Employee Wellness & Benefits
  Jan 14, 2025     6 MINS READ  

Difference between GPA and GMC Insurance Policy

S

Sourav Banik

Author

GPA insurance vs GMC Insurance

The terms GPA Insurance and GMC policy may often be used interchangeably, although they have certain differences. These insurance policies aim to provide insurance against accidents and diseases, although they differ considerably. The difference is still daunting, and one may not understand it initially. Employers buying insurance policies to safeguard their employees must be aware of these differences. This blog will explain the differences and also provide an inclusive guide on choosing the right insurance policy.

What is GPA Insurance?

GPA insurance full form stands for Group Personal Accident, an insurance policy meant to protect employees in case of an accident. Let’s get to the complete details here.

Definition of GPA policy

Let’s first get to know GPA insurance in full form. As the name implies, GPA refers to insurance that compensates for employee injury or critical damage from an accident. This type of insurance is used mainly in case of employee disability due to an accident. Let’s get to understand this with an example. Mr. Patel, a factory worker, gets GPA insurance purchased in his name by his employer. On a fine day, Mr. Patel suddenly falls victim to a fatal accident and loses his ability to work due to damage to his limbs. Becoming permanently disabled, Mr Patel discontinued regular working. His hospitalisation expenses, including his per day bed fee and scanning expenses are all covered by GPA policy.

Coverage provided against:

  • Permanent disability due to accident
  • Loss of income due to temporary disability
  • Accidental death
  • Hospital expenses such as scan expenses, per-day bed expenses, surgery cost
  • Disability causing loss of livelihood

Major perks offered:

  • Provides coverage for spouse, maternity benefit in case of total disability
  • Can offer coverage for children’s education in case of permanent disability
  • Improves the morale of employees by ensuring that they are financially covered against all physical hazards
  • Provides coverage to spouse or legal heir in case of death due to accident
  • Covers funeral expenses and post-death expenses
  • Offers daily allowance for hospitalisation Employers can create a healthy work culture and attract good talent to their workspace by offering GPA insurance, as it implies that the employer is concerned about the health of the employees. Moreover, employees after getting insured from major physical harm feel mental peace and can work more productively.

What is GMC Insurance?

Although GMC looks similar to GPA policy, the GMC scheme has variations from GPA in certain aspects. First, let’s know the GMC full form, and proceed to understand the basic coverage benefits the insurance provides along with other perks.

Definition of GMC policy

GMC's full form stands for Group Medical Coverage. This type of insurance policy offers coverage against diseases or any medical complexities, including coverage against pre-existing diseases. GMC is more popular than most other health insurance policies because of its large coverage, including pre and post-hospitalisation expenses, maternity benefits and even pre-existing illness. Also, GMC is the most economical coverage for a business to buy rather than insuring every single employee individually.

Coverage details:

GMC insurance includes all the coverage provided by GMA. In addition to that, GMC also provides coverage for a few things which GPA does not provide. Here is a list:

  • Coverage for medical emergencies
  • Coverage for diseases/disorders that restrict the employability
  • Teleconsultation expenses
  • Pre and post-hospitalisation expense
  • Coverage for room rent, per-day bed charges
  • Maternity expenses including normal and C-section childbirth expenses

Major perks offered:

  • Offers coverage for both diseases as well as medical expenses arising out of accidents
  • All expenses ranging from surgeon’s fees, operation theatre charge, ICU expenses and covered post-hospitalisation
  • Long-term or chronic diseases can be supported A GMC policy covers pre and post-hospitalisation expenses, and in addition to that, it also covers expenses related to maternity coverage and OPD (in case OPD expenses have been opted in by the insured and are provided by the insurer)

GPA vs GMC Insurance Policy

Major ParametersGMC PolicyGPA Policy
Full FormGMC full form in insurance stands for Group Medical CoverageGPA insurance full form stands for Group Personal Accident Cover
PurposeProviding support to employees in the event of medical conditions and diseases as well as accidents in the workplaceProviding support to employees suffering from accidents during work or outside the workspace
Coverage LimitA GMC insurance has a high limit of coverage, GPA is a part of GMCLimited coverage as compared to GMC
Can Be CustomizedYes, employers can completely customise the features and benefits (also depends on the insurance provider terms)No, cannot be easily customised
ExclusionsDoes not cover self-inflicted injuries, drug or alcohol abuse diseases, disorder from any voluntary damage done on purposeDoes not cover accident from any adventurous activity, participation in any illegal activity that may risk well-being or cases of attempted suicide
Target CustomersEmployees, can be from any sector or industryEmployees who are exposed to risky work environments or any such environment that may cause physical health injury as well as non-risky environments too

Choosing the Right Insurance Policy

Choosing the right policy for your employees can be a gruelling task. This is a short guide to get you started on choosing the right policy with maximum coverage.

  • Compare the policies - Before choosing the policy, always compare it with other insurance providers. Every insurance provider has different prices set and different benefits tied to a GMC or GPA scheme. By comparing, you will get to decide on the most beneficial policy.
  • Look for Claim Settlement Ratio - The Claim Settlement Ratio (CSR) essentially refers to the number of claims settled against the number of claims received. Choosing an insurance provider that has a high CSR is beneficial, as it implies that this insurance provider has settled a huge number of claims.
  • Choose a budget-friendly plan - Medical and accident insurance policies may have a higher premium, so choosing based on budget is a vital task. On choosing budget-friendly insurance which is affordable, the insured can easily pay the premium without worrying too much about the payment cap.
  • Check the coverage details - Checking the coverage details is the primary task to do, as it may not cover every possible disease or accident damage. Before buying, usually the insurance provider informs all the critical diseases and types of accidents that are covered, so be sure to read that.
  • Check for the waiting period - Different insurers have different waiting periods, so it is important to first check in with the actual waiting period of a particular insurance policy. While most critical diseases have a 30-to 90-day waiting period, many insurance policies that cover accidents do not have any waiting period. The waiting period is crucial to check on as during this period, your employees cannot claim the insurance benefits.
  • Know the co-payment clause - If your insurance provider has set a co-payment clause, then your employees have to pay a proportion of the entire premium from their pockets, while the remaining amount is paid by the business. Before buying a GMC insurance or GPA policy, inquire about the co-payment clause.

Conclusion

The coverage benefits of a GPA and GMC policy differ, which is why deciding on the insurance type is prudent. Both of these insurance policies have different purposes and wholly different sets of disease coverage, although they both offer coverage for accidents and diseases. Buying both a GMC and GPA policy is a wise decision, as these insurance policies cover expenses both from accidents and critical illness.

Frequently Asked Questions

Which business is eligible for GMC and GPA policy?

Any registered company business or startup is eligible for GMC or GPA policy, provided the company has a minimum of 7 employees.


Is it compulsory to insure employees in GMC or GPA?

There is no mandatory rule to insure employees in GMC or GPA, although it is preferred as it improves employee morale and increases workplace engagement.


Are part-time employees covered by GPA or GMC scheme?

Although IRDAI does not indicate any specific guidelines on this, part-time employees can be insured as per company policies if supported and according to the negotiation between the employer and the insurance provider.


Do you have more questions?

Contact us for any queries related to business insurance, coverages, plans and policies. Our insurance experts will assist you.

Reach out to us: [email protected]

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