Yearning for the pitter-patter of tiny feet? You know you're entitled to maternity leave but what about maternity insurance? Chances are you may not get one since none of the general insurance companies in India offer such a cover because pregnancy is not considered to be an unexpected risk, which is what insurance normally covers.
However, maternity insurance benefit is available under group covers. So if you're a working woman, you could ask your employer to buy it for you.
Country head of head-hunting firm Watson Wyatt, Anita Belani told moneycontrol, "In the last six months, around 73% of the companies spread across pharmaceutical, information technology and manufacturing sectors have bought group covers with a maternity insurance benefit for their employees."
And sources at Cholamandalam General Insurance say that out of around 450 group policies they sold last year, 65%-70% were with maternity benefits. And the maximum demand for such covers comes from the IT sector.
Here's a look at what the cover offers
Maternity insurance under a group cover, takes care of all pregnancy-related hospitalization expenses, surgery, pre- and post-hospitalization for 60 days and complications arising therefrom.
Cholamandalam General Insurance also provides for pre-natal and post-natal expenses as a sub-head under maternity benefits. Let us say the maximum limit is Rs 50,000. Out of this, Rs 10,000 would take care of pre-natal and post-natal expenses. But then, not all general insurance companies cover pre-natal and post natal expenses. Such a benefit would be particularly helpful when the entire amount of Rs 50,000 is not exhausted, in which case, the above expenses can be factored in.
Exclusions
What maternity insurance will not cover, however, is your monthly check ups and termination of pregnancy for the first 12 weeks.
Also, there's a nine-month waiting period before you avail of maternity insurance as per the conditions of the cover.
Sources at New India say that maternity insurance covers hospitalization expenses to a maximum of Rs 50,000 only. Know that this will not cover the monthly expenses you incur, on visits to your doctor, during your pregnancy. Also note that the cost of medicines, tonics recommended to you every month will also have to be borne by you. What the cover will essentially take care of is your hospitalization anytime during your pregnancy.
Factors that influence the price of a group cover: The minimum sum assured should be at least Rs 1 lakh to avail of the benefits say New India officials.
So what is the minimum group size? Marketing head, ICICI Lombard General Insurance, Kartik Jain, says, "It's difficult to say since it all depends on a case to case basis and a number of other factors." Officials at New India say that the minimum size should be 100 employees. The premium for a group cover is decided on the basis of a number of factors, including the profile of the group, the group size, the age profile, the previous claim experience, the work profile among others.
Besides other factors such as previous claims experience, the number of days of medical leave taken in the past by the employees of a group, etc are also taken into account, before arriving at the premium amount.
Moreover , the location of your organization, the industry in which you are operating, the continuity of cover, the number of days medical leave taken in the past, among others are also considered.
This is because the claims experience varies among industries. In case of the manufacturing sector, the claims are lower compared to IT companies. In terms of costs also, location matters: medical costs in Mumbai are higher compared to other cities.
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