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GPA and GMC: Are these Two Health Policies Same?

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Navigating the world of insurance can be a perplexing endeavour, with numerous terminologies and policies to understand. Two commonly encountered insurance options are Group Medical Coverage (GMC) and Group Personal Accident (GPA) insurance policies. These medical insurance policies are designed to provide financial protection and peace of mind to individuals within a group setting, such as employees of a company or members of an organisation. But confusion looms large when colleagues discuss their insurance policies during lunch breaks, wondering which plan truly safeguards their health and financial well-being. Let’s try to unpack the mystery by understanding the differences in their scope of coverage and other terms and conditions.

What is GMC Insurance Policy?

GMC insurance full form is Group Medical Coverage. It is a customised healthcare plan that covers a group of people, such as employees belonging to the same organisation, and all the insured members get the same benefits. The employee’s spouse, children and dependent parents can also be covered. GMC can be customised according to the needs of the organisation. The premium of GMC is low and much lesser compared to individual health insurance as the risk is distributed among a large number of people. It depends on many factors such as the number of employees covered, age, occupation, and income of employees and add-on covers if bought.

Benefits and Coverage of GMC Insurance

• Hospitalisation expenses are covered, but one must be hospitalised for more than 24 hours

• Pre- and post-hospitalisation expenses, including consultation, lab tests, cost of medicines, and pre-medical screening tests

• Pre-existing diseases, such as blood pressure and diabetes, are covered from day one. There is no waiting period

• Day-care procedures for illnesses, as mentioned in the policy

• Domiciliary hospitalisation expenses

• Critical illnesses such as cancer and heart problems

• Maternity and Newborn coverage

• Cashless treatment facilities at network hospitals

What is GPA Insurance Policy?

GPA insurance full form is Group Personal Accident. It is personal accident insurance that provides financial protection to employees in case of accidental death, disability, or injury. There is no scope for customisation in GPA insurance as the policy has predefined features and benefits applicable to all insured employees. The premium is less because, like GMC, the risk is distributed among many people. GPA policy is also known as the 24-hour international accident policy because it provides coverage to employees not only during duty hours but also when they are not on duty or even when travelling outside the city or country.

Benefits and Coverage of GPA Insurance

• If the employee suffers total, partial, or permanent disability due to an accident, a predetermined amount will be provided.

• In case of accidental death, the family will be provided with death benefits.

• Ambulance charges will get covered.

• The cost of transportation of mortal remains will be covered.

• The cost of education of dependent children in case of an insured employee’s death will get covered.

GMC Vs GPA

Parameters	Group Medical Cover (GMC)	Group Personal Accident (GPA)
Scope of Coverage	Wide coverage as it covers hospitalisation expenses, cost of medicines, lab tests, consultations as well as medical emergencies	Covers only accident-related eventualities, such as injury, disablement, or death
Type of Coverage	Indemnity-based, which means the policy will reimburse the exact expenses incurred up to the sum insured	Benefit-based, which means, a lump sum amount will be provided depending on the type of injury
Who is Covered	Employees’ spouses, dependent parents and children can be covered	Only for employees
Customisation	Benefits can be customised based on the organisation’s needs	Cannot be customised
Ideal For	Ideal for any industry, irrespective of the nature of business	Ideal for industries where there is a high risk of accidents

Which policy to choose?

Both GPA and GMC have their pros and cons. Which policy to choose depends on the nature of the organisation and the insurance requirements of the employers and employees. The employer should take the final call by comparing the benefits and coverage of both policies and which one is ideal. For instance, GPA policy is a must, along with GMC, for high-risk industries, such as construction sites. Usually, most organisations buy GMC with a GPA add-on.

Conclusion

GMC and GPA are meant for the welfare of employees. Irrespective of which type of medical insurance is provided by your employer, it is wise to have a separate health insurance plan for comprehensive coverage. In group plans, the coverage is not as extensive, and you may have to shell out certain expenses from your pocket. So, it is important to buy the best health insurance based on your and your family’s medical needs and stay financially secure.

Disclaimer: The above information is for illustrative purpose only. For more details, please refer to policy wordings and prospectus before concluding the sales.

RELATED ARTICLES

• Here’s Why Employees are Not Using Group Medical Cover

• How Employees Can Port from Employer’s Group Health Insurance to Individual Health Cover

• Be double insured with a corporate and individual Health Insurance

• Group Health Insurance Plan or Regular Health Insurance Plan - How to choose one?

• All Things to Know about Group Health Insurance

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