GET HEALTH COVERAGE FOR YOUR EMPLOYEES
Employees can avail coverage for medical & hospitalization expenses and extensions to home country treatments.
HEALTH COVERAGE FOR SME & LARGE CORPORATES
Protection against unforeseen medical expenses for your employees.
Group health insurance is not just beneficial for employees, but also for the employer as healthier employees make a more productive workforce.
Mandated by Law in Abu Dhabi (DOH) & Dubai (DHA)
Valid health insurance is mandatory in Abu Dhabi and Dubai for an uncomplicated and penalty-free visa issuance process.
Employees can present their medical insurance cards to avail of medical services instead of paying cash for treatments.
COVERAGE OF ADDITIONAL BENEFITS
Employees can avail coverage for alternative treatments, routine check-up & wellness programs, and dental & optical cover.
Enjoy Value-Added Services
Your employees can avail value-added services like virtual consultations with doctors, medicine delivery at your doorsteps, gate-keeping facilities, basic health checkups, doctor visits at your premises. Also, get access to wellness programs like health talks & various exclusive offers arranged through our network of medical providers partners.
Features and Benefits
Coverage against unforeseen medical expenses
An unforeseen illness can overwhelm one with mental anguish and stress. Having a health insurance policy that covers your medical expense will ease the process and support your healing.
Coverage of Pre- hospitalization & Post-hospitalization Expenses*
The medical costs incurred prior to getting admitted to the hospital and post the treatment are covered in our Group Health Insurance plans.
Coverage of inpatient and outpatient treatment
The need for inpatient and outpatient treatment will depend on the severity or type of ailments. Get Group Health Insurance coverage for your employees including coverage for both.
Covid-19 Coverage *
Amidst this pandemic, a cover for Covid-19 is crucial for everyone, hence, we have this covered in our Group Health Insurance plans.
*Depends on conditions laid down by Health Authorities of specific Emirate. Coverage will be subject to the severity of the disease and subsequent hospitalizations.
Emergency Medical cover
The Emergency Medical benefit covers your employees’ treatment for an unexpected illness or injury or any life-threatening conditions by offering extensive coverage and acting as a financial cushion in case of medical emergencies.
Access to the Major Medical Providers/Hospitals for Direct Billing*
Certain health conditions might require treatment from specialists. Under our Group Health Insurance plan, members have access to an extensive network of medical service providers/hospitals to choose from.
Safeguard financial security
In the absence of a Group Health Insurance policy, employees would be forced to dip into their life savings during medical emergencies. Hence, Group Health Insurance plays an important role in safeguarding the financial security of your employees.
Vaccination Cover for the Kids*
Our Group Health Insurance plan covers the cost of immunizations and preventive care services for the children of policyholders.
*Applicable for selected vaccines.
Annual Health Checkups*
Members of a Group Health Insurance plan can avail themselves to health checkups, including routine screening tests to ensure good health and timely identification of underlying diseases/ailments.
*T & C apply
Pre-Existing and Chronic Conditions Coverage
Pre-existing & chronic conditions can be covered, subject to terms and conditions of the Group Health Insurance plan.
Additional Benefits Coverage
We offer dental, optical, and alternative medicine coverage as a part of Group Health Insurance.
As per the UAE regulations, maternity benefits are included in the Group Health Insurance policy.
