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Non Life Insurance - Non-Employer Group Insurance Vs Personal Health Cover: Which is better for you amid the Omicron outbreak?
07-Feb-2022

Though all types of health insurance plans safeguard the policyholders against unanticipated medical expenses, we will help you decide on how you should go about choosing the right one.

The Covid-19 pandemic, for now, seems to be an everlasting one. From the first SARS-CoV-2 virus to the Delta variant and now the Omicron, effort towards normalizing life still seems like a distant affair. The highly transmissible latest strain can evade some antibodies and immunity and has a higher risk of reinfection, though mild, than the earlier variants. In India, the effect of this variant has been immense, with over 1.5 lakh cases being reported every day.

This scenario has once again brought to the limelight the importance of health insurance and how it has become a non-negotiable proposition for each individual. But the several options make people perplexed on which one to purchase, especially with the third wave in motion. 

When looking for health insurance, you will come across an individual health plan, corporate group insurance, and a combination of both, i.e. informal group insurance. Though all safeguard the policyholders against unanticipated medical expenses, we will help you decide on how you should go about choosing the right one.

Know your plan

The informal group insurance, also known as non-employer-employee group insurance, is purchased collectively by people belonging to the same society, cultural association or even those who hold an account in the same bank. Any informal group such as users of a website, mobile app, etc. can also offer group insurance to its customers.

Alternatively, individual health insurance or retail insurance is a more formal method of getting health insurance cover. It is an insurance package bought by individuals for themselves or their families.

The key difference between Individual health insurance and group health insurance is that individual health insurance is regulated strongly by IRDAI and policyholders’ interests are far more protected in individual policies as compared to group policies.

Renewability of the plan

The biggest differentiator of the individual insurance policy and non-employer group insurance is renewability. The former enjoys lifelong renewability, while in the case of group insurance plans, long-lasting renewability is not an option.

In the informal group plan, the other uncertainty is a particular product or policy that one had opted for may be discontinued or withdrawn by the bank or the insurance company. The validity of the policy is subject to a specific set of terms and conditions. Furthermore, if, due to any reason, you need to exit the group or decide to change your current active bank account in the same bank, your group policy will no longer be valid. On the other hand, an individual policy is permanent until you change or cancel it. Thus, opt for a personal policy that also covers consumables, which in this Covid-19 era has risen to 20-30% in the total hospital bill and additional coverage of choice.

A premium of the policy

As mentioned before, under the individual health plans, the pricing is stringently monitored by the IRDAI guidelines. However, in the informal group plans, the pricing can be flexible and be determined as per the cumulative prerequisites of the group, i.e. if required, altering them is possible. So, considering this factor is vital before choosing your preferred health policy. There have been instances of complaints raised, especially by senior citizens, that their Group policy premiums have increased by 2x or 3x also. Such conditions never happen in individual policies as they are monitored closely by IRDAI.

Consider the pros and cons

Covid-19 cases are already seeing a massive increase in India, and Omicron is predicted to engulf even more people during the peak. Thus, opting for an insurance plan, group or personal insurance, is integral. 

The individual plans alternatively offer worry-free continuity, flexibility, high sum assured inclusive health check-ups, and keep a good check even during medical inflation, which is essential, especially during the Covid-19 times. They also provide adequate coverage and riders of choice, have no dependency on the bank or association with a group. Moreover, it gives better control and allows selection factors like the claim settlement ratio, wellness benefits, OPD coverage, consumables, the network of hospitals, among others.

Source : Financial Express back