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Health Insurance

Mediclaim Policy (Group / Family Floater And Individual)

Good health is a necessity. The challenge of being fit and remaining fit is, at times, marred by genetic disorders, congenital problems, or illnesses stemming from pollution and unhealthy lifestyle habits. Advancements in medical science and innovation in treatment methods have ensured that people are able to seek necessary treatment without delay. However, inflation has had its effect on medical expenses too, thus, resulting in many people remaining untreated and suffering from their disorders. Health insurance fulfils the need by availing the necessary medical cover in lieu of regular payment of nominal premiums. 


Currently, health insurance plans are sold under two broad categories:

  • Individual health insurance
  • Family floater health plans

In addition, companies today are availing the benefits of health insurance coverage to their employees under various Group Health Insurance schemes. 


Individual health plans are taken by policyholders to insure themselves. The Family health plans are actually extended versions of individual health insurance policies that customers buy to ensure that their loved one(s) or dependent(s) are secure against unforeseen medical disorders and are, thus, able to seek treatment at their choice of hospital. Under family health insurance, one can seek cover for spouse, children and aged parents beside themselves. 


A corporate or group health insurance policy is like a benefit that is passed on by a company to its eligible employees. This is one of the perks that most companies are currently giving to their employees to ensure their loyalty and prolonged service. Some group health insurance policies are structured to include the family members of the employees under the ambit of the policies. The top group health plans sold by insurance companies that sell health insurance policies include:


  • Star Health and Allied Insurance Policy
  • HDFC ERGO Group Health Insurance
  • Future Generali Group Health Insurance
  • ICICI Lombard Group Health Insurance

Let us understand the kinds of health insurance plans with the help of some examples:


Example of An Individual Health Insurance Plan

Shikha Dhawan, aged 28, works with the private sector and understands the need to buy health insurance. Shikha’s parents are retired Government employees. This means that any expenses incurred on their treatment are reimbursed by the government. Since Shikha is not covered under any health insurance policy, she decides to buy a health insurance plan that would secure her against any future hospitalization and medical costs, if any. Since Shikha chooses to get only herself insured, she chooses to buy an Individual Health Insurance Plan. 


Example of Family Floater Insurance Plan

Niladri Shekhar Dutta, aged 34, is a married man with two children and lives with his parents in the same house. Being the only earning member in his family, each member of the family is dependent on Niladri’s income. This also implies that Niladri has to bear every expense including the medical costs of his family members.


Niladri realizes that hospitalization expenses and treatment costs are gradually rising. He seeks a health insurance plan that would cover his entire family in lieu of nominal premiums. He logs on to the internet to read about various family floater plans and chooses one that promises an adequate amount of coverage at reasonable premium rates. Since the family floater health policy covers each member of his family, he is secure from the burden of bearing exorbitant medical costs incurred during the treatment of his family members at the hospital of his choice. Moreover, the insurance company he chooses promises him additional benefits like claim settlement of daycare treatment expenses in addition to the amount expended as pre and post-hospitalization expenses. 


Example of a Group Health Insurance Plan

Sakshi Mehra, aged 32, is employed with a company that promises perks and benefits as an effective employee retention method. The company has tied up with Kotak Insurance that covers all its employees under its Group Insurance Cover Plan. In lieu of the premiums paid by the company, each employee including Sakshi is guaranteed a cover, not exceeding Rs 4 lakhs, to secure against treatment costs in case of any sudden medical emergency stemming from illness or accident. Sakshi, who is currently not covered under any health insurance policy, finds it an effective financial instrument to manage future medical expenses, if and when they arise. 


However, Sakshi also realizes that this cover is guaranteed only until she remains employed with the company. She will be bereft of this important cover once she resigns or is officially relieved from her services. 

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