Hear what our customers have to say about us
Greetings! This is actually a great platform to appreciate the staffs who really deserve. Mr. Irfan Pasha, Ms. Nimmy and Ms. Anupama Rao - The best insurance staffs I have ever dealt with. Loads of Thanks for their working experiences, valuable knowledge the professional customer service techniques, best efforts to solve the issues, smoother and quicker to ensure customer satisfactions. The service from Gargash Insurance has continually been amazing!- Deepika Devajana
We had a challenge getting our medicines through insurance as we were flying on an emergency. However thanks to some excellent support from staff at Gargash Insurance, especially Linta. we got our approvals and our medicines on time. Keep up the good work.- Chris Abraham
Dealt numerous times with Ms. Tina Auditor Guinto, she was prompt in replying, resolving the issue. Her follow-up of the matter was meticulous coupled with excellent PR skills.- Govind Nayak
One of the best Professional, friendly and Customer oriented teams who are ready to serve us with all kind of insurance plans within our budget. Thanks!!!Special thanks to Ms. Reshma Ajith for her quick and prompt assistance.- Sahu ns
A highly professional and trustworthy insurance service. I have to specially mention Dr.Krishna Sethu who helped me with my health insurance. She is not only professional but is very knowledgeable and ethical too. I would like to thank her and the Gargash Insurance company for their services.- parvathyhari 1992
Kayezel is very responsive and fulfilled assistance of helping me on the clinic that is so much convenient for me. She is a person I will look for my future requests as she is a way over helpful to me keep up the good work.- Nitheesh Gopalakrishnan
I have been interacting with M/s. TINA AUDITOR GUINTO since 4 years for insurance claims and i am extremely happy by the way i have been given response in setting the claims at the shortest time and clarifying the queries and timely arranging of necessary approvals from the insurer. I appreciate her sincere efforts and wish her all the very best in her work. Asif Ahmed Sr. QHSE Engineer Ocean Rubber Factory LLC-SHJ.- Quality System & Training
We have enjoyed continuous relationship with Gargash Insurance Brokers LLC. for our insurance requirements. They are very professional, go out of the way to serve our needs, are available on call beyond working hours or work days. I personally wish to thank Anupama Rao for her extended support and excellent service. Recommend this Company for your related requirements. Kind regards,- Dipti Lilani
Gargash Insurance is the most professional and customer oriented company, I have been dealing with Mr. Irfan Pasha for my family medical insurance, most responsive service always.- nidheesh nidheesh
Hello, David here, Actually, I made my first impression on her from the first sight. I was facing a trouble with some credential and arrangements but when I called Linta Merlin. She told me it's a quite easy and it's going to get just a few minutes to resolved. I really got surprised when she came back with the solution of the issue I face. I want to say thank you so much you are an asset to your organization.- David Mackman
If you are looking for professional brokers who can fulfill your insurance related requirements then Gargash Insurance service is your best bet. They are good at collecting accurate information & presenting best rates from market. You can easily leave all that hassle to them and their professional team will take care of the rest for you. They will stay in touch with you and take you through the process so that you can make the best informed decision.- uniCare Medical Centre HR Dept
Why Choose Us?
Gargash Insurance, an integral part of the Gargash Group of Companies, has been delivering excellence in insurance broking and risk management services in the UAE since 1994. A team of over 300 qualified insurance professionals, an expansive network of local and international insurers, our extensive knowledge of the insurance industry and the regulatory framework has enabled us to consistently deliver excellence to our diverse range of clientele.
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What you need to know about Group Health Insurance Policies
- Mandatory requirement - As part of their efforts to create an integrated healthcare system in the UAE, the health authorities (DHA & HAAD) have mandated all companies to have a valid insurance policy that covers their employees’ medical expenses.
- For visa stamping purposes - In HAAD & DHA, all employers and individual sponsors insuring their employees, domestic help or dependents must provide medical insurance. Failure to do so will result in complications with visa issuance and will be penalized for the same. The law ensures that only those with a valid insurance card can proceed with visa stamping.
- To cover the medical expenses – Group health insurance provided by employers helps pay for employees’ health treatments. It can help cover services ranging from routine doctor visits to major medical costs and covers many preventive services to keep you healthy.
- Pre-existing medical conditions are illnesses or injuries that exist before you take out a health insurance policy, they include chronic diseases, such as hypertension, respiratory diseases, and diabetes as well as any diseases that you may be receiving treatment for, such as cancer. Mental health conditions such as depression and anxiety may also fall under pre-existing conditions
- Large corporates do not require any declarations. However, most of the SME plans require declarations. Also, a declaration would be required for aged members in the group.
- For the policies with declarations, premiums will vary based on the conditions declared.
Kindly note, the coverage of the medical insurance is subject to the table of benefits under the policy, where the coverage is well defined with the limits and sub-limits.
Some of the coverages under the medical insurance are as below, which again depends on the benefits the group chooses.
- Maternity cover - Maternity coverage includes the prenatal, postnatal and delivery expenses as per the agreed policy terms.
- Emergency cover - The Emergency Medical Benefit covers treatment for an unexpected illness or injury or any life-threatening conditions which offer extensive coverage and acts as a financial pillow in case of medical emergencies.
- Vaccination cover for the kids – It covers the cost of immunizations and preventive care services as per the health plan.
- Diagnostic test & treatments – The medical policies will cover the medically indicated tests, diagnoses, treatments, and surgeries in hospitals for non-urgent medical cases.
- Outpatient services – Any services as an outpatient, such as consultation, lab/radiology tests, pharmaceutical/medicine, etc., will be covered.
- Inpatient services – Any treatment which required more than 12 hours of admission is referred as inpatient services and the same will be covered as per the terms agreed.
- Day case – Any day case admission for any small procedures will also be covered under the medical insurance.
All medical insurance plans have a standard set of exclusions and any services mentioned under the same will not be covered.
