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April 16, 2019

Multiple Health Insurance Policies? Here's How To Make A Claim

Bajaj Allianz Health Insurance

Holding a health insurance policy is very important but not everyone has one. However, it is surprising that many people hold multiple policies, which means they buy health insurance from a number of insurers.

Some do it for a wider coverage, while some do it to have a diverse set of benefits offered by each insurer. Experts have the opinion that holding two similar policies will not extend your coverage drastically or provide enough benefits for the extra premium you would have to pay. Hence, you must be very careful in buying medical insurance online.

One very important point to note is that while taking up a second health policy with a new provider, you must inform the insurer about your existing policy. This is a very critical part of underwriting.

Holding multiple policies

In case you hold multiple insurance policies, the claim can be settled by any of the insurance providers in the event of hospitalisation. You do not have to approach all the insurance providers to settle the claim. Instead, you can choose to go to anyone you prefer.

Earlier, there was a 'Contribution Clause' for health insurance, which has been eradicated. According to this clause, the total hospital expenses had to be shared by the insurers in proportion to the sum insured by them. However, this is not the case anymore.

Today, you can choose any general insurance provider to settle your claim irrespective of the number of policies you hold.

Exhaustion of the sum

Medical bills are skyrocketing day by day. In case your hospital bill exceeds the sum insured, you may choose to claim the balance amount from another insurance provider.

The Insurance Regulatory and Development Authority of India (IRDAI) has stated that you have the option of selecting another insurance provider if the sum assured amount has been exhausted from one insurance provider. The decision to claim the balance amount from another insurer must be made after considering the deductibles or co-payment.

Choosing the right policy

As a holder of multiple policies, you have the right to claim the medical bill amount from any insurance provider. However, the important question is, what are the criteria for choosing the insurance provider? This is a pertinent question considering the clause of waiting periods in between the two policies.

For those who have a group insurance policy, the choice is relatively simpler. If you have a group insurance policy along with an individual health insurance policy, it is best to make claim under the group insurance policy as the features like CB and health check-up are absent in group policies. Another point to consider is that the scope of coverage in case of multiple policies is much wider than retail policies, especially that related to the waiting periods. You can also check which insurer provides cashless health insurance because, in times of emergency, this is a crucial distinguishing factor.

How to make a claim in cases of multiple insurance policies

It is very important to preserve the original bills of the hospital, as well as, the discharge summary. In case the hospital bill is more and you need to make claims from multiple insurance providers, you need to be very particular about the documentation. Additionally, you must submit the self-attested copies of the documents along with original settlement letter from the first insurer whom you had approached.


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