Recovery Benefit in Group Health Insurance

Many businesses and organisations provide group health insurance coverage to their employees. This policy covers the cost of healthcare for the employees. Depending on your chosen group health insurance plan, its features can vary in different ways. 

Hospitalisation coverage, policy coverage, and other benefits can differ depending on the premium rate and type of insurance policy selected. You must review all the benefits in detail before purchasing a group health insurance plan. 

One such benefit that you must be aware of before purchasing group health insurance is the recovery benefit. To learn more about this, continue to learn about them in detail.

 What is Recovery Benefit in Group Health Insurance Policy?

Recovery or convalescence benefit in group medical insurance is the total amount that the insurance provider pays the insured during recovery. Medical emergencies can be stressful for any individual, which is why insurance providers offer customer-oriented or need-based features like recovery benefits, ensuring enhanced financial support during the period of medical distress. 

The insurance provider pays an extra amount to the insured when they are recovering from an injury or disease. Additionally, the insurer will pay you the recovery amount even if the insured has completely or partially exhausted the insured sum for medical treatment.  

 How Does Recovery Benefit Work for the Insured?

If the insured is hospitalised beyond the pre-decided period, the insurance provider offers a certain amount according to the policy features. This recovery benefit is included in the terms and conditions of the group health insurance. 

The total amount that the policyholder receives may differ depending on the specific attributes and terms of the group health policy. This coverage is also known as resting period coverage because the insured receives it while recovering from an ailment or treatment.

Integrating recovery benefits with group health insurance creates an all-inclusive solution for the employee. This benefit helps employees receive financial compensation for their medical treatments and a lump sum amount to cover the loss of income incurred during their absence from work.

 Understanding Convalescence Benefit With an Example

Let’s take an example to understand the workings of convalescence benefits in a better way. 

Suppose an employee, Karan, gets hospitalised for a prolonged period because of an accident. As a result of this situation, Karan is not able to work while recovering, which results in a loss of income. To compensate for the lost income, Karan receives a lump sum amount as a convalescence benefit. 

Karan received this benefit because his employer opted for it under the group health insurance policy. The period (after which this benefit is applicable) and the total amount can differ depending on the insurer; its details are mentioned in the group health insurance policy document. 

 When to Claim Convalescence Benefit in Health Insurance?

Your policy must mention the benefit of convalescence as an inclusion in the group health insurance policy document. If this benefit is a part of exclusions or is not mentioned in the policy document, then you may not be able to raise a claim against it. 

However, you can purchase this benefit as an add-on (if permitted by the employer). To claim convalescence benefit, your insurance policy should include this coverage and you should meet the terms and conditions. The policy documents mention the days after which you can claim convalescence benefits.

Note that this period differs depending on the insurance provider.  For instance, if your benefit starts after seven days of hospitalisation, you cannot claim a convalescence benefit just after four days. 

The amount you receive under the convalescence benefit is predetermined. You can check the details of the amount in your group health care plan policy document or contact the insurance company’s customer care team. 

 Important Points to Note About Recovery Benefits in Group Healthcare Plans

Below are some essential points you should know about this benefit. 

• Convalescence benefits can be a part of group health insurance policies as well as individual health insurance policies. 
• The total amount you receive in recovery benefits can vary depending on the terms of the group health insurance policy.
• To be eligible for the recovery benefit, the policyholder must be hospitalised during recovery. 
• If the recovery benefit does not come under your group medical insurance plan, you can add on this benefit by paying a little extra premium. 
• Typically, the period after which you can claim this benefit is seven to ten days of hospitalisation.   

 To Wrap It Up

Not all group health insurance plans include fitting features like recovery benefits. Research and seek expert advice to find group health care plans that include such benefits, ensuring the best coverage. Ensure that your chosen insurance provider is credible and has a good market reputation. 

Additionally, make sure that the insurance provider offers excellent support and that all your insurance-related queries are promptly and effectively handled.