personal finance

What is the difference between a group health insurance plan and a regular one?


How are group health insurance plans different from regular health insurance plans? Why do they enjoy low premium compared to regular health insurance plans?

Raj Khosla Founder and Managing Director, Mymoneymantra.com replies: The advantage of group health plans is that waiting periods, which are characteristic of regular health plans, are usually waived off. This results in considerably higher claims settlements. Medical examinations are not needed. The premiums of group health plans tend to be low because people are insured in large numbers, thus allowing insurers to benefit from the economies of scale. The disadvantage of a group plan is that insurers or employers may not extend the insurance. So, you cannot rely on them for your medical coverage. In regular plans, the law requires insurers to renew the policy lifelong even after you make a claim.

I bought a floater health insurance plan in May 2017 and ported the policy in May 2018. The previous policy did not offer maternity benefits and the new policy has a waiting period of two years for maternity benefits. Can I avail of the benefits after June 2019?

Sanjeev Mantri Executive Director, ICICI Lombard General Insurance replies: The customer is allowed waiting period credits for the new policy to the extent she has served the waiting period in the previous policy. Since the earlier plan you had subscribed to was without maternity coverage, you will have to serve the entire two year period under the new plan to be eligible for availing maternity benefits.

I have been renewing my health insurance policy every year for the past five years. I have just developed high blood pressure. Do I need to inform the insurer about this?

Sanjay Datta Chief, Underwriting Claims and reinsurance, ICICI Lombard replies: As you have been renewing your health insurance policy for the past five years without any break, any change in your health status or a medical condition after the issuance of the policy will not be considered as a pre-existing ailment. Therefore, such a condition need not be revealed to the insurance company.





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