Does a Group Health Insurance Policy Cover Congenital Diseases?

An important feature of Group Health Insurance Policy is coverage for Congenital Diseases. This article will explain the coverage for Congenital Diseases in a Group Health Insurance Policy for employees.

What are Congenital Diseases?

Diseases that exist since the time of birth are called Congenital diseases. A Congenital Disorder or a Congenital Disease is a birth defect caused by genetic or environmental factors.

There are 2 types of Congenital Diseases: Internal Congenital Diseases and External Congenital Diseases.

Internal Congenital Diseases

Congenital Anomalies which are not in the visible and accessible parts of the body are known as Internal Congenital Diseases. As per IRDAI, a Group Health Insurance Policy for employees usually covers Internal Congenital Diseases.

External Congenital Diseases

Congenital Anomalies which are in the visible and accessible parts of the body are known as External Congenital Diseases. If a person is suffering from an External Congenital Disease, it is usually not covered under a Group Health Insurance Plan. However, some Group Health Insurance Plans for employees can provide coverage for congenital diseases if the employer pays extra premium.

Some common congenital diseases are cleft lip and cleft palate, congenital heart disease, cerebral palsy, fragile X syndrome, Down syndrome, Spina Bifida, chromosome 22 abnormalities, first arch syndrome, clubfoot, gastroschisis and cystic fibrosis.

Does Group Health Insurance Cover Congenital Diseases?

Yes, a Group Health Insurance Policy covers Internal Congenital Diseases while External Congenital Diseases are not covered. Some Group Health Insurance Providers might need employers to pay extra premium to avail coverage for Congenital Diseases.

A Group Health Insurance Plan might provide coverage for diagnostic tests, Hospitalisation, Treatment etc for Congenital Diseases. Employers should read through the terms and conditions in detail to understand the extent of coverage provided for Congenital Diseases under a Group Health Insurance Policy.

What is the Waiting Period for Congenital Diseases under a Group Health Insurance Policy?

A Group Health Insurance Policy does not have any waiting period for coverage for Internal Congenital Diseases. Congenital Diseases can be covered from Day 1 under a Group Medical Insurance Policy. This is a big advantage of Group Health Insurance Policy over an Individual Health Insurance Policy as Individual Health Insurance Policies usually have a waiting period of 24 months for internal congenital diseases after the inception of the policy.

What is the treatment for Congenital Diseases?

The type and diagnosis of the Congenital Disease determines the course of treatment. Some congenital diseases require surgery while other can be cured by means of medications.

Which Group Health Insurance Companies in India covers Congenital Defects?

A Group Health Insurance Policy covers Congenital Diseases without any waiting period.

Some Group Health Insurance Companies which offer cover for Internal Congenital Diseases are as follows:

1. SBI General Group Health Insurance Policy
2. Tata AIG Group Health Insurance Policy
3. ICICI Lombard Group Health Insurance Policy
4. New India Assurance Group Health Insurance Policy
5. The Oriental Insurance Group Health Insurance Policy
6. Iffco Tokyo Group Health Insurance Policy
7. GoDigit Group Health Insurance Policy

Hence, it is a big benefit if your employer opts for congenital diseases cover a Group Health Insurance Policy for Employees as treatment costs for congenital diseases are substantial which can be saved by availing Congenital Disease Coverage under a Group Health Insurance Plan.

Get Best Group Health Insurance Quotes with Qian!

The best Group Health Insurance Policy in India offers comprehensive insurance coverage and benefits which motivate employees and boosts retention. Hence, a comprehensive Group Health Insurance for employees is a must-have and all employers should purchase a GMC Policy.

Qian is an experienced Group Health Insurance Broker with tie ups with top Group Health Insurance Providers in India and can assist you with the best Group Health Insurance Quotes. Our dedicated team can assist you in customising group health insurance coverage to meet all employer group health insurance requirements and also assists in quick claims settlement.

Additionally, we also specialise in Small Business Group Health Insurance for as few as 7 employees. So, if you wish to purchase a Group Health Insurance Policy for Employees, feel free to contact us at insurance@qian.co.in or 022-22044989 or fill this Contact Form.

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3. What is an Employee Group Health Insurance Policy?
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5. What is not covered under a Group Health Insurance Policy?
6. How is a Group Health Insurance Policy different than an Individual Health Insurance Plan?
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10. Should employers opt for a Pre-Existing Disease Coverage from Day 1 in Group Medical Insurance Policy for employees?
11. Does a Group Medical Insurance Policy provide Maternity Benefits?
12. What are Waiting Periods under a Group Health Insurance Policy?
13. What are the benefits of Group Health Insurance Policy for Employers?
14. What are the benefits of Group Health Insurance Policy for Employees?
15. Why should you purchase an Employee Group Health Insurance Policy for your organisation?
16. How many employees do you need to purchase a Group Health Insurance Policy?
17. Who is eligible for Group Health Insurance for Employees?
18. Are Employer Group Health Insurance premiums Tax-Deductible?
19. How much does a Group Health Insurance Policy Cost?
20. Which are the leading Group Health Insurance Companies in India?
21. How to purchase a Group Health Insurance Policy?
22. What are the Documents required to make a claim under a Corporate Health Insurance Policy?
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