Group insurance for startups: Policies to consider | Mint

I am the founder of a 25-person startup. What types of group insurance should I buy for my team? Are these policies available for small companies like ours, or are they exclusive to larger companies?

—Name withheld on request

For a startup, often the right set of insurances become critical to attract the right quality of talent. Thankfully, you could buy the best of group insurances available to larger companies. Some of the key insurances that you should consider include group health insurance, group personal accident and group term life. The group programmes can be customized to specific requirements of the company. Elements like sum assured, policy sub-limits and exclusions, can be modified depending on the budget of the company. You should consult a employee benefit-focused insurance broker to help you design these plans.

What are modern treatments, and are they covered by regular health insurance policies?

—Name withheld on request

For health insurance policies, specific “modern treatments” have been listed under the Insurance Regulatory and Development Authority (Irdai)’s guidelines. This list comprises advanced methods of intervention that were often excluded by insurers. Now, IRDAI has made it mandatory for all health insurance policies to cover a list of modern treatments, including balloon sinuplasty, deep brain stimulation and robotic surgeries. So, irrespective of the insurer, these treatments are covered under health insurance. However, the regulator has allowed insurers to put sub-limits for such treatments. As a result, insurers impose an absolute cap or limit coverage to a proportion of the sum assured.

Can health insurance claims be settled with just a soft copy, or is it mandatory to submit a hard copy?

—Name withheld on request

Traditionally, insurers used to insist on hard copies of all claim documents, including the discharge summary, hospital bills and receipts, which were required to be submitted in original. However, over the last few years, some insurers have started to settle claims based on soft copies. The documents can be emailed to the insurer for processing. Furthermore, a handful of insurance intermediaries have the provision of mobile apps, through which health claims can be submitted. In such cases, the claim submission process becomes even more straightforward. All policy details are pre-filled in the app. Policyholders must click pictures of the documents and upload it on the app. Submission of claims through app or portal has reduced the turnaround time of claim settlements substantially. Since these apps are connected directly with insurer’s claim processing system via APIs, data get transferred in digitized format. This reduces the workload of insurers and ensures a lower turnaround time.

You should note that even if one insurer settles the claim on soft copy, this does not mean that the originals can be submitted to another insurer to make the same claim twice. Since insurance is issued under the principle of indemnity, a policyholder can claim only up to the actual expenditure incurred.

(Abhishek Bondia is principal officer and managing director at SecureNow.in)