Group Medical Insurance

Group Medical Insurance (GMI)

Medical Insurance covers medical expenses for both out patient as well as hospitalization due to accident and illness. This insurance is particular useful as the insured can claim even minor medical expenses such as OPD Doctor fees and expenses in medicines.

This plan is perfect for companies to provide group medical coverage for staff to take care of their medical expenses.

Premium Structure for medical
Individual 1,000 2,000 3,000 3,750
With Spouse and Dependants 1,500 3,000 4,500 5,625
Benefits structures and their Ceiling
SN Benefits PA/P Days Limit Rs. Per illness limit PA/P Days Limit Rs. Per illness limit PA/P Days Limit Rs. Per illness limit PA/P Days Limit Rs. Per illness limit
A Hospitalisation (A)
1 Room Charge and Nursing attendance 400 10,000 800 20,000 1000 30,000 1000 40,000
2 Fees of Surgeon & Anesthetist, Operation theatre charges, use of Surgical appliances, Oxygen, Anesthesia, Blood Transfusion: 8,000 16,000 24,000 30,000
3 Consultants & Specialists fees including services of specialists for use of diagnostic materials i.e. X-Ray, E.C.G., all types of deep-therapy, radiological and radium examination and treatment, all types of electrical treatment & physical massage: 2,000 4,000 6,000 8,000
4 Fees of Medical practitioners 800 1,600 2,400 8,000
5 Medicines Drugs & Injections 1,000 2,000 3,000 5,000
B Domiciliary Treatment
1 Fees of Medical practitioners: 800 1,600 2,400 3,000
2 Consultants & Specialists fees including services of Specialists for use of diagnostic materials( As in A,3 above) 800 1,600 2,400 3,000
3 Nursing Charge: 1,000 2,000 3,000 5,000
4 Medicines Drugs & Injections 1,000 2,000 3,000 5,000
5 Maximum limit from 1 to 5 5,000 pa 2,000 10,000 pa 4,000 6,000 10,000
C The maximum limit for A and B above 25,000 50,000 75,000 100,000
D Excess (for A and B) 15% of claim or Rs.25, which ever is highest 15% of claim or Rs.25, which ever is highest 15% of claim or Rs.25, which ever is highest 15% of claim or Rs.25, which ever is highest

Special Features

  • Covers expenses in OPD and medicine expenses that does not require any hospitalization (as per schedule)
  • Can claim for medical expenses from Nrs.25 onwards.
  • Covers expenses in case of hospitalization (as per schedule).
  • Is perfect for health insurance cover for any employee groups, and can also include dependent family members.