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Group Health Insurance
Oct 24, 2023

Reasons why you should not rely on Group Health Insurance

One of the major perks provided by a lot of corporate organisations these days is group health insurance. If your employer provides you with health insurance coverage, it can prove a great benefit in many cases. After all, medical emergencies can crop up anytime. Having a health insurance policy that is provided by your employer, and in some cases, even funded by them, can help you deal with those emergencies. However, despite its usefulness, group health insurance coverage can have its limitations, especially if you do not have your own private health insurance policy. Let us explain to you why and how that may be the case. And to do so, let’s first briefly understand how group health insurance works.

How Does a Group Health Insurance Policy Work?

A group health insurance policy is provided by an employer and covers the employees of the organisation. In most cases, each member has the same sum assured amount and extent of coverage. The premium for the coverage can be deducted from the employee’s salary or may be paid by the employer. A member looking for higher health cover or extended coverage can opt for the same by paying an additional premium. In the case of a claim, the process is often similar to regular health insurance. A claim is raised, and if approved, the compensation is paid out. Now, you may be wondering, how can this prove to be a limitation? Let us explain.

Why Group Health Insurance May Not Be Enough  

Group health insurance can discourage people from buying their separate health insurance. The presence of group health insurance makes a person believe that all their health insurance needs are being met. One might think that there is no need to buy health insurance separately. This would be more common in cases where the plan is funded by the employer. However, group health insurance has limits set by the employer. Its coverage cannot be tailored to your specific medical needs. When medical emergencies come knocking, these limitations can prove to be an obstacle to getting the right financial help. Let’s understand this better with the help of the following illustration: Ankit was an IT professional working in an organisation that provided him with group health insurance. The Rs 4 lakh coverage provided under the plan covered his parents as well. Hence, he did not feel the need to buy a separate plan of his own. Ankit felt satisfied with the health insurance coverage until his mother was diagnosed with kidney failure.  The multiple tests required in the process, as well as the consequent dialysis, surgery, and medication, came at a very heavy price. The bill for all the expenses was way past the sum assured of his group health insurance plan.  Ultimately, he had to pay a large amount from his savings.  While the group health insurance policy did help Ankit, having a separate health cover would have provided even better support.

Benefits Of Having a Private Health Insurance Policy 

If you buy a private health insurance policy to complement your group health insurance coverage, you can enjoy the following benefits:

-  Customised coverage 

With a private health policy, you can set the sum assured at your desired amount. Moreover, you can opt for coverage for medical issues that you or your loved ones are susceptible to. Plus, you can choose from the different types of health insurance policies and thus, you only get to pay for the coverage and features that you want. *

-  Inclusion of more members 

In a group health insurance plan, you can only add a few members, such as your dependent parents or your spouse and children. With your private family health insurance plan, however, you could add your siblings, your in-laws, grandparents, and even other family members. This may allow you to provide comprehensive coverage to all your loved ones.

-  Coverage up to the desired date

One of the biggest limitations of a group health insurance plan is that the coverage lasts if you are a member of the group. If you quit your job and resign from the organisation, for instance, the coverage of the group health insurance plan also ends. This can mean that you are bereft of any health insurance coverage. With a private health insurance plan, the coverage is valid as long as you keep paying premiums. * In conclusion, one can say that a group health insurance policy can indeed be beneficial. However, it may need the assistance of a comprehensive private health insurance plan to provide an individual with complete coverage. If you have a group health insurance policy, you should make use of it whenever needed. However, you should also realise that it can have its limitations and hence, a private policy can prove beneficial in that regard.   * Standard T&C apply. Insurance is the subject matter of solicitation. For more details on benefits, exclusions, limitations, terms, and conditions, please read the sales brochure/policy wording carefully before concluding a sale.

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