Group Hospital Cash Insurance Policy

Group Hospital Cash Insurance

Health insurance plans do a great job, beyond any doubt, when it comes to covering medical bills. However, there are some additional and peripheral expenses that a health insurance plan might not cover, such as money spent on traveling, food expenditures, lodging, and so on. 

To meet these extra expenses occurring during hospitalization, one may opt for the hospital cash benefit. Simply put, this insurance will give the insured total peace of mind and guarantee a simple and hassle-free recovery process!

This post will highlight some of the important aspects of a group hospital cash plan that one should comprehend before buying a health insurance policy.

Definition Of Group Hospital Cash Insurance

Group Hospital Cash Insurance is a beneficial insurance product that provides a set insurance amount for each day of treatment that lasts longer than 24 hours. 

The policyholder receives a set daily allowance to cover other costs while they are being treated in the hospital. The daily cash benefit is typically included in a basic plan or is an optional cover that can be bought.

Why Should One Go For Group Hospital Cash Insurance Plan?

There is a plethora of reasons why one should zero in on a group hospital cash insurance plan. Some of them are mentioned below:

  • Coverage For Additional Expenses: There are a lot of medical expenses that are not covered under a standard group health insurance policy, such as medical kits, consumables, and so on. Therefore, a group hospital cash insurance becomes a cushion for covering all such additional expenses during the period of hospitalization.
  • Payment For Loss Of Income: Some employees may lose their pay for the period of their hospitalization due to a higher number of leaves. A group hospital cash insurance works as a life savior by providing compensation for the loss of income during the hospitalization period.
  • Preserves No Claim Bonus: In case of minor hospitalizations, where bill amounts are not significant, one can pay off the bills with the help of group hospital cash insurance. This will assist the policyholder in preserving his No Claim Bonus (NCB) that he/she would otherwise lose.
  • Reasonable Rates: Since the insurance allows all the employees in an organization to contribute to the policy, the employer needs not to break the bank for purchasing and maintaining the policy. Similarly, the insurance proves less expensive for the employees as the insurance cost is divided among all the employees of an organization.
  • Tax Benefits: As per the current laws and legislations, both the members and the master policyholder can enjoy tax benefits on the premium paid. This allows them to save a great deal of money, which they can use for other important purposes.
  • Double Allowance In ICU: Since the charges for ICU are more expensive than a standard hospitalization, various insurance companies double the group hospital cash allowance to overcome the expenses occurring in case any of the covered members is admitted to the ICU.

Inclusions Under Group Hospital Cash Insurance

Below-mentioned expenses are covered under a group hospital cash insurance:

  • Daily hospital cash benefit
  • Day-care surgeries
  • Modern treatments:
  • Uterine Artery Embolization
  • Stereotactic Radio Surgeries
  • IONM – (Intra Operative Neuro Monitoring)
  • Deep Brain Stimulation
  • Oral Chemotherapy
  • Immunotherapy
  • HIFU (High-Intensity Focused Ultrasound)
  • Balloon Sinuplasty
  • Intra Vitreal Injections
  • Robotic Surgeries
  • Stem Cell Therapy

Exclusions Under Group Hospital Cash Insurance

Below are the expenses that are not included as a part of group hospital cash insurance:

  • Maternity expenses
  • Hospitalization for less than 24 hours
  • Neo-natal expenses
  • OPD (Out-Patient Department) treatment
  • Diagnostic costs before and after hospitalization
  • Refractive error less than 7.5 dioptres
  • Dental treatment
  • Treatment for sterility and infertility
  • Gender change treatment
  • Obesity or weight control treatment
  • Self-injury or suicide
  • Breach of law
  • Unproven treatments
  • Treatment of drugs, alcoholism, and other intoxicating substances

Claim Process For Group Hospital Cash Insurance Policy

For claims against the group hospital cash insurance policy, the policyholder can follow any of the two methods below:

  • Cashless Claim Process: In case the policyholder’s hospitalization is planned or is in a network hospital of the insurance provider, a cashless claim process can be followed. The insured has to present his health e-card at the hospital and the claim amount will be directly settled between the insurance company and the hospital.
  • Reimbursement Claim Process: In case the hospitalization is not planned or is in a non-network hospital, the reimbursement claim process can be followed. Firstly, the insured needs to inform the insurance company about hospitalization as soon as possible. Then he needs to collect all his original bills, diagnostic reports, and other important documents and then request a claim by submitting all the documents to the insurance company. Once the documents are verified, the insurance company will reimburse the amount to the registered bank account of the policyholder.

Documents Required For The Claim Process Of Group Hospital Cash Insurance Policy

For claims against a group hospital cash insurance policy, one should submit the following documents:

  • Original medical reports
  • Duly filled and signed claim form
  • Health e-card
  • Valid ID proof 
  • Original hospital bills, discharge summary, etc.
  • Doctor’s prescriptions

Frequently Asked Questions

Here are some of the frequently asked questions that you must know.

The age requirement for purchasing hospital cash insurance is still the same as that stated in the basic health insurance plan.

The daily hospital cash policy allows for a minimum coverage limit of Rs 100 and a maximum coverage limit of Rs 10,000. There is no set limit, so this will depend on your health insurance coverage and the health insurance provider.

A health insurance plan covers your medical expenses up to the sum assured in case of your hospitalization of more than 24 hours. Whereas, a hospital cash benefit offers a fixed sum assured for the hospitalization period (for more than 24 hours). The hospital cash benefit can be purchased as a rider along with your health insurance plan to enhance its coverage.

Generally, the insurance companies offering the plan will have a 30-day waiting period for any claim for hospitalization. However, the waiting period may differ from one insurance company to the other.