Group Insurance



GHI policy covers Hospitalisation expenses, 30 days pre & 60 days post hospitalization expenses.

Your policy can be tailor made to suit the requirement of your group.

Listed below are the various covers that are generally available:-

  • In hospitalization expenses due to Sickness or Accidents
  • Including Room, Boarding Expenses as provided by the Hospital / Nursing Home;

    Nursing Expenses; - Surgeon, Anesthetist, Medical Practitioner, Consultants,

    Specialist Fees; - Anesthesia, Blood, Oxygen, Operation theater Charges, Surgical Appliances, Medicines and Drugs, Diagnostic Materials and X-Ray, Dialysis, Chemotherapy

  • Pre Hospitalization Expenses
  • Post Hospitalization Expenses
  • Domiciliary Hospitalization Expenses
  • Day Care Treatments

The Optional Benefits

  • Maternity Benefit
  • Inclusion of Pre Existing Disease
  • Family Floater to covers member's immediate family viz. Spouse, Dependent Children, Dependent Parents etc.
  • Waiver of waiting period
  • Waiver of First,Two Year Exclusions
  • Reimbursement of Ambulance Costs
  • OPD Out-Patient Claim
  • Baby day1 cover
  • Pre & Post natal expenses
  • Corporate floater

Premium

The premium for the policy would depend on the following parameters:-

  • Size of the Group
  • Profile of Members e.g. Name, Gender, Age,Relationship, Annual Income etc
  • Benefits opted
  • Claims dump

Group Personal Accident

This policy offers compensation in case of death or bodily injury to the insured person, directly and solely as a result of an accident, by external, visible and violent means.

The policy operates worldwide and is a 24 hours cover.

Different coverages are available ranging from a restricted cover of Death only, to a comprehensive cover covering death, permanent disablements and temporary total disablements.

Group personal accident policies are also available for specified groups with a discount in premium depending upon the size of the group.

The following types of coverages are offered under Group Personal Accident policy:-

Death

Death cover wherein 100% of the capital sum insured is payable.


Partial Total Disability PTD

Death cover wherein 100% of the capital sum insured is payable.

Loss of two limbs / both eyes / one limb and one eye wherein 100% of the capital sum insured is payable.

Loss of one limb or one eye wherein 50% of the capital sum insured is payable.

Permanent Total Disablement other than above e.g. paralysis due to an accident, wherein 100% of the capital sum insured is payable.


Partial Permanent Disability PPD

Death & PTD as per earlier clause

Permanent Partial Disablement i.e. where a part of the body becomes permanently disabled due to an accident, e.g. total and irrevocable loss of use of a finger due to an accident. In such cases, a percentage of the capital sum insured as specified in the policy is paid.


Temporary Total Diablility

Death, PTD & PPD as per earlier clause

Temporary Total Disablement i.e. where the insured person becomes temporarily disabled from undertaking any work as a result of an accident for e.g. fracture of legs. In such cases, a weekly payment of 1% of the capital sum insured subject to a maximum limit, is paid for the number of weeks or part thereof (maximum 100 weeks), during which the insured person is totally disabled.

The insured can claim only under any one of these sections as a result of any one accident.

The policy also covers expenses incurred for carriage of dead body from place of accident to the residence subject to a limit of 2% of the capital sum insured or Rs.2,500 whichever is less. Under an Individual Personal Accident policy or Family Package Policy, an education fund is payable for a maximum of 2 dependent school going children, in case of death or permanent total disablement of the insured person.


Add on covers

Group personal accident policies can be extended to cover medical expenses incurred in the treatment of an accident covered under the policy, subject to a limit of 10% of the sum insured or 40% of the death / disability compensation claim payable, on payment of additional premium.

The policy issued to Indian personnel working in foreign countries on civilian duty can be extended to cover War risk on payment of additional premium.

The policy can also be restricted to cover Personal Accident risk during duty hours only or during off-duty hours only with discount in premium. It is also possible to issue group P.A. policy excluding the death benefit subject to a group life policy covering death benefit being taken for the same group of persons for the same policy period.TopTop


How to claim?

In the event of an accident giving rise to a claim the following steps should be taken:-

In case of death claim:-

1. Assignee under the policy should immediately notify the policy issuing office.

2. Submit the claim form alongwith death certificate, post mortem report, police report and original policy.

In case of injury claim:-

1. Notify the policy issuing office immediately.

2. Submit Police report if any.

3. Submit claim form alongwith medical certificate certifying the disablement.

4. In case medical expenses extension has been taken, then the prescription alongwith bills are to be submitted.

Note: Policy details given are indicative, not exhaustive. Please contact your nearest office for further details.