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Archive for the ‘Group Insurance Plans’ Category

Group Health Insurance

Posted on: November 8th, 2019 by shiv No Comments

The policy covers expenses incurred by an insured person during hospitalization. The main benefits in the policy are:

  • Self, Spouse, Two Children and Parents (1+5) can be covered under family floater.
  • Maternity expenses are covered from the day the policy starts or from the day an employee joins.
  • New born baby covered from the time of birth
  • Pre-existing Disease is covered.
  • All expenses can be covered from the 1st day of the policy. i.e. waiver of all waiting periods
  • Cashless treatment at more than 3000 hospitals across India and all major hospitals in all cities.
  • Expenses incurred 30 Days before and 60days after hospitalization are also reimbursed.

Insurance Companies:

The policy is available from all non-life and health insurers in India. However we have observed that the four government companies give better prices and better services for group larger than 500 persons.

Why should Optima be a Preferred Partner for Group Health Insurance:

  • More than 4 lakh lives covered through us
  • More than 150 large companies are covered through us.
  • Strong relationship with TPAs, insurers and hospitals

We would provide the following services if we are given an opportunity to manage your health portfolio:

  • Sessions with employees on policy benefits
  • E-Enrollment of dependents to reduce HR work load.
  • Manage additions and deletions of employees, issuance of TPA cards and reimbursement claims
  • Provide SOS support for cashless claims
  • Maintain and provide updated MIS of various activities like – cards, claims, endorsements 
  • Help in claims control
  • Periodic review of the portfolio with the management team

Some of our value added services are:

  • Organizational Health mapping
  • Doctor on call / chat service
  • Pre defined SLAs with penalty clauses for all our deliverables to bring accountability.

Group Personal Accident Insurance

Posted on: November 8th, 2019 by shiv No Comments

Accidents can happen anytime. While boarding a bus, going to the bathroom in the night, traveling in the train etc

Insurance provides financial relief in case of an accident. The personal accident policy provides the following coverage:

Low Cost Insurance Cover
This cover can also be given to a group of persons who can come together for a purpose other than insurance e.g. group of employees, group club members etc.

Coverage

  • Accidental Death – The Sum Insured is paid to the nominee of the insured.
  • Accidental Disability – The Sum Insured or a part of it, depending upon the extent of disability, is paid to the insured on loss of limb/s in case of an accident. This benefit can cover both Permanent Total Disability (PTD) and Permanent Partial Disability (PPD)
  • Loss of Pay – In case the insured is bed ridden due to an accident and is not able to attend office, the policy pays 1% of the Sum Insured as compensation upto 104 weeks. The benefit is also called ‘Weekly Benefit’ or ‘Temporary Total Disability’
  • Medical Expenses – The policy reimburses medical expenses incurred on treatment incase of an accident.

Highlights

  • Accidents mean anything, which is unforeseen, and therefore cover all types of accidents including road accidents.
  • It is a 24 hours cover, world-wide cover.

Group Term Life Insurance

Posted on: November 8th, 2019 by shiv No Comments

What is Group Term Insurance?

A type of insurance coverage offered to a group of people. This coverage will provide a monetary benefit to the beneficiaries if the covered individual dies during the defined covered period.

As with other types of group benefits, group term life insurance is generally cheaper than comparable individual policy coverage. For this reason, group term life insurance is often a key component in employee benefit packages.

The premiums are based on the company’s deaths experience, proposed sum assured, range of employees’ ages and the occupation of the employees.

Why is Group Term Life Insurance Important?

Most of us do not use of insurance as a risk management tool. Insurance is still used to save taxes or make savings.  Therefore most of us buy investment based plans, which have meager sum assureds.  In case of untimely death of a person these policies are unable to provide a sufficient corpus, which can replace the income of the person. 

A Group Term Life cover supplements the sum assured taken by an employee and provides financial relief to the family in case of the employee’s untimely death.

Salient Features of the Policy:

  • One master policy issued covering all members of the group
  • One year renewable plan
  • Sum assured is payable on death (either due to natural causes or accidents)
  • Addition and deletion of group members on pro-rata basis
  • No health tests required for group members upto a defined sum assured limit which is called ‘Free Cover Limit’. Health tests applicable to members who have sum assured above the Free Cover Limit.

While Fire Insurance also covers damage to assets from explosions, damage to boiler or pressure plant itself is not covered in the Fire policy. Damage to boiler and pressure plant due to an explosion can only be covered through this policy. The policy provides coverage for all types of boilers and other pressure plants.

FAQs

Can the member carry the policy on leaving the group?

No, all benefits under the plan are terminated when a member leaves the group.

Can the Sum Assured be changed mid term?

No, sum assured cannot be changed mid term unless the sum assured for the whole group or the particular hierarchy is being revised. Sum assured can also be changed if any person has been promoted during the policy duration and the new designation enjoys a higher sum assured.

Information Required By Insurers to Quote:

Insurers require the following information for each member of the group:

  • Date of birth
  • Date of Joining
  • Designation
  • Proposed Sum Assured
  • Declaration of any deaths in the three previous years


Optima’s core group has more than 100 man-years of experience in insurance. Our experience has trained us in reading the fine print of insurance policies, understanding it and applying it for the benefit of our clients.

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info@optima.co.in

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