Group policies offered by employers are slowly undergoing a transformation. Restrictions, such as those on room rent and sub-limits on claims, which were a part of individual Mediclaim policies so far, are slowly being incorporated in group insurance covers too. The employers are reducing benefits because the premium they have to pay has shot up by 30-100% due to rising claims. To cut down the premium, corporate are negotiating with insurance companies on lower coverage areas and ways to restrict claims.

Here are some ways that your MEDICLAIM policy may be tweaked.

• The number of hospitals in the insurer’s network has been reduced.

• The employee will have to pay partially (co-pay) in certain hospitals.

• The employee’s parents may not be provided coverage. In some cases, part of the claims for dependants will have to be borne by the employee.

• Sub-limits to be fixed for specific diseases.

• Cashless facility could be removed.

• Restrictions to be placed on room rent.

Industry sources said that scenarios for group health covers are going to be quite different from 2011 vis a vis 2008-2009. Now companies are eying on reducing premium cost by waiving off covers like room rent cap, cashless facility, co-pay. This means that from now on the employees will have to shell out money from their pockets for the same covers they used to get previously from the employers.