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April 02, 2017

Health Insurance Claim Process For Filing Claims Under Multiple Policies

Bajaj Allianz Health Insurance

A Health insurance policy gives you access to the best medical care and treatment while being financially protected. Health Insurance policies have multiple features such as medical insurance claims for pre and post hospitalization expenses, cashless treatment, room rent, ambulance charges, and much more.

In these changing times, medical costs have skyrocketed and hence people are opting for multiple health insurance policies. Another major reason is that a single policy is proving insufficient to cover all the family members.

While there are obvious benefits to having multiple health insurance policies, it also comes with the confusion of making multiple health insurance claims.

Here are some pointers that will help you when you are filing a health insurance claim under multiple health insurance policies:

  1. Always remember to inform all your insurers about all of your existing policies either at the time of buying a new health insurance policy or during the health insurance claim process. Forgetting to do so can result in the violation of the health insurance contract and may lead to claim rejection.
  2. A Policy holder reserves the right to claim the insurance amount from the insurer of his choice. But the insurers can opt for applying contribution clause if the claim amount is greater than the sum insured.
  3. For instance, consider a scenario where a person has 2 health insurance policies. Policy A with Rs.3 Lakh and policy B with Rs.4 Lakh as the sum insured. Suppose this person claims an amount of Rs.2 Lakh, he has the right to choose whether the claim has to be filed with Policy A or Policy B. 
    Suppose this person claims Rs.7 Lakh then the insurers can decide to settle the claim in equal proportion to the sum insured.
  4. In case there are two health insurance policies - group cover and individual cover, it is advisable that medical insurance claim should be made against group cover first as it usually has simplified clauses and the claim processing is generally faster. 
    Individual health insurance policies have a clause - NCB (No Claim Bonus). Hence it should be the last choice of the policy holder while filing a claim under multiple health insurance policies.
  5. Always remember to check the older policy first, as the waiting periods and pre-existing exclusions are likely to have been completed in the older policy.
  6. Always remember to submit the original bills and obtain the claim settlement summary from the first insurer before moving to the next insurer.

The Final words of wisdom

It is always advisable to go through the health insurance contracts and understand all the clauses before buying the policies and filing the health insurance claim. Consider the above factors as well when filing claims with multiple insurers.


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