Care Group Health Insurance

Care, one of India's leading health insurance providers, offers a diverse range of health insurance products. Because of its robust distribution channels, the insurer has a distinct business presence in the health insurance market, ranging from healthcare delivery to preventive health solutions.
Care Group Health Insurance provides financial security to employees in the group, protecting them against financial burdens arising out of medical emergencies. Employees are the life force of any organization, and providing them with outstanding health care facilities, especially in these times, is one of the primary responsibilities of the organization. When the need arises, Care can be an excellent partner. This group’s medical insurance provides comprehensive coverage, with a customization facility, as per the requirements.
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Key Statistics of Care Group Health Insurance
GHI Premiums
₹2,334 crores
FY 2021
GHI lives insured
49 lakhs
FY 2020
Health lives insured
1.28 crores
FY 2020
Claims Processed
10,68,571
FY 2020
Claims Settlement Ratio
92.83%
FY 2020
Claims Settled within 3 months
95.47%
FY 2020
*Source - IRDAI and IBAI annual reports  **GMC - Group Medical Cover
***Claims Settlement Ratio (CSR) is the percentage of claims settled by the insurance company against the no. of claims obtained in a financial year. A high claim settlement ratio indicates the good financial health of the insurance group.
GHI Premiums
₹1,009 crores
FY 2021
GHI lives insured
53 lakhs
FY 2020
Health lives insured
1.72 crores
FY 2020
Claims Processed
1,67,673
FY 2020
Claims Settlement Ratio
86.52%
FY 2020
Claims Settled within 3 months
86.42%
FY 2020

What is Group Health Insurance?

A group health insurance policy is advantageous to both employees and employers. Employers benefit from employee loyalty while reducing their financial burden and covering treatment costs.
Highlights  of Care Group Health Insurance
8350+ Cashless claim providers
24/7 claims Support
95.2% Insurance Claim Settlement Ratio
A highly trusted brand of the insurance sector in India

Why Choose Care Group Health Insurance?

When choosing a group medical insurance, an organization aims to provide financial protection to its employees. It also shows that the company cares about them. In Care group medical insurance, the standard health insurance cover is there, and additionally, an employee gets an option to tailor the policy suiting the specific needs, which in turn provides a greater sense of satisfaction. The various advantages of the policy are listed above for better understanding.
Flexibility to choose a plan as per the requirement
A dedicated relationship manager for addressing the different queries and needs of the insured
Cover for the pre-existing disease from Day 1 of the health insurance
A cashless claim settlement at the network hospitals. As of now, the Care group has cashless hospitalization facilities at over 10000 hospitals
Direct claim settlement entails that the insured can claim the medical expenses incurred directly from the insurer
There is no pre-policy medical checkup required to initiate the health insurance policy
Newborn cover starts from Day 1 of the insurance
Employees prefer group insurance plans
92%
are willing to share the premium costs to buy voluntary plans.
33%
employees can spend 1-2%
37%
are willing to spend to 3-5%
83%
want customisation
78%
are willing to contribute to premium for parents coverage
31%
organisations have enhanced programs for women
Source - The Economic Times
GHI Premiums
₹1,009 crores
FY 2021
GHI lives insured
53 lakhs
FY 2020
Health lives insured
1.72 crores
FY 2020
Claims Processed
1,67,673
FY 2020
Claims Settlement Ratio
86.52%
FY 2020
Claims Settled within 3 months
86.42%
FY 2020

Standard Benefits Offered by Care Group Health Insurance

Here is a comprehensive summary of the Care Group Health Insurance Plan. The features mentioned below can be customised as per your organization’s requirements.
Feature
Type of cover
Daycare treatment
540+ daycare treatment procedures are covered under this policy, the medical expenses incurred on the procedures at a network hospital or medical centre can be claimed with a written certificate of the medical practitioner.
Inpatient treatment
In case of hospitalization, the insured can raise a claim to the sum insured.
Room rent
Charges up to 1% of the sum insured can be claimed towards the room rent incurred, if the room charges incurred are higher than 1%, then the insured will have to bear the extra charges.
ICU charges
Charges up to 2% of the sum insured can be claimed for the ICU charges incurred, if the ICU charges incurred are higher than 2% of the sum insured, then the insured will have to bear the extra charges.
Exclusions
Waiting period
Medical expenses incurred during the first 30 days of policy initiation will not be covered under the Care group health insurance. Any injury suffered during this time will be covered.
Specified waiting period
For the initial 2 years, no claims will be admissible for the specified illness or the procedures.
Please note that Plum has collated and presented this data for informational purposes only and at a particular point in time. Plum does not endorse, rate, or recommend any particular insurer or insurance product offered by an insurer. The final terms, conditions, and premiums may vary depending upon factors including group size, age, location, and applicable taxes.

