You need health cover regardless of what you take two at a time - pills or stairs.
  • Why Employer Health Insurance is not Enough?

     4.5 / 5.0   by 130 users
    Used this product? Write a review >>

    Cashless Treatment

    Customer Service

    Medical Coverage

    Claim Experience

    Responsiveness

    Getting a job in a good company means you’re entitled to a bunch of benefits in addition to your salary – one of the more important perks is the fact that your employer will provide you (and, in some cases, 2 members of your family) with best health insurance.

    But is it enough?

    As we all now, insurance providers will only pay out the promised amount only if they absolutely have to. They protect their money using the fine print in their offer document, and pay out what they promised only once they have no more fine print to hide behind. While getting the insurance providers to honour their agreements for regular insurance policies is hard enough, it’s even harder when claiming through an employer-group policy.

    Companies and employers, too, seek to minimize costs, by providing bare-minimum coverage insurance policies to their employees. Policies that include co-pay clauses, for example, are usually cheaper, and more attractive to companies who focus on the bottom line of the P & L account, rather than their employee’s wellbeing. Even a bare minimum insurance policy can still be used as an “insurance benefit” to lure or retain employees.

    A recent report by ICICI Lombard Insurance Company revealed that as many as 76% of insurance policies offered by employers have co-pay and room-rent limiting clauses. The fine print is a tool that insurance providers use to limit or even nullify their liability.

    Here are some things you may have overlooked in your employer’s insurance policy, and also why you may need additional cover.

    • Co-pay clauses: This means that the insurer will only cover a part of the total expenditure incurred, and the insured party will have to pay the rest. This effectively reduces the total benefit of even having insurance cover, as the financial burden is just lightened, not eliminated. Most regular insurance policies do not have co-pay clauses, and offer a higher total amount of financial aid.
    • Room-rent limiting clauses: This clause basically means that your room rent per day in the hospital will only be covered up to a certain amount, which is usually as low as half the total rent. This clause also means that the cover will only extend as far as the room rent alone, and nothing inside the room like nurse and doctors expenses – which form the major chunk of the expense.

    Clauses in the policy document are only one of the many methods which employers and insurer employ to limit their total liability. There are many other reasons that you may require additional coverage through a separate insurance policy, like:

    • Employment status: Your employer’s insurance coverage will only protect you as long as you are employed with the company. The second your employment stands terminated for whatever reason, your insurance cover stops. Between the time you have no employer insurance and find another policy, you will be out of insurance cover and liable to pay every penny for hospitalization. Having a primary insurance policy as an individual will cover you despite your employment status.
    • Number of persons covered: The health insurance policy you get from your employer may or may not cover your dependants. In India, a very important aspect of owning a health insurance policy is so that you dependant parents, or children, can be brought under the coverage of the policy. The whole point of owning insurance is so that you will have to pay little or no amount when you (or your dependants) are faced with hospitalization. Employer and company insurance policies are group policies which may only cover the employee.
    • Employer insurance is a perk, not a right: Insurance cover offered by your employer is a perk. It’s a benefit and a tool used to retain employees and sweeten the employer-employee relationship. The employer can pull the insurance cover without having to worry about any legal ramifications whatsoever. Should you be faced with hospitalization when your company decides to save money and stop paying premiums, you will be stuck in a right fix.
    • Post-retirement coverage: As mentioned earlier, you will only be covered for the duration of your employment with the company. After your retirement, which is when you’ll need insurance coverage the most, you will not have the benefit of insurance cover. Getting a policy after the age of 50 is an extremely arduous task, and requires medical tests to be undertaken. Getting a new insurance policy after the age of 50 also means that you will be signing a form that says there will be no coverage for “pre-existing medical conditions” – which effectively means that the insurance provider has no liability or responsibility towards you, should your hospitalization be due to a disease or medical condition that you’ve had before taking the policy. 80% of hospitalizations for senior citizens are for pre-existing conditions, and this does not help you at all. Getting a private insurance cover in your youth, which extends beyond your retirement age, is how you need to play this.
    • Changes in the terms and conditions of the employer policy: Employers and insurers work together to save money and limit their liability. At any time, they could change the terms and conditions in your policy to remove certain types of coverage, or include clauses that don’t cover pre-existing medical conditions, or certain types of illnesses. They could also remove your dependants from the coverage, or basically do whatever they want with the policy from cutting benefits to the bone, or even raising them (which is unlikely).
    • Total effective cover: Group policies taken by employers for their employees don’t cover too much, financially. It’s likely that the total coverage (if all terms and conditions are met) could be up to Rs.1,50,000 or Rs.2,00,000 (if you’re lucky). For serious illnesses and long hospitalizations, this amount will hardly be 20% – 30% of the total expenditure.

