagnostic tests, consultation fees, etc. known as the pre hospitalization expenses. The GMC also covers the expenses to about 60 days (or as specified in specific policies) after the insured is being discharged from the hospital known as the post hospitalization expenses.

Day Care Procedures: with advancement in the technology, there are certain medical procedures or treatments which take less than 24 hours and the insured need not have to be in hospital for at least 24 hours. Such procedures as specified in the policy are also covered under GMC.

Domiciliary Hospitalization Expenses: Medical treatments taken at home as prescribed by the medical practitioner is termed as domiciliary hospitalization. The expenses for undertaking such hospitalization is also covered under group mediclaim coverage.

Additional Covers: The group mediclaim coverage (gmc) offers various other additional benefits which can be opted by the employer or the head of the group on payment of additional premium which includes maternity cover, inclusion of pre existing diseases, Waiver of waiting period, cost of spectacles, contact lenses, dental treatment, family floater to covers member’s immediate family viz. Spouse, dependent Children, dependent Parents, etc.

Cashless Hospitalization: The cashless hospitalization is the major boon under gmc. The insured may get a cashless treatment under the network hospital listed by the insurance company.

Group Personal Accident (GPA)

The group personal accident policy is a type of group insurance policy which offers financial protection against any accidental injuries, accidental disability or accidental death.

The following benefits are covered under the Group Personal accident policy:

Accidental Death: Death due to an accident is covered under a group personal accident policy.

Dismemberment: Loss of limbs, loss of eyesight, loss of hearing, etc. due to an accident are covered under the GPA policy.

Permanent Total & Partial Disability: The injury leading  to permanent disability or permanent partial disability is covered under the scope of GPA policy.

Accident Medical Expenses ReimbursementEntitles insured to claim both OPD and inpatient expenses.

Additional Benefits: Optional benefits like dependent kid’s education allowance, Daily hospital cash allowance, Family Transportation, Modification Allowance, Repatriation Of, funeral expenses, etc. can be opted on the payment of an additional premium.

Both the group mediclaim and personal accident policies are beneficial for the group of insureds. The policies also offer financial protection against all major uncertainties of life in the most cost effective way.

Both the policies are customized and can be altered as per the requirement of the group. The conditions and benefits may vary from insurance company to insurance company. It is prudent to read the policy wordings carefully before buying the GMC and GPA policies.

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