Pros and Cons of Group Medical Insurance Cover
Pros and Cons of Group Medical Insurance Cover

With a myriad health insurance plans that you can choose from, picking a policy can get confusing. Different plans are designed for different age groups and illnesses. For instance, a family floater policy is designed to cover many beneficiaries under one insurance cover. On the other hand, a critical illness insurance can help to tackle the soaring treatment costs for life-threatening ailments like cancers. Among these many types of health insurance plans, one plan that often does not get its much-deserved attention is the group health insurance plan. This article elaborates on the pros and cons of a group insurance scheme so that you can consider it as a part of your insurance portfolio. 

But for starters, let us understand how does a group insurance policy work. 

Group health insurance often popular as a corporate insurance plan is the one that covers a group of people with a common association. It is most commonly found in a corporate setting where employers provide this facility as an added perquisite to its employees. But it is not limited to an employee-employer relation. A group health insurance is a common policy purchased by the primary policyholder who is also the administrator of that policy. This administrator, the employer in the above instance, defines the benefits available under the policy cover. This policy can then be purchased by the members of the group, here the employees. 

The pros of buying a group insurance policy

  • Waiting period: Unlike other individual or family health insurance, a group insurance policy does not have waiting period. You no longer are required to wait to get any of your ailments covered by your insurer. This condition of waiting period applies to pre-existing ailments or for maternity cover and a few other critical ailments. 
  • No medical check-up: A group insurance policy is issued without undergoing a medical examination and that is even the case when buying health insurance for senior citizens. These pre-medical checks are required for other types of insurance plans.
  • Premium paid on your behalf: The premium of a group insurance cover is generally paid by the administrator of the policy. Only if you choose to increase the sum assured or load additional features, you need to pay for such incremental amount. 

The cons of buying a group insurance policy


  • Amount of coverage: Group insurance plans have pre-defined coverage with a limited sum assured. You can not customise these plans as per your requirement. Thus, with the soaring treatment costs, relying solely on group health cover may not be advisable. 


  • Policy coverage: This insurance policy is only available till you are associated with that particular organisation. The coverage ends the moment your association with that organisation terminates. So, having a group insurance policy exclusively will not be recommended. It should be paired with other forms of insurance plans.


  • Capping on expenses: A downside of group insurance policy is the limitation on the amount of expenses admissible under the insurance policy. Not all expenses relating to the treatment can be claimed. Some expenses like room rent charges have a capping on the amount that can be claimed under the insurance policy.


A group health insurance policy has some notable advantages like zero waiting period, lower premiums and more, but do not miss on understanding the impact of its downsides. It can at times be insufficient to avail the necessary treatment. Insurance is the subject matter of solicitation. For more details on benefits, exclusions, limitations, terms and conditions, please read sales brochure/policy wording carefully before concluding a sale.