Difference between GMC and GPA insurance policy

Find out the difference between GMC and GPA insurance policy. What is Group medical coverage & group personal accident? Which is better?

Group policies are generally insurance policies provided by an organization to its employees. GMC (Group medical coverage) and GPA (group personal accident) insurance policy are two popular group insurance policies in the market.  In this article, we are decoding what these two policies are and which is better for your employees.

What is group medical coverage?

A group medical coverage also called group health insurance covers all hospitalization-related expenses made by the employees. In fact, accidental hospitalizations are also covered in GMC. Group health insurance is a highly customizable insurance policy. Employers/HRs can choose what they want to add to the policy to best suit the employees. For example, you can choose what can be the maternity cover, if dependents need to be added, ICU and room rent limits and more.

What’s covered in a GMC policy

  1. All pre, during and post hospitalization expenses are covered.
  2. All pre-existing diseases are covered with zero waiting period
  3. All hospitalization is covered including accidents.
  4. Coverage for maternity insurance and new-born if included in the policy
  5. Covid-19 treatment is covered

What is group personal accident insurance?

Group personal accident policy covers all expenses incurred by an individual due to an accident. This policy protects employees from financial strains after accidental injuries. This policy takes claims only related to accidents. GPA policies are generally worldwide in nature.

What’s covered in a GPA policy

  1. Hospitalization due to accident
  2. 100% sum insured to the nominee in case of death
  3. 100% sum insured in case of total disablement
  4. 2 to 60% of the sum insured in case of partial disablement or loss of vital organs.
  5. A percentage of the sum insured can be put towards the education of two dependent children based on the policy
  6. Ambulance charges are covered
  7. Expenses incurred in the transportation of mortal remains are covered

Difference between GMC and GPA insurance policy

Paramaters GMC GPA
What it covers Hospitalization for any health concern Hospitalization caused by accidents. Includes death and disability.
Coverage It is generally a blanket cover for all employees. Companies can choose to keep it graded.
Ex, employees under 5L CTC - 3L coverage and above 5L CTC - 5L coverage
The coverage can be different based on the designation or CTC of employees.
Ex, 3x CTC
Claims Cashless and reimbursement claims. No waiting period. Cashless claims in case of hospitalization. Insurer will pay the insured or nominee in case of disability and death after assessing the details.
People covered Employees are covered. Company can extend the policy to employees’ dependents. Not extended to family members generally.
Inclusions Depends on the policy chosen. General inclusion includes pre and post-hospitalization expenses and pre-existing diseases. Maternity, and day-care if it exists in the policy or is bought as an add-on. Depends on the policy chosen. General inclusion include Accidental death, permanent total disability, permanent partial disability, temporary total disability, cover loss of income.
Exclusions Depends on the policy chosen. treatment for alcohol abuse, drug abuse, self-inflicted injuries, etc. are generally excluded. Depends on the policy chosen. Accidents caused by adventure sports or by being involved in illegal activities are excluded

Which is better? GMC or GPA insurance policy?

GMC is a more comprehensive cover whereas GPA covers only accidents. GPA can be bought as a rider (add-on) to your GMC. This way, you can include coverage for disability and death due to accidents in your GMC as hospitalization is already covered.

Overall, if you are deciding between GMC and GPA, your best bet is GMC as it provides more value to your employees.

Read: Why including parents in group health insurance policy is important

Pazcare for group insurance

Pazcare offers all types of group insurance for the best prices in the market. We are IRDAI certified broker and work with all the insurers in India to get you the best policy. Along with this, you also get the Pazcare admin/HR dashboard to manage your employee benefits insurance easily. You can make endorsements, get reports, check usage CD balance, etc. without depending on the TPA or insurer.

As a cherry on top, with group health insurance from Pazcare, there is also a super top-up option. Super top-up in health insurance allows employees to increase their cover and add dependents to their policy by paying a premium.

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