Group Health Insurance Policy
A group health insurance policy usually provides coverage to a group of people, typically employees of an organisation or members of an association. A group health insurance policy can only be purchased by a group which extends coverage to its members. Typically, a participation rate of 70% or more is required for the arrangement to work. Each group policy is tailored to meet the group’s requirements. Hence, the terms of one group policy vary significantly from another.
Group health insurance policies come with some advantages. Limited features and pooling of risk result in lower premiums. Underwriting is done at the group level, meaning individual underwriting is almost non-existent. Members of the group are covered without any individual restrictions or waiting periods.
However, group policies often offer restricted coverage and lower sum insured options. As a result, the health insurance coverage provided by your employer may not be adequate. Additionally, you lose the coverage once you leave the group. Hence, an individual health insurance plan is recommended to get continuous and comprehensive coverage.
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A
- Accident
- Acute Care
- Acute Condition
- Age Limit
- Agent
- Ambulance Cover
- Annual Health Checkup
- Annual Renewal Date / Renewal Date
- Any One Illness
- AYUSH Treatment
B
C
- Cancer Insurance
- Cashless Facility
- Chronic Condition
- Claim
- Claim Assessment
- Claim Rejection / Claim Repudiation
- Claim Settlement
- Claim Settlement Ratio
- Comorbidity
- Congenital Anomaly
- Consumables
- Continuity Benefit / No-Lapse Benefit
- Contract
- Convalescence Benefit
- Copayment
- Critical Illness
- Cumulative Bonus / No-Claim Bonus (NCB)
D
- Daily Hospital Cash / Daily Cash
- Day Care Treatment
- Deductible
- Discharge Summary
- Domiciliary Hospitalisation
- Durable Medical Equipment
E
F
G
H
I
- Illness
- Indemnity
- Injury
- Inpatient Care / Inpatient Hospitalisation
- Insurance Ombudsman
- Insured Person
- Insurer
- Intensive Care Unit (ICU)
- IRDAI
L
M
N
O
P
- Personal Accident Cover
- Planned Hospitalisation
- Policy Document
- Policy Schedule
- Policyholder
- Portability
- Post-Hospitalisation Expenses
- Pre-Authorisation (of Cashless Claims)
- Pre-Existing Disease (PED) / Pre-Existing Condition
- Pre-Hospitalisation Expenses
- Pre-Policy Medical Check-Up
- Premium
- Proportionate Deduction
R
- Reasonable and Customary Charges
- Reimbursement
- Renewal
- Renewal Premium
- Restoration Benefit / Automatic Restoration
- Rider / Add-on Cover
- Room Rent Limit
S
- Shared Accommodation
- Sub-Limit
- Sum Insured
- Super Top-Up Health Insurance Plan
- Surgery or Surgical Procedure
- Survival Period