The insurance industry in India consists of Government-endorsed as well as private insurance providers. It is a Rs. 5.53 trillion segment sustaining a 12.65% growth in the last fiscal year.
A large number of citizens opt for health insurance plans to have a substantial financial coverage in place. Some may also avail insurance schemes provided by their employers. This creates a unique opportunity to choose between individual or group health insurance policies.
However, before you select any particular insurance scheme, you should know the difference between both individual and group health policies to determine which one will be best suited for you.
Let’s take a look at a brief comparison between these two insurance policies.
- Definition –
Group health insurance policies are offered by companies to cover their employees and family members (usually including spouse and two dependent children). These insurance policies typically protect against a balanced set of conditions that an individual may come across.
Health insurance for individuals is availed by customers with a direct exchange with the insurer. These plans usually include medical expenses that one might come across at different stages of their life. The insured pays the insurance premium directly to the insurer and have the facility to renew it once the term ends.
- Cover –
Individual health coverage includes any expense incurred because of the hospitalisation, doctor’s fees, pre and post-hospitalisation treatment charges, transportation fee, etc. These expenses can be covered for up to 60 days prior to and 90 days post hospitalisation. The insurance policy covers only the insured individual.
Group health insurance includes the individual and his or her family under the policy. It can cover the medical expenses of multiple individuals simultaneously.
- Sum insured –
The amount of sum insured usually stays similar between these two insurance policies. For example, group/employee health insurance policy from Bajaj Finserv comes with a sum assured of Rs. 1.5 Lakh to Rs. 50 Lakh for each insured individual. The sum insured also includes coverage for their family as well.
Similarly, their Individual Health Insurance policy offers a sum assured of Rs. 1.5 Lakh to Rs. 50 Lakh. It does not include any family members; however, the insured can opt to include up to 3 family members under the coverage. Bajaj Finserv offers a family discount of 10% for two family members and 14% for three family members.
Individual Health Insurance Plans also do not require the insured to go through any medical tests for up to 45 years of age. It makes the entire process significantly hassle-free and quick.
- Cashless facility –
Both individual health insurance and group insurance policies allow the advantage of the cashless facility. It eliminates the worries of gathering the necessary funds to pay for the expenses upfront. Cashless claim settlement is available in all networked hospitals that are partnered with the financial institution.
- Additional features –
Both insurance policies offer several additional benefits for the insured. For example, one can enjoy tax savings on individual health cover under Section 80D of the Income Tax Act of India. It can save up to Rs. 60,000 on premiums paid during the term length.
Group insurance policies include medical cover for pre-existing diseases, maternity expenses, and such incidents that are usually not covered under general insurance policies.
Such inclusions make these policies ideal for particular scenarios. For example, the tax saving aspect can be beneficial for individuals while an organisation may benefit by providing a wide gamut of insurance coverage with one combined scheme.
Read Also: Difference Between Group and Individual Health Insurance
Group and individual health covers are two of the most popular insurance policies in India. Group insurance provides coverage for multiple individuals against a single premium amount, whereas individual insurance is ideal for someone looking for a more comprehensive coverage with additional tax benefits and claim-free bonuses every year. One should make a wise choice with an eye towards your current and future requirements.