Some of the excluded services are as below.
- Any treatment which is not medically indicated will not be covered.
- Treatments related to cosmetics will not be covered.
- Treatments related to obesity will not be covered.
- Any hazardous sports activity, suicide, etc., will not be covered.
- External prosthetic devices and medical equipment.
- Patient treatment supplies (including for example: elastic stockings, ace bandages, gauze, syringes, diabetic test strips, and similar products; non-prescription drugs and treatments,) excluding supplies required as a result of Healthcare Services rendered during a Medical Emergency.
- Pre-existing conditions
- Age Factor - Overage members
- Marital Status (E.g., Married Females)
- Loss Ratio
- Type of coverage (Network/Benefits, etc.)
- The deductible is applied based on the policy terms and conditions.
- For groups, you have the options to choose from such as 20% with a CAP.
- The amount is being borne by the member/insured and paid from their own pocket when going for the outpatient check-ups and/or diagnostic, whenever applied as per the terms and conditions of the policy.
Yes, the PEC conditions are covered as per the policy terms and conditions and also based of the declaration, if required for the group policy.
- These days, most of the policies are cardless policies, that can be activated on the Emirates ID and medical insurance policy is linked through the member’s Emirates ID.
- Emirates iD is a mandatory requirement for all medical providers.
- Members can use insurer’s or TPA Mobile Application.
- Members can use E-Cards.
- The coverage is subject to the updating of the marital status as ‘Married’ in the insurance system with a valid marriage certificate.
- For Abu Dhabi & Dubai Visa holders, it is a mandatory cover (DOH & DHA). So yes, it is covered.
- For the Northern Emirates, some plans may not have maternity cover.
- Any undeclared maternity cases will not be covered, for the group policies with declaration.
- For Daman AUH Basic, if the member was added as single and is newly married (after policy inception), maternity benefit can be requested to Daman during midterm amendment to add/update in the policy of the member. However, if the marriage date mentioned in the certificate is prior to the policy inception date, maternity correction can only be done during the renewal period and must be informed accordingly.
- Optical & dental is an additional benefit covered if chosen by the group (additional premium applies), and wil be covered as per the agreed terms.
- Dental and Optical covers always have certain services with a specific limit.
- There are no restrictions on the number of claims during the policy period, however, the maximum coverage will depend on the annual limit and sub-limits.
- At the same time, certain services will have limited sessions like physiotherapy, alternative benefit, etc., which will be as per the agreed benefits.
- The coverage outside the network is subject to the availability of the reimbursement benefit under the group policies.
- In case of any life-threatening emergencies, the member can access a non-network provider with a case notification to the insurer within 24 hours from the time of the incident
- There will not be any reimbursement for elective treatment for the basic policies, without reimbursement benefits.
- Yes, we can categorize the employees in different categories based on the designations or salary bands.
Yes, this can be done based on the proof provided of the association.
Yes, the policies can be customized as per the company requirements. However, the pre- underwritten plans modifications will be limited.
In order to obtain group health insurance in UAE, the business/ company must be registered and approved legally by the regulations and guidelines of UAE (with a valid trade license). An organization also needs to have a minimum number of employees for a Group Health Insurance policy.
The minimum number of employees required to get a group of medical insurance varies from insurance provider to provider.
Medical Claim Reimbursement Checklist:
- Duly filled out claim form of the concerned insurance company / TPA, signed and stamped by the treating doctor with beneficiary signature
- All official itemized invoices with the service details
- Payment proof such as official receipts, paid stamp, card payment slips, etc.
- Prescription from the treating doctor for all the medications availed and for optical items.
- All the diagnostic reports including but not limited to Laboratory and Radiology reports
- Referral letter from specialist consultant and progress reports (after every 5 sessions) for claims related to physiotherapy treatment/ chiropractic treatment
- Discharge summary with the operative notes (for surgical treatment) for all the inpatient, daycare, emergency admissions
- Medical Report with injury details (when, where and how) for claims related to any kind of injuries
- Medical Insurance card copy
- Bank Details (if applicable)
- Copy of passport showing exit and entry stamp for the treatments done outside the UAE
- A police report in case of an accident (if covered under the medical policy)
- The insurance company has the right to request further documents not mentioned above such as detailed medical report, etiology, medical justification, etc. if required to further process the claim
- Pre-approval / intimation is required for In-Patient and Daycare treatments outside network and outside UAE including high cost (invasive) Out-patient procedures
- All Emergency cases must be notified within 24 hours from the admission date per DHA exclusion # 21
- Claim documents must be in English or Arabic language only
- All the documents must be submitted with the cut off period per policy terms and conditions