The Care Advantage

Care  insurance provides comprehensive coverage, which can be adjusted to suit the needs of employees. Some of the advantages of Care health insurance are:
Cashless claims
Care policy comes with cashless claims at the network medical centres. The process to claim the same is quite simple, this can be done with a policy number and valid identity proof. The Care claim process is a direct claim-filing system, which makes it more efficient.
Sum insured
Sum Insured differs from one insured person to another as per their needs and levels at the organization. No matter how much the sum insured is, all inpatient treatment expenses are covered up to the sum Insured.
Annual health check-ups
Care group medical Insurance comes with free-of-cost annual health check-up features. It is a good feature for group medical insurance, as it can be an effective team-building event for companies.
Flexibility
When opting for Care policy, there is flexibility at all levels to choose the sum insured and a system to tailor the cover as per the specific requirements of the individual employee. This removes the system of the single-cover-fits-all system and makes employees appreciate it more.
Ambulance cost
The group health insurance policy is available in two variants, both of which include ambulance charge coverage of Rs 1000 and Rs 2500, depending on the policy selected.
Pre- and post-hospitalization cover
Pre- and post-hospitalization cover follow the 30:60 system under the Care policy. The 30:60 system entails pre-hospitalization cover of the insurance of 30 days and post-hospitalization cover of 60 days.
Therapy coverage
The policy provides coverage for chemotherapy and radiotherapy.
Prenatal and postnatal
The insured can avail of this benefit for 30 days and an expense of Rs 2500 or Rs 5000, as per the insurance plan, which is settled within the maternity benefits.
Alternative treatments
Care also provides coverage for alternative treatment modes, such as Ayurveda, Unani, Homeopathy, and Siddha. As the psychology of each individual differs, so can the faith of people in terms of choice of treatments. A policy that provides coverage on alternative treatment adds to the satisfaction that employees get.
OPD treatments
Care group health insurance also provides coverage for outpatient treatment and 540+ day treatment procedures.
Maternity cover
This policy comes with in-built maternity coverage. A maximum of two children’s maternity covers can be claimed through the policy.
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Here's how Care Group Insurance is better with Plum

Care  insurance provides comprehensive coverage, which can be adjusted to suit the needs of employees. Some of the advantages of Care health insurance are:
Complete digital experience
From cashless claims to digital health IDs, and much more, go digital with Plum.
Track claims status
With a single click have a detailed look at how the policy is working for your employees.
Size does not matter
Add or remove employees and medical benefits as you scale.
Get doctors on call
Book online appointments with your preferred doctor with Plum Telehealth.
Employee Wellness
Plum provides your employees with various wellness programs from time to time.
WhatsApp's facilities
Start a claim, download your eHealth card, check policy details, and much more on WhatsApp.
Single Dashboard
Be it employer or employee, desktop or mobile, check your insurance plan & health benefits dashboard anywhere.
Track your claims
Know how your team is utilizing their employee benefits and medical coverage.
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How Does Plum Work?

Open
app.plumhq.com
to access your insurance
Select
Open WhatsApp
and continue to chat
Click on use
my insurance button
on the dashboard
Open
app.plumhq.com
to access your insurance
Click on use
my insurance button
on the dashboard
Select
Open WhatsApp
and continue to chat

How to Use Care Group medical Insurance

The documentation depends on the type of claims process you have chosen - Cashless or Reimbursement.
Reimbursement Claims
Cashless Claims
The policy comes with a reimbursement feature when treatment opts at a centre, which is not on the network
If there is a planned hospitalization, an insurer should get advance information at least 2 days before the said hospitalization. If the same happens in case of any emergency, it should be conveyed to the insured within 24 hours of hospitalization.
The policy will enable a cashless cover at the various network hospitals. The same can be claimed by providing policy details and valid identity proof.
Reimbursement claim
Cashless claim
Completely filled  claim application form for reimbursement process with employee id and group policy details
All original bills related to medical treatment
Payment receipts done manually
Discharge certificate
If you have taken implants, the invoice has to be submitted
Doctor’s prescription
Nurses/attending physicians notes
KYC details for deposit transfer - NEFT/IFSC/Bank Statement
FIR or police certificate or post mortem report  in case of accident/death
Claims application form
Cashless claims application form - you can get this from the TPA desk at the hospital
Health card or health id or policy number
Id proof - PAN & Aadhaar is mandatory
Medical bills and daily treatment summary

Here’s why you will love Plum

With Plum, get complete access to your insurance plan on WhatsApp
Check your healthcare benefits
Intimate your claim
Read what’s covered and not covered
Select other health benefits
Download your Digital health ID Card
See daycare treatment list

Conclusion

With the rising costs of healthcare services and lifestyle diseases, health insurance has become a necessity. When it comes to group medical insurance, financial protection needs to be ensured by an organization for its real assets. A properly designed policy helps an employee to achieve a sense of belongingness. With Care Group Health Insurance, an employee gets a comprehensive health insurance cover and the flexibility to design the policy as per the specific requirements of the insured.

Frequently asked 
questions

What is a Group Insurance Policy?

A Group Health Insurance policy is a health insurance policy that is given to a group of employees in a company or organization. These Plans are generally customizable to suit the individual needs of employees.

Can group insurance plans be customized later on during the tenure as per changing needs?

Yes. The insured individual will need to get in touch with the designated person with the required addition, and our representative will advise catering to the need in the best possible way.

Can a group of employees buy these plans on their own?

No, employer endorsement is necessary for obtaining the group health insurance plan.

Can an addition and Deletion be done on WhatsApp when using Plum?

Yes, Plum provides the organisation with a single comprehensive dashboard, using which employers can access, modify and delete the policy as per requirements.