Group Mediclaim Insurance Vs Individual Health Insurance
Parameter
General meaning
Who is insured?
Who is the purchaser?
Intiaital waiting period of 30 days, Ist year, IInd Not Applicable- Coverage would be from Day 1
year, 4 th year Exclusion.
Coverage for Pre-existing diseases:
Maternity Benefits
No Claim Bonus:
Medical Check-ups before purchase:
Claims Processing
Option to choose the preferred TPA
Assistance from the Insurance Consulting
Agency in terms of Administrating the claims
support to Insured incase of any assistance
Pre-requisities to be an insured
Group Mediclaim Insurance Individual Health Insurance
A Group health insurance plan covers a group of An Individual health insurance policy offers coverage
people under health insurance. to the Indvidual policyholder.
The Group of insured person and their dependent Policyholder & his dependents only
family members.
Group Health Insurance is usually purchased by an The policyholder purchases an Individual health
Employer/Association insurance plan.
Waiting period Applicable
Coverage from day 1 No coverage for Preexisting diease, also to get the
same covered Insured has to bear Additional
premium and coverage is subjtect to waiting period of
Available - Subject to choosing the coverage Not Available.
Not Applicable Applicable - As per the Plan Opted
Not required Medicals requried based on the Age, Medical history
of the person seeking for coverage.
Claims are usually processed through a Third- Claims can be directly processed by the insurance
Party Administrator or Inhouse TPA as applicable. company and in some cases Third Party
Administrators would be involved.
Available Not Available.
Available Not Available.
Person has to member in the Association Group Member has to fill & Sign the Proposal form, & also
and No additional details such as Individual has to go through Medicals when ever required.
Proposal form, Medical checkups or other