Employment Benefits

Employees consistently rate benefits as one of the key factors in job satisfaction and so it is important for an employee benefits package to be attractive to both current and prospective employees. Employee benefits related to insurance are an added advantage to companies in the war for talent as they can establish a company as the “employer of choice.” In India, the awareness of the importance of these insurance benefits is slowly catching up and in the coming years is surely bound to influence a corporate’s ability to attract and retain highly qualified people.

Employee Benefits Insurance can be broadly classified into:

  • Group Health Insurance / Hospitalization Benefits
  • Group Accidental Benefits
  • Workman Compensation

Throughout the world, Benefit professionals are becoming increasingly concerned about the impact of rising health care on their companies futures and fortunes. The sobering reality is that total health care costs in India will likely double faster than anyone would like to admit. Employee benefits professionals need to tread the thin line to balance the benefits choices that best meet both the business objectives of their management and the needs of their employee population. And that is where the Employee Benefits vertical at India Insure is ready to guide employers to develop customized benefits plans that drive engagement, promote responsibility and accountability, help participants manage health risk and chronic conditions.

Group Health Insurance

The Risk

  • Quality medical costs are becoming increasingly expensive and could eat up our savings.
  • The cost of a simple surgery can easily touch Rs 1 lakh. Cancer treatment would cost lakhs. Even the upper middle class are forced to sell their valuable assets to meet the medical expenses.
  • Other expenses like travel, lodging, loss of income account for as much as 35% of the overall cost of treatment.

The Solution

  • Abhivridhi organizes Group Health Insurance schemes that provide health insurance coverage for employees/ members and their dependants for expenses related to hospitalization due to illness, disease or injury.
  • The standard health policy that reimburses you the actual hospitalization cost of treatment of any disease, offered by non life insurers / standalone health insurers are popularly called ‘Mediclaim’ policies.

The Cover

  • Expenses on Hospitalization for a minimum period of 24 hours are admissible.
  • Room and Boarding Expenses, Intensive Care Unit charges, Doctors fees, Nursing Fees, Surgical Fees, Operating Theatre,
  • Anesthesia and their administration, Drugs and Medicines consumed on the premises, Hospital
  • Miscellaneous Services (such as laboratory, x-ray, diagnostic tests), Dressing, ordinary splints and plaster casts shall be
  • reimbursed provided they are incurred in India within the policy period and up to the level of cover that the member is entitled to.
  • Dependants of Employees can also be covered.
  • There can also be a single Family Floater Limit rather than an individual limit per member.
  • Other benefits like pre-existing diseases, maternity cover, and baby cover from day one can be offered under a Group Scheme.

Group Personal Accident Insurance

The Risk

  • In today’s fast-changing world the chances of bodily injury due to accident has increased by leaps and bounds.
  • Bodily injury of the bread earner resulting in death or disablement may prove particularly distressing for the dependants and family members.

The Solution

  • To protect the dependants and the family members from such a scenario, protection under Group Personal Accident Policy is available.

The Cover

  • The policy kicks into action and pays compensation in case of death or bodily injury to the insured member of the group due to an accident.
  • Various options are available under this policy ranging from cover for death due to accident, permanent partial disablement to temporary total disablement etc.
  • The compensation varies for death, permanent disablement and temporary disablement. Though, it is difficult to put a value on human life, to avoid any misuse of the policy, the Sum Insured depends on the Income of the person/ member of the group.

Workmen’s Compensation Insurance

Employee Insurance India

Workmen’s Compensation provides cover to target clients as required by law in support to project insurances or property insurances.

Standard Cover

The policy provides cover for any insured employee who may sustain personal injury by accident or disease arising out of and in the course of his employment. The company will indemnify the insured against all sums for which the insured is held liable to pay to his employees under Workmen’s Compensation Act, 1923, the Fatal Accidents Act 1855 and at Common Law.

And also, the costs and expenses incurred with the consent of the company in defending any claim for such compensation.

Salient Features

  • Workmen’s Compensation Insurance provides for two forms of Insurance:
  • Table A: Indemnity against legal liability for accidents to employees under the Workmen’s Compensation Act, 1923, the Fatal Accidents Act 1855 and at Common Law
  • Table B: Indemnity against legal liability under the Fatal Accidents Act 1885 and at Common law
  • All the employees in the enterprise, as per the provisions of W.C. Act are to be insured
  • In case of public bodies where employees can be covered section wise or unit wise, or in the case of a risk where the employees are covered under ESI act 1948, Table B cover can be issued for employees not falling under the definition of Employee as per WC Act 1923 as amended
  • The policy is adjusted on the basis of the actual wages at the end of the policy period

Principal Exclusions

  • Any injury by accident or disease directly attributable to war invasion and like perils
  • Liability towards the contractor’s employees
  • Any liability attached due to an agreement, which would not have attached in the absence of that agreement
  • Any sum which the insured would have been entitled to recover from any party but for an agreement between the insured and party

Extra Covers on payment of Additional Premium

  • Contractors employees can be covered by charging additional premium:
  • Tariff rate on total contract amount, if the contract is for labour only
  • If the contract is for labour and materials, labour value shall be ascertained as per merits subject to a minimum of 75% of the contract amount.
  • Where the contract includes equipments also minimum percentage shall be 50% of the contract amount
  • Occasional domestic servants for house, garden or stable Charging can be covered at additional premium of 25% of the premium charged for permanent servants
  • Table A may be extended to cover costs of medical, surgical & hospital expenses incurred by the insured for an additional premium as specified in the tariff

Abhivridhi Advantage

  • Single Point Contact
  • Service Level Agreement
  • Periodic Review Meetings
  • Fortnightly distribution of cards to new members
  • Support in quick settlement of claims
  • Monthly premium Accounting Statement
  • Monthly Claim status MIS

Single Point Contact

Single Point Contact

Service Level Agreement

Service Level Agreement

Periodic Review Meetings

Periodic Review Meetings

Fortnightly distribution of cards to new members

Fortnightly distribution of cards to new members

Support in quick settlement of claims

Support in quick settlement of claims

Monthly premium Accounting Statement

Monthly premium Accounting Statement

Monthly Claim status MIS

Monthly Claim status MIS