The Jammu & Kashmir government group medical insurance scheme, which is managed by ICICI Lombard, has witnessed a 35% growth since its inception in 2014. The number of employees enrolled under the scheme went up from 18,102 employees in 2014 to 24,356 in January 2017. The company had settled over 6000 claims during this period. The health insurance scheme has significantly increased the penetration of health insurance among the state employees.
The health insurance policy covers medical expenses up to ₹5 lakh for employees and their families including parents, children, spouse, and in-laws. In 2016, parents and in-laws accounted for 44% of the total claims settled and were the biggest beneficiaries of the scheme, followed by spouses with 29% of claims. In terms of age, 40% of claims were settled in the age group of 56-75 years followed by 32% in the 36-55 year age group.
Since the inception of the scheme, employees from different state and autonomous bodies including the Shrine Board, Sher-e-Kashmir University, and Shri Mata Vaishno Devi University have been enrolled in the scheme. The scheme offers several key benefits including treatment of all medical or surgical care requiring minimum 24 hours hospitalisation, coverage up to ₹5 lakh on a family floater basis, day care procedures, and cashless treatment within or outside Jammu & Kashmir.
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