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What is medical Extension in GPA policy?

QuestionsCategory: Group Health InsuranceWhat is medical Extension in GPA policy?
default avatarPlan Cover Staff asked 2 years ago
1 Answers

Best Answer

default avatarSrinivasan Mahadevan answered 2 years ago
The purpose of Group Personal Accident insurance is to pay fixed compensation for death or disablement resulting from accidental bodily injury. The personal accident insurance policy provides that, if at any time during the policy, the insured person shall sustain any injury resulting solely and directly caused by an accident then this insurance policy shall pay the sum if resulting in specified contingencies such as death, permanent disablement etc.
The GPA policy also cover for accidental medical expenses. Some policies pay for only hospitalisation, few plans pay only if there is a claim under the GPA policy and some plans pay for both hospitalisation and Out-Patient treatments. 

  1. Most companies provide medical expenses as a % of capital sum insured or a % of admissible claim under the policy. The claims admissible in the policy include either accidental death, permanent total disability, partial disability or a weekly compensation ( also called temporary total disability). Only if any of these claims are paid under the policy, the medical expenses will be paid. 
  2. Another option for payment of medical expenses in a GPA policy is to pay for inpatient expenses up to a certain % of capital sum insured. It ranges typically from 10% to 25% of capital sum insured. 
  3. There are plans available which can pay for both hospitalisation (in patient) and OPD expenses. The OPD expenses will be restricted to an amount not exceeding INR 25,000/- per accident. 

In all of the above options, the maximum payable will not exceed the actual expenses incurred by the insured person. 
PlanCover has structured hundreds of personal accident insurances for clients. Some of the plans have a high customisation on medical expenses cover suiting to the requirement of the client. You can reach out to them for your own GPA policy