How To Introduce Mediclaim Policy For Employees?

Dear seniors,

Hope all are doing well,

I am working in a small-scale (Annual Turnover: 25 Cr. INR) chemical manufacturing company. It has its headquarters in Mumbai (Total Employees: 22, all on payroll) and four branches in Ankelshwar (Total Employees: 30/32, 8 on payroll), Baroda (Total Employees: 27/28, 7 on payroll), Silvas (Total Employees: 60/65, 42 on payroll), and Ahmedabad (Total Employees: 13, 4 on payroll).

My management wants to introduce Mediclaim facility at least for all on-payroll employees.

I have a few queries as nobody in my organization has a clear conception:

- Is there any minimum employee limit to introduce this scheme?
- Which company (like LIC, Bajaj Allianz, etc.) and which policy will be beneficial?
- How to start the procedure from scratch?
- What sort of documents will be required (organizational or individual)?

In short, I have zero idea about it.

Kindly help me out.

Hi,

That's an extremely good thought. Well, I've also introduced mediclaim benefits in the organization where I am working. The minimum amount of sum assured earlier was 50,000, but now it seems that the minimum mediclaim coverage has been increased to 1 lakh Rs. per employee.

You can compare offerings from different companies to find the best option, or you can engage a broker who will provide you with all the comparisons and assist you in closing the deal at the lowest possible quote. They also prove to be of great help in settling claims or facilitating cashless services for almost all cases. If you need, I can provide you with more details.

To start the process, you need to first compile the data of employees, including employee code, name of the employee, sex, department, names of dependents if any, to whom the coverage is being extended, and the sum assured for each employee. The sum insured can be a floating amount against which the entire family can receive coverage without any extra payment.

Regards,
Nidhi

Dear seniors,

Hope all are doing well.

I am working in a small-scale chemical manufacturing company with an annual turnover of 25 Cr. INR. The company has its headquarters in Mumbai (Total Employees: 22, all on payroll) and four branches in Ankleshwar (Total Employees: 30/32, 8 on payroll), Baroda (Total Employees: 27/28, 7 on payroll), Silvas (Total Employees: 60/65, 42 on payroll), and Ahmedabad (Total Employees: 13, 4 on payroll).

My management wants to introduce a Mediclaim facility at least for all on-payroll employees.

I have a few queries as nobody in my organization has a clear understanding:

- Is there any minimum employee limit to introduce this scheme?
- Which company (e.g., LIC, Bajaj Allianz, etc.) and which policy will be beneficial?
- How do I start the procedure from scratch?
- What sort of documents will be required (organizational or individual)?

In short, I have zero idea about it. Kindly help me out.

Hi T Sarkar,

Mediclaim Policy : As there is no limit on the numbers who are to be covered by the Company – it varies from 10 no.s to over 1000 +.

As a good gesture, if you wish to you can cover the permanent employees as well as their family too which includes their spouse and upto two children.

Would recommend that you cover the employees not on your payroll either on temp basis for a short period – on mediclaim policy as well on individual basis – the basic premise being that you are the Principal Employer!.

Which company : My experience with both has shown that it is better to have association with the Nationalized one but again it all depends upon your leverage/exposure to the Insurance schemes. Its better to associate with the insurance company which has other schemes with your organization like fire, burglary, personal accident insurance etc..which would give you the flexibility to flex your muscles. Please remember at the time of pitching for your account they would make many promises while collecting the premium and while during the claims processing they would sing a different tune altogether ! Please note that the claims are processed – not by the insurance company but by the TPA – Third Party Administrators. Please check on their reputation as well.

To Start ? – Give a call to them and ask them to send their representatives.

Documents – Name, Age, Date of birth, Limit of insurance amount .

Would recommend from my experience that it is better to take a floating cover say Rs One Lac for the person and his family than Rs One lac for the individual.

Please note that which ever party you choose – please stick to them atleast 4 years to avail the following advantages viz :
1. Pre-existing diseases are covered only after 4 continuous and claim free renewals
2. Pre-existing conditions like Hypertension, Diabetes, and their complications are covered after two years of continuous insurance on payment of additional premium.

Regards,

Rajat

Hi,

Always opt for a government insurance policy; it would be beneficial to select the Third Party Administrator (TPA) affiliated with them. It would be even better if the TPA is located near your office area for easier follow-ups in case of any claims.

Hello Dear,

It's a good proposal in my point of view. Bajaj Alliance Mediclaim is a good policy if your organization's employees are ESIC-exempt employees. One can also personally opt for a mediclaim policy. From a management standpoint, if the management deducts ESIC, why can't they opt for a mediclaim policy? It is more expensive for management.

