Insurance Advisory Newsletter – Group Insurances Compared : GMC vis-a-vis GPA : May 2024
Group Insurances Compared: GMC vis-a-vis GPA
Group insurance pertains to an insurance plan that offers coverage to a group of individuals under the same policy. A standard coverage is provided to all the employees covered within the same policy which is called as the “Master Policy”. The employer is often the administrator of this policy, and employees are the beneficiaries who can avail benefit as long as they remain a part of the group.
Group Personal Accident (“GPA”) and Group Mediclaim (“GMC”) insurance policies are two popular group insurances which are purchased by employers and are important pillars of corporate insurance. These policies are designed to meet a variety of needs, strengthening employee well-being and organizational resilience through carefully considered risk assessment and tailored premiums.
GPA serves as a specialized and crucial form of a group insurance plan that is specifically curated to safeguard and protect the named employees and directors (Insured Person/s) against in the event of any bodily and physical injuries sustained during an accident (whether during or outside the scope of employment). To read more in detail about the inclusions and exclusions of GPA, please refer to our earlier newsletter here. A GMC is a comprehensive group insurance scheme specifically designed to cover and provide efficient health insurance benefits to a group of people, usually, employees of a company, organization or association that have been identified in the insurance policy. To read more in detail about the inclusions and exclusions of GMC, please refer to our earlier newsletter here.
Key differences between GMC and GPA
| Points of distinction | GMC (Group Mediclaim) | GPA (Group Personal Accident) |
| Applicability | GMC is an indemnity-based health insurance. This means that the Insurance company will pay out the cost of treatment which has been incurred by the employee, subject to the policy limits and terms and conditions. This gives the employees freedom to choose the services they need. | GPA is a Fixed-Benefit Health Insurance. In case of any accident, the insurance company will pay out a fixed amount to the employee which is pre-determined under the policy. |
| Expenses covered | It offers medical cover against maternity expenses, pre and post-hospitalization, Day-care expenses, medicines, diagnosis, treatments and more for a group of employees. | GPA on the other hand provides cover against accidents or accident-related complications such as accidental
disability – total or partial, accidental death, and more for a group of employees. |
| Covered persons | GMC policies cover the employees (primary beneficiaries) as well as their spouse and dependent children (only up to a certain age, depending upon the policy terms). | Under the GPA policy, only the insured employee is covered. Dependents of the employee and other family members are not covered. |
| Range of Cover | As compared to GPA, GMC policies have a wider range of coverage, as they offer a broad range of health insurance coverage. However, as a rider to a GMC policy a personal accident cover can be added. | GPA insurance has a narrower range of coverage because it only covers accidental-related eventualities. |
| Customization | Based on the number of employees, industry/domain of the employer, type of occupation, average age of the employees, etc. a wide range of customization is offered by the GMC policies. | As GPA has a fixed insurance plan there is no scope for any major customizations. |
