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Individual Health Plans OR Group Plans
Aug 03, 2012 | 86 VIEWS

Corporates do have medical health insurance for all their employees for a certain limit which depends on their grades, salaries, etc. Corporate Insurance is highly encouraged by employers and used as a retention tool especially in the pre-recession era. Many IT companies offered covers even up to Rs 7 lakh for their key personnel and their elderly parents in a bid to attract and retain talent. Many opted for expensive treatments such as knee and hip replacement surgeries, often leading to a high claims ratio.


Group insurance provided by the employers mostly covers self, spouse and two dependent children. Sometimes it does cover dependent parents also. However a lot of big corporates have stopped covering parents as the claim ratio has increased phenomenally which led to a rise in the premium for the employers.

Shiv Chopra had Rs 7 lakh umbrella health cover from his office for himself, his wife and his little daughter Sonia. He never realized the need and importance of having an individual health insurance policy till it was quite late. He thought he was adequately covered, as the group insurance provided for a lot of benefits including his wife’s maternity charges for their daughter’s delivery.


However, when his wife was suffering from chronic asthma and had to be admitted to the hospital every now and then; he was completely caught up with his job at one hand and wife being constantly at the hospital in the other! In those crucial days, he got an amazing job offer which he had applied long back and had completely forgotten about the same. But when he got the offer, he was in complete dilemma because his wife’s medical expenses were huge and if he changes his job, his wife’s treatment would be affected and it would take a huge toll on his pocket.


That is when he realized the importance of having a separate Individual Health Insurance policy which could have covered for his wife’s medical expenses without him having to worry about getting the same from his office’s group insurance.


Areas of Concern for Group Plans:

Thus ponder on the points mentioned below before you come to a conclusion whether you require individual health insurance plan or your group insurance is adequate enough:

  1. What happens if you change your job? Will you still be covered?
  2. Pre-existing diseases are covered only after a certain waiting period. If you change your job or your company decides to change the insurer, then will your pre-existing diseases be still covered? Can you continue the same plan all on your own or can you change the insurer while still continuing the ‘waiting period” benefits?
  3. What happens if you choose to start a business or be self employed instead of being employed in the corporate? You will have to plan your health insurance afresh. In some cases, individual insurance can be difficult to obtain at any price. People with pre-existing, previously diagnosed, or treated health problems seeking new health insurance policies are considered high-risk by insurance companies, and may be unable to find affordable health insurance or any health insurance at all.

 

There could be many reasons why you should plan your individual health insurance even if you have group insurance from your employer, but before buying the same, you must do a thorough research and analysis of your requirements and the market.

 

Individual Health Plans provide Comprehensive Benefits:

Health Insurance needs to be purchased only after analyzing the requirements. Hospitalization Benefits, network of hospitals, cashless benefit, accidental cover, critical illness cover, etc. needs to be understood and accepted according to the requirement of the family and then chosen with care, as pre-existing diseases are only covered after certain waiting period. Hence continuity with the same company becomes important as far as health insurance is concerned. Also claim payment history and procedure needs to be easy for efficient claim payment.


Thus, most people prefer to opt for an Individual Health Insurance Plan even though they are provided health coverage by their offices. It can be continued as long as you wish to pay premiums and now with Health Insurance Portability, you can also change the insurer if you wish.

Deepak Yohannan
Deepak Yohannan is the CEO of MyInsuranceClub. He enjoys writing on Personal Finance and contributes regularly on sites like Reuters & Moneycontrol. He is a strong proponent of online insurance and is often found pointlessly babbling about it!

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