Thanks,
Sukumar Sahoo
HR Executive

Hi,

You can contact any agents like LIC, OIC, or any other insurance company. They will clearly explain to you. There is no limit to introducing this scheme. It is a very good scheme and useful to all employees in case of any emergency.

MANOKAVIN

Hi Sharkar,

Great idea to have a mediclaim policy for the employees who are exempted from ESI. First of all, have the employee database updated. Do a survey about the employees' willingness and try to equip them with the benefits of mediclaim. Ask about the policies from the government and private companies. Third-party administrators (TPA) can help you regarding your queries as well as finding a policy that suits your employees' needs.

All the best for the successful implementation.

Dear Mr. Sarkar,

It's a great idea to provide a Mediclaim policy to employees who are exempted from ESIC. Talk with some of the general insurance companies and get quotes from them. Generally, the rates vary from company to company, and it depends on the size of the group. The larger the group, the lower the premium. Some of the companies to consider are:

- ICICI Lombard
- Bajaj Allianz
- Religare
- New India
- Reliance
- Oriental
- Apollo

Regards,
Amit Seth

Dear Sarkar,

I appreciate your consideration of providing Mediclaim benefits to your employees. However, I suggest that you understand how to choose a policy for a corporation. It does not matter which insurance company you choose, but the product (policy coverages) does matter significantly in selecting the TPA. For further clarifications, please call me.

Hi Tirtha,

First of all, you need to prepare the list of employees (On-Roll) who are exempt from ESI, including all necessary details such as Name, Date of Joining, and date of birth. Next, try to identify 3-4 corporate insurance brokers and obtain the best offer. Once you finalize the insurance provider, the broker will assist you with the documentation process.

Ajay Padnekar

We have IFFCO Tokio Medical Insurance in Samsung for employees and family cover of Rs. 300,000 per annum. If the total number of covers is more than 100, including family members, it is very reasonable, approximately Rs. 500-900 per month depending on the age group, cashless direct settlements, etc.

Hi All,

What are the advantages of tying up with an insurance company for a group mediclaim policy as compared to managing it internally by the organization itself?

Hi,

I would suggest you to contact the representatives from a few insurance companies like New India, Oriental, Star, LIC, etc. Get the schemes available, do a comparative study, check all the benefits of group insurance, and try to avail of more benefits. Meantime, prepare the data from your end.

Thanks,
Viji
Mgr HR

As we find the Chemical Manufacturing Company has 5 different branches with 83 employees on payroll, it is possible for us to extend them group mediclaim facility which can be offered at a very competitive terms with comprehensive coverage than what probably they are contemplating from M/s Bajaj Allianz.

What we need now is details of names of 83 employees on payroll with their name, date of birth (age), gender, names of their spouse, spouse age, name of 2 children with age and name, gender. On getting this information, we can arrange a quote for them under two to three options with a family floater limit of INR 100,000 or INR 200,000 or INR 300,000.

In case they want any specific senior employee to be covered among 83 employees with a larger limit, the same can also be arranged. The coverage that can be obtained under group mediclaim policy would include:

- Coverage of pre-existing disease from inception
- Waiver of 30 days waiting period
- As an option, inclusion of maternity either from day one of coverage or with 9-month waiting period (here there will be some reduction in the premium)
- Cashless settlement using third-party administrator
- Provide each employee and their family with mediclaim cards to choose among 6000 hospitals spread across the country for treatment.

Now, in order to proceed further, we need the data as sought above and await your response.

Regards,

N. Vaidyanathan, Risk Management Consultant
Email: vaida17@gmail.com

Good idea. First, you have to prepare all family particulars along with age. You have to ask for quotations from the known insurance companies in your area. Then, you have to discuss with the management any contribution from the management side, employee & employer contribution, or only employee contribution. You can also ask the insurance company whether pre-existing diseases are covered, maternity, newborn coverage, parents' coverage up to what age, and all other details. You should advise the management on better coverage options and premiums suitable for your organization.

Dear Ms. Tirtha,

It is better to opt for a tailor-made policy from Star Health Insurance as it is one of the standalone insurance companies. My company has taken a Mediclaim policy for 500 employees. You need to collect the employees' photos and DOB certificates for applying for the policy.

Recently, one of my employees suffered from abdominal pain and was admitted to the hospital. The insurance provided cashless facility in their network hospitals.

Regards,
Krishna