Group Health Insurance

Earlier, insurance was offered only by agents, and then came banks. Now, thanks to the advent of digitisation, a lot of online platforms have started offering insurance policies. Many e-commerce apps, app-based cab booking companies like Ola and Uber, digital wallet platforms like Phonepe, etc. have started selling health insurance plans. Many of the policies available on these platforms, however, are group policies.

How do group plans work? What are the benefits of opting for group plans? Are there any drawbacks? How should you approach insurance policies offered by these online platforms?

We answer these and a lot more questions - in this article.

So, let’s begin!

Group Health Insurance Policy

What Is A Group Health Insurance Policy?

Just like the name suggests, a group health insurance policy provides coverage to a group of members with a common purpose. Examples of groups include account holders of a bank, employees of an organisation, members of a club, registered users of a mobile app, etc.

How Do You Know If A Policy Is A Group Policy Or Not?

Here’s how-

  • You can tell if the coverage being provided to you is a group cover or not by examining the terms and conditions of the policy. Look for the word ‘group’ in there. If you find it, the policy being offered to you is a group policy.

  • If you've already purchased a policy and want to know what type it is, check for the words 'Certificate of Insurance' on the policy document. These words will be mentioned on your policy document only if it’s a group policy. The policy document will also include a 'Master Policy Number,' which indicates the group’s policy number.

Which Platforms Offer Group Health Insurance Policies?

Group health insurance coverage is offered by-

  • Corporates

    Many corporates provide group health insurance covers to their employees. In some cases, the health cover is extended to the family members of the employees, too. The employees can keep the policy as long as they are working for the company.

  • Banks

    In addition to managing your savings account, banks also offer a wide range of financial products, including insurance policies. Banks provide group health insurance plans to their account holders, depositors, borrowers, etc.

  • Associations

    Today, insurance can also be facilitated by groups who engage in a common activity or share similar interests. These groups may include members from cultural, social, or welfare associations. In most cases, the group administrator or head of the association purchases the group insurance coverage to protect the members.

  • Other Platforms

    A lot of platforms, like online travel agents, app-based cab booking companies, e-commerce apps, etc. have started offering micro insurance policies. The insurance is offered while you're buying some other product.


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exclusion of health insurance plans
Not Covered In Health Insurance
  1. Pre-existing disease for a Fixed Term
  2. Cosmetic Surgeries
  3. Injuries caused due to suicide attempts

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Benefits Of Group Health Insurance Plans

Some benefits of group health insurance policies are -

  • Cheaper Than Individual Policies

    The risk is shared by a large number of people under a group health insurance coverage. As a result, the premiums are lower compared to retail health insurance.

  • Exclusive, Special Discounts Available

    A group health insurance policy is purchased for a group of people. So, the group owner can negotiate a bulk deal and request extra perks and discounts from the insurer.

  • Less Documentation Required

    Compared to retail health insurance policies, very less paperwork is required while buying a group health insurance plan.

  • No Medical Checkups Needed

    Generally, insurance companies issue a group health insurance plan without any medical tests.

  • Fewer Restrictions

    Obtaining personal health insurance can be challenging at times owing to severe health conditions or age limits. In such circumstances, group health insurance may be a better alternative because they have fewer restrictions - and can cover people with a complicated medical history.

  • Gets Issued Instantly

    Most insurance companies issue the group health insurance cover immediately - in less than 24 hours.


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Drawbacks Of Group Health Insurance Plans

Here are some things you should be mindful of when opting for a group health insurance scheme-

Coverage Is Linked To Your Membership

A group health plan is issued to you because you’re a part of a group. So, if you're no longer a member of the group, i.e., if your relationship with your group ends, so does the policy.

For instance, the group health insurance plan with your company will end as soon as you leave your job or retire.

The Scheme Can Be Cancelled At Anytime

If things don't work out for the insurer or the group, the insurance scheme might be withdrawn. If this happens, you’ll be left without a cover. In the case of health insurance, however, if the scheme is discontinued, it is the insurer's job to migrate you to a personal plan.

Limited-Time Contract

A group insurance coverage is often a one-year agreement. Based on the claims received in the previous year, the insurance company might evaluate and adjust the pricing and terms of the policy in the following year.

No Control Over Policy Terms And Conditions

Since a group insurance policy is purchased for the whole group, you will have no control over the policy terms, conditions, features, etc. The group owner would choose a policy that would fit their budget and so, they’ll be less bothered about buying a policy that would be suitable for your needs.

Poor Service Can Be An Issue

Normally, banks, corporates, and other group owners would have little or no knowledge of how insurance policies or claims work. Many a time, they'll leave all this entirely in the hands of the insurance company. This means you'll have to contact the insurance company every time you need help.


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How To Approach Group Health Insurance Plans?

When it comes to buying health insurance from such platforms, you should not get swayed away by attractive propositions such as low pricing, quick issuance, and so on. These plans may include hidden terms and conditions that may prevent you from availing full benefits.

You will also have no say over the policy terms and customisations. Therefore, if you want a customised, sufficient health insurance cover for your family, skip group policies and buy a personal plan.

Group health insurance products should be bought only as a last resort - if you are unable to get health insurance elsewhere due to age or health reasons.

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Sameer-Yadav
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Jyoti-Sharma
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Sumit-Khanna
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Kishor Kumar Bijlani

My experience with SMC Brokers is excellent. They provide support from the beginning till end i.e from issuance of insurance policies till settlement of claims. They explain very nicely various provisions relating to Insurance Policy also facilitate settlement of claims with Insurance Companies. Show More

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