Group Hospital Cash Insurance Policy

Group hospital cash insurance is a fixed benefit insurance product. It provides you with a fixed sum insured for each day of your hospitalization of 24 hours or more. A daily cash benefit can be part of your basic health insurance cover or can be purchased as an additional cover. The objective of daily cash allowance is obtained to meet the miscellaneous expenses incurred by the policyholder during a hospitalization case.

• Additional expense cover: A lot of additional expenses such as consumables, medical kits used during hospitalization are not covered under your group health insurance policy. So, group daily cash allowance becomes the cushion for all the additional expenses that are incurred during a hospitalization.
• ICU cover: Owing to the fact that ICU charges are much more expensive than regular hospitalization, insurance companies generally double the daily hospital cash allowance in case the insured or any of the covered members is admitted to an ICU.
• Miscellaneous expenditure cover: Many added costs arise due to hospitalization, something as simple as food from the canteen for the patient and the attendants can become a burden for your finances. A fixed sum of amount for everyday can help meet your household or other expenses during the difficulties of a hospitalization.
• Compensation for loss of income: A group daily cash allowance can be a savior for the period of your hospitalization, where some employees lose their pay due to lack of sufficient leaves. This product holds high relevance for daily wage earners and gig-workers.
• Preserve your no claim bonus: For minor hospitalizations, where the bill amounts are also small, you can pay off the bills from your daily hospital cash and this will preserve your no-claim bonuses that you would otherwise lose.

For employees-

• A fixed cash amount is payable for each day of hospitalization, irrespective of actual medical costs incurred
• The policy can be bought for family, including spouse and up to 3 kids
• Multiple hospitalizations are allowed in a year
• Typically, such a product will have a deductible of one day.

For employers-

• Premium amount paid by any mode other than cash is eligible for deduction as a business expense under the Income Tax Act.
• Employee loyalty and productivity is directly proportional to the perks they receive from the employer. Benefits as such definitely attract quality employees.

Below benefits are covered under a group hospital cash policy:

• Daily hospital cash limit provided is generally doubled in case the insured or other covered members are admitted to the ICU.
• Pre-existing diseases and specific diseases are covered after 24 months of waiting period.
• Fixed daily cash allowance can range from Rs. 500 - Rs. 5,000 and the actual amount can vary based on your requirement and the insurance company.

Below details are not covered as part of a group hospital cash insurance policy:

• Cost of diagnostics before and after hospitalization
• Maternity expenses
• Neo-natal expenses
• Hospitalization for less than 24 hours
• Any Out-Patient Department (OPD) treatment taken

There are two methods for claiming benefits for a group hospital cash insurance plan

• Cashless claims processing: In case your hospitalization is planned or your hospitalization is in a network hospital of your insurance provider, the claims become cashless. You have to produce your health e-card at the hospital and any claim within the sum insured will be settled between the insurance company and the hospital directly.
• Reimbursement claims processing: In case you are hospitalized in a non-network hospital, then reimbursement claim processing happens. You are required to intimate your insurance provider as soon as you get admitted, get hold of all your original bills and diagnostics reports and then make a claim by submitting a claim request after your discharge.

Following are the documents required to claim hospital daily cash benefit

• Duly filed and signed claim form
• Health e-card and valid Govt. ID proof in case of cashless treatment and a valid ID proof in case of reimbursement claims
• Original medical reports
• Original hospital bills, daycare summary, discharge certificates, etc.
• Prescription from the doctor suggesting active line of treatment