    It’s definitely a benefit having insurance cover from your employer, and of course, insurance providers and policies differ between companies.

    Your company could have an excellent group health insurance policy, or a really bad one – you need to analyse the policy document to know exactly how much coverage you have, and how good it is.

    It’s advisable to always treat your employer’s insurance policy as a secondary cover, should your primary policy (that you take as an individual, with no connection to your company) run out.

    GST rate of 18% applicable for all financial services effective July 1, 2017.

    Disclaimer: Premiums may vary depending upon factors like age, location and prevailing taxes/GST.

    Why Employer Health Insurance is not Enough? Reviews

  • Page 1 of 7 1 2 3 4 5
    • National Insurance Health Insurance
      "Very easy to get a claim"
      0.5 4.0/5 "Great!"
      My employer has provided me a health insurance with National Insurance. They have given the health insurance policy for my family also. I have got the coverage amount of Rs. 29 lakhs and the chained hospitals list was good. In ten days, i have got my claim settlement. They are providing a cashless treatment facility.
      Was this review helpful? 0
      , bangalore
      Reviewed on Nov 12, 2018
    • Tata AIG Health Insurance
      "Good Service"
      0.5 5.0/5 "Blown Away!"
      I've a health insurance policy with the TATA AIG. The policy is for myself and I've employer provided health insurance for my family. , I am paying a premium of 4000 monthly, the annual coverage of the policy is 5 lacs and I do not have any claim experience with the policy so far.
      Was this review helpful? 0
      , bangalore
      Reviewed on Sep 26, 2018
    • review Health Insurance
      "Good Service"
      0.5 4.0/5 "Great!"
      I've a health insurance policy with the Aditya Birla health Insurance Co. I am paying a premium of 4000, this policy is only for me as I have employer provided group medi-claim for the entire family. I do have a claim experience with the policy where I availed a cashless hospitalization benefits of 2 lacs.
      Was this review helpful? 0
      , chennai
      Reviewed on Aug 13, 2018
    • Reliance General Health Insurance
      "Good Service"
      0.5 4.0/5 "Great!"
      I've an employer provided health insurance policy in partnership with the Reliance general Insurance. I do not have any experience with the policy so far. So far there hasn't been any issues with the policy so far.
      Was this review helpful? 1
      , hyderabad
      Reviewed on Jul 26, 2018
    • United India Health Insurance
      "Good Service"
      0.5 5.0/5 "Blown Away!"
      I've been using the employer provided health insurance policy from the United India Insurance. I claimed this policy for my father , the company is paying the premium. By default it offers an annual coverage of 4 lacs. For an add on coverage of 10 lacs I'm paying a premium of 800 per month., They process the claim immediately, I got the whole amount 6 lacs.. It was a great experience
      Was this review helpful? 0
      , bangalore
      Reviewed on Jul 21, 2018
    • ICICI Lombard Health Insurance
      "Good Service"
      0.5 4.0/5 "Great!"
      I've an employer provided health insurance policy with the ICICI Lombard. The company is paying the premium. It offers of a coverage of 2 lacs for me annually. I do not have any claim experience with the policy. So far there hasn't been any issues with the policy. I'll have to wait and see how they respond to my claims in future if I'll have any.
      Was this review helpful? 0
      , bangalore
      Reviewed on Jul 17, 2018
    • New India Health Insurance
      "Good Service"
      0.5 4.0/5 "Great!"
      I've a health insurance policy which is provided by the employer in partnership with the New India Insurance . The company is paying the premium, so far there hasn't been any claim experience with the policy. It offers 10 lacs hospitalization coverage and a whopping 1 Crore accidental benefits. Considering the features and benefits it is recommendable health insurance policy to have.
      Was this review helpful? 1
      , mumbai
      Reviewed on Jul 16, 2018
    • Bajaj Allianz Health Insurance
      "Useful Service"
      0.5 4.0/5 "Great!"
      I've an employer provided insurance policy with the Bajaj Allainz. The company is paying the premium, I do have a claim experience with the policy where I claimed 100% amount needed for the treatment. It was a cashless treatment and the whole process was smooth and hassle free.
      Was this review helpful? 0
      , new delhi
      Reviewed on Jul 16, 2018
    • HDFC Ergo Health Insurance
      "Good Service"
      0.5 5.0/5 "Blown Away!"
      I've an employer provided health insurance policy with the HDFC Ergo. It offers an annual coverage 5 lacs, the company is paying the premium. I do have any claim experience with the policy. I have claimed this policy two times for me and wife both they approved. The claim processing was really easy and they settled almost 30000.
      Was this review helpful? 0
      , pune
      Reviewed on Jul 14, 2018
    • Star Health Health Insurance
      "Good Service so far"
      0.5 3.0/5 "Satisfactory"
