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A health insurance is one of the most important benefits that any employer can provide their employees. It’s the best way to protect employees and when they are less burdened by financial stress, it is likely to boost everything from attendance and productivity, to even company profits!
When it comes to employee health insurance, Group Medical Covers (GMC) and Group Personal Accident (GPA) Insurance are two common options to choose from. But they are very different policies with distinct features and benefits.
Let’s take a look at both policies, so that you can better understand them and choose whichever is best for your company and your employees:
A Group Medical Cover, or GMC, is a type of health insurance that is offered to a group of people, such as the employees of the same organization. Their dependents, including spouse, children, and parents, can also be covered under this.
Generally, such a policy is offered as a benefit by an employer, who bears the cost of the premium. As the risk of this kind of health insurance is spread across a pool of insured individuals, the premiums are kept low.
A Group Personal Accident Insurance (GPA) is a type of insurance that protects a group of people financially in the case of any unforeseen accidents that result in death, fatal injury, or disability.
Accidents can occur at any time, and can have unexpected health consequences. Thus, a GPA policy comes with certain in-built features to cover employees in case an accident leads to their death or disability which can affect their income. It provides a measure of financial protection for them or their dependents.
Like a GMC, the premium of a GPA is also borne by the employer, or it is contributed to from an employee’s salary.
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To get a better understanding of how these two policies compare, let’s take a look at the difference between Group Medical Cover and Group Personal Accident:
Parameters |
Group Medical Cover |
Group Personal Accident Cover |
What is it? |
It covers hospitalization expenses and illnesses faced by employees and their dependents. |
It covers expenses resulting from accidents that lead to injury, disability, or death. |
What is covered? |
The policy covers hospitalization, pre-existing illnesses, pre-and post-hospitalization expenses, daycare procedures, maternity expenses, newborn baby cover, and more. |
The policy provides financial coverage against death and disabilities caused by an accident. |
What is excluded? |
Generally, this policy excludes medical expenses that are a result of suicide, self-injury, cosmetic treatments, alcohol or drug abuse, or HIV/AIDS. |
This policy generally excludes expenses relating to natural deaths, accidents resulting from illegal activities, self-injury, suicide attempts, pre-existing diseases, and alcohol abuse. |
What is the scope? |
Since it covers a wide range of hospitalization expenses and illnesses, it has a broader scope. Additionally, a personal accident cover can also be included as an add-on. |
This kind of policy only covers expenses resulting from accidents, so it has a comparatively smaller scope. |
Who is covered? |
It covers employees and their dependents, i.e., spouse, children, and parents. |
It generally only covers employees of the organization. |
Can it be customized? |
Yes, it can be customized by the employer based on employee needs. |
This cover is non-customizable. |
Who should get this policy? |
Group medical cover is suitable and necessary for all organizations, irrespective of the nature of business. |
GPA is an important component and suitable for businesses that involve risk of accidents, for example, construction and travel businesses. |
Both Group Medical Cover (GMC) and Group Personal Accident (GPA) Insurance can do a great deal to help with employee satisfaction and talent retention, so it is important to know what they are and make the right choice.
So whether you’re an employee looking to understand what’s out there, or an employer making a choice for your employees, hopefully now you can make a more informed decision.
Usually, it is only full-time employees who are covered under a GMC or a GPA policy. But depending on the agreement between the insurer and the employer, part-time or contract-based employees can also be included.
Usually, it is only full-time employees who are covered under a GMC or a GPA policy. But depending on the agreement between the insurer and the employer, part-time or contract-based employees can also be included.
For both a GMC and a GPA policy, premiums are dependent on various factors such as group size, coverage, features and add-ons included, and demographics like age, income, and the nature of the job.
For both a GMC and a GPA policy, premiums are dependent on various factors such as group size, coverage, features and add-ons included, and demographics like age, income, and the nature of the job.
In most cases, the premiums for the GMC or GPA policy are paid by the employer. However, in some cases, employees may be asked to contribute towards the premium payment, especially if they are opting for any added benefits at an individual level.
In most cases, the premiums for the GMC or GPA policy are paid by the employer. However, in some cases, employees may be asked to contribute towards the premium payment, especially if they are opting for any added benefits at an individual level.
Under a GMC policy, all employees above 18 years and up to 70-95 years (depending on the insurer) who are employed with an organization are covered; they can also add their spouse, parents, and dependent children aged between 3 months to 25 years.
Under a GMC policy, all employees above 18 years and up to 70-95 years (depending on the insurer) who are employed with an organization are covered; they can also add their spouse, parents, and dependent children aged between 3 months to 25 years.
If your company has at least 10 employees, then you should think about getting a group health insurance to protect them all. You can conduct a survey to decide what coverage to offer, and if they would prefer a GMC or GPA policy.
If your company has at least 10 employees, then you should think about getting a group health insurance to protect them all. You can conduct a survey to decide what coverage to offer, and if they would prefer a GMC or GPA policy.
This depends on the type of corporate health insurance plan you have. However, since this plan is tied to your employment, opting for an additional Individual Health Insurance will help you stay covered even if you leave. Additionally, you will also have more coverage and get personal tax savings. Read: Health Insurance Tax Benefits
This depends on the type of corporate health insurance plan you have. However, since this plan is tied to your employment, opting for an additional Individual Health Insurance will help you stay covered even if you leave. Additionally, you will also have more coverage and get personal tax savings.
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Author: Team Digit
Last updated: 01-04-2025
CIN: U66010PN2016PLC167410, IRDAI Reg. No. 158.
Go Digit General Insurance Limited (formerly known as Oben General Insurance Ltd.) - Registered Office Address - 1 to 6 floors, Ananta One (AR One), Pride Hotel Lane, Narveer Tanaji Wadi, City Survey No.1579, Shivaji Nagar, Pune-411005, Maharashtra | Corporate Office Address - Atlantis, 95, 4th B Cross Road, Koramangala Industrial Layout, 5th Block, Bengaluru-560095, Karnataka | Trade logo of Go Digit General Insurance Ltd. displayed above belongs to Go Digit lnfoworks Services Private Limited and is provided and used by Go Digit General Insurance Ltd. under license.
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