When a company issues a single insurance policy to cover many individuals, it is called Group Medical Insurance. Such policies have standard terms and conditions applicable to all the beneficiaries. The insurance premium charged per head is less in such policies due to bulk discounts.
The categories of expenses that are included in the policy include expenses for the treatment of critical illnesses, expenses for treatment of injuries caused due to accident, Corona Kavach - Cover for the treatment of Covid-19 infection.
Expenditures allowed as a claim for the treatment are room rent, consultation fees paid to surgeons, specialists and resident consultants, medical examinations that are carried out to diagnose the disease. Daycare procedures for the treatment of the illness. Medicines prescribed for the treatment, pre- and post-hospitalisation expenses from 30-90 days as mentioned in the policy, cost of surgical or other sophisticated procedures, and daily cash allowance.
The hospitals that have a tie-up with the Insurance company to provide medical facilities to the policyholders are called network hospitals. You can avail of seamless medical treatment along with cashless facilities at such hospitals.
Your insurance claim can be rejected in any of the following cases, if you use alcoholic or harmful substances leading to your disease or medical emergency for which you are taking treatment, pre-existing disease not disclosed in your application, if the wounds are self-inflicted, if your claim exceeds the maximum permissible limit for treatment fixed by the insurance company.