What is the difference between GMC and GPA Policy?
Today, employees play a huge role in the success of an organisation. A well-motivated workforce helps the organization reach new heights and is a big competitive advantage for the company over their competitors. Thus, employers must do everything in their power to keep employees happy and motivated. One way to do that is to take care of employees during their tough times such as illness, injury or disabilities.
What is a GMC Policy?
The full form of GMC Policy is Group Mediclaim Cover. A Group Mediclaim Insurance Policy for Employees is a health insurance plan which covers the hospitalization expenses of employees. Usually, employers purchase a GMC Policy for their employees.
What are the benefits of a GMC Policy?
1. The main advantage of a GMC Policy is that the premium per person for a GMC Policy is much lesser than the premium per person of a comparable Individual Health Insurance Policy. This is because a Group Health Insurance Policy insures a greater number of people in a single policy as compared to a individual or a family floater health insurance policy.
2. Another benefit of a GMC Policy is that it is customizable. The employer can customize the features of a GMC Policy as per his requirements and budget. Group Mediclaim Coverage like Room Rent Capping, Co-Payment Clause, Maternity Coverage and Sum Insured can be customized to fit the employer group health insurance requirements.
3. Another big advantage of a GMC Policy is that it offers tax benefits for employers. The premiums paid for a GMC Policy are a tax-deductible expense for the employers. You can read our blogpost to understand the Tax Benefits of a Group Mediclaim Policy in detail.
What are the coverages in a GMC Policy?
Group Mediclaim Coverage includes the following:
1. Hospitalisation Cover: A GMC Policy provides cover for hospitalization expenses incurred by the employees for hospitalization period of more than 24 hours.
2. Pre and Post-Hospitalisation Coverage: Group Mediclaim Coverage also includes coverage for pre and post-hospitalisation expenses, usually for 30 days and 60 days respectively
3. Pre-Existing Diseases: Another advantage of a Group Mediclaim Insurance Policy is that Pre-Existing Diseases can be covered without any waiting period while Individual Health Insurance Policies have a waiting period of 3-4 years.
4. Maternity Coverage: A GMC Insurance Policy can also provide cover for Maternity Expenses without any waiting periods. This is another benefit of a Group Health Insurance Policy as Individual or Family Floater Health Insurance Policy have a waiting period of 3-4 years for Maternity Expenses
5. New-Born Baby Coverage: A GMC Policy provides coverage for New Born Baby from Day 1 while individual health insurance policies can provide coverage for new born baby from subsequent renewals
What are the exclusions in a GMC Policy?
1. Diseases, Illnesses or Injuries directly attributable to war, invasion etc are excluded from coverage in a GMC Policy
2. Dental Treatments are also excluded from GMC Policy Coverage
3. Congenital External Disease or Intentional Self Injury (Including Suicide attempt) are not included in the Group Mediclaim Policy Coverage
4. Any form of illness or injury arising from consumption of alcohol, drugs are excluded from GMC Policy Coverage
5. Any form of Infertility Treatments are also excluded from Group Mediclaim Coverage
What are the coverages in a GPA Insurance Policy?
1. Accidental Death: A Group Personal Accident Insurance Policy provides 100% of Sum Insured as compensation in case the Insured suffers from accidental death.
2. Permanent Total Disability: A GPA Insurance Policy Coverage also includes coverage for permanent total disability and Permanent Partial Disability.
3. Temporary Total Disability: A Group Personal Accident Insurance Policy Coverage also includes coverage for Temporary Total Disability such as a Fracture in which case Bed Rest becomes compulsory. In such a case, a GPA Insurance Policy will pay the Insured Person a weekly benefit which is specified as a % of Sum Insured.
What are the exclusions in a Group Personal Accident Insurance Policy?
1. A Group Personal Accident Insurance Policy excludes injury or death caused due to attempted suicide or self-injury
2. A GPA Insurance Policy also excludes any form of natural death due to any cause other than an accident
3. GPA Insurance Policy Coverage also excludes death or injury caused due to participation in a war
4. GPA Policy Coverage also does not include death or injury caused due to Drug Use or under the Influence of Alcohol
What is the difference between GMC Policy and GPA Insurance Policy?
1. Coverage: A Group Mediclaim Policy for Employees is a health insurance policy which offers cover for hospitalization expenses while a Group Personal Accident Policy Coverage for accidental death and injuries.
2. Coverage Territory: A GMC Insurance Policy does not offer worldwide coverage while a GPA Policy offers worldwide coverage.
3. Customisation: A GMC Policy can be customized with regards to features such as Sum Insured, Room Rent Capping, Sub -Limits, Co-Payments while a GPA Insurance Policy cannot be customized.
4. Claim Admissible: A GMC Claim is admissible if the Insured is hospitalized for more than 24 hours while a GPA Claim requires the Insured Person to suffer from an accidental death or disability for claim to be admissible
5. Insured Person: A Group Medical Insurance Policy usually covers employees, spouse and dependent children while a GPA Policy provides coverage to employees only.