      I've an employer provided Health Insurance policy with the Star Health. The company is paying the premium, it offers an annual coverage of 2 lacs for the entire family. I never had any claim experience with the policy so far.
      Was this review helpful? 1
      , chennai
      Reviewed on Jun 26, 2018
    • Star Health Health Insurance
      "Very good service"
      0.5 5.0/5 "Blown Away!"
      I've been using the employer provided health insurance from the Star Health Insurance company. The company is paying the premium,I do have a claim experience with the policy. They settled a claim of 75000 and the claim process was easy and hassle free.
      Was this review helpful? 0
      , bangalore
      Reviewed on May 24, 2018
    • Bajaj Allianz Health Insurance
      "Good Service"
      0.5 3.5/5 "Pretty good"
      I've a health insurance policy which is provided by my employer. The company pays a premium of 1500 Per year. I never had any claim experience with the policy and I am not aware about a core details of this policy.
      Was this review helpful? 0
      , chennai
      Reviewed on May 18, 2018
    • United India Health Insurance
      "Good Medical policy"
      0.5 5.0/5 "Blown Away!"
      My employer have provided United India Insurance with the medical cover of Rs. 2 lakhs its cover for me. I could download the medical card in their own website, its convenient to get the cash less facility. They are providing cover for major diseases.
      Was this review helpful? 0
      , madurai
      Reviewed on Nov 20, 2017
    • ICICI Lombard Health Insurance
      "Good protection for the family cover"
      0.5 4.0/5 "Great!"
      My company have recommended this ICICI Lombard policy, my employer is deducting Rs.1500 from my salary but my premium was Rs. 3600 it covers entire family. They gave me good medical cover value around 7 lakhs, I got medical card for the medical treatment.
      Was this review helpful? 0
      , avinashi
      Reviewed on Nov 09, 2017
    • Oriental Insurance Health Insurance
      "Good protection for my family"
      0.5 5.0/5 "Blown Away!"
      MY employer have provided health policy with Oriental insurance, they deducted only Rs. 120 from salary on yearly basis. They gave me 4 lakhs for medical cover for my entire family its good. Earlier they didn't provide any medical card, but now a days they started giving it.
      Was this review helpful? 0
      , new delhi
      Reviewed on Oct 30, 2017
    • National Insurance Health Insurance
      "Good"
      0.5 4.0/5 "Great!"
      I got the health insurance policy with the National Insurance company through my employer. The total coverage value is for nuclear family with the amount of 4 lakh Rupees. I heard from some of my friends like they have got around 85% to 90% of cost of treatment as reimbursement.
      Was this review helpful? 1
      , ahmednagar
      Reviewed on May 23, 2017
    • review Health Insurance
      "Good "
      0.5 4.0/5 "Great!"
      I am having health insurance policy with the Bharti axa general insurance company. I have not faced any claims with them and its been provided by my employer. Coverage value is good with them and I have heard that some of my friends have got the claim benefits within a week of time.
      Was this review helpful? 0
      , pune
      Reviewed on May 08, 2017
    • United India Health Insurance
      "Descent"
      0.5 4.0/5 "Great!"
      I have faced a claim with the United India Insurance for my health insurance, which was availed for me by my employer. They have provided me around 95% of the cost of treatment exclusive of room charges. Services are descent one with the United India Insurance company.
      Was this review helpful? 1
      , hyderabad
      Reviewed on Apr 15, 2017
    • Chola Ms Health Insurance
      "Not a good choice"
      0.5 3.0/5 "Satisfactory"
      I am having health insurance company with Cholamandalam general insurance company and its been provided by my employer and am with them from the last twelve years of time, also it covers full of my family. Recently, I have claimed for my father and I have got around 50% of money as reimbursement due to some lacking of documentation. I would like to suggest that they need to focus on the customer, also they need to enhance their diversity across all geographical location.
      Was this review helpful? 0
      , gurgaon
      Reviewed on Mar 18, 2017
    • New India Health Insurance
      "Simply the best"
      0.5 3.0/5 "Satisfactory"
      NEW India health insurance. I am working in that company for 2.5 years and I did not go for claim settlement till date. It is the simply the best my employer takes care of it and they make the payment on my behalf . I have got the ID card and other health documents too
      Was this review helpful? 0
      , hyderabad
      Reviewed on Dec 22, 2016
    Common Loader Icon
    Page 1 of 7 1 2 3 4 5

    Display of any trademarks, tradenames, logos and other subject matters of intellectual property belong to their respective intellectual property owners. Display of such IP along with the related product information does not imply BankBazaar's partnership with the owner of the Intellectual Property or issuer/manufacturer of such products.

    reTH65gcmBgCJ7k
    This Page is BLOCKED as it is using Iframes.