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How to use Multiple Medical Insurances for a Single Claim
Dec 29, 2022

Have Multiple Medical Insurance Plans? Here’s How to Use Them for A Single Claim

With the rising medical inflation and the increasing costs of hospitalization, the need for a supportive health insurance plan cannot be underestimated. Financial assistance from a health insurance policy can ensure that you receive high-quality treatment without having to pay the high costs involved. * However, in some cases, a single medical insurance policy may not be sufficient. There may be a chronically ill patient within the family, or the sum insured provided by one insurer may not be adequate for the multiple members of a joint family. In such a case, many people often buy dual or multiple health insurance plans for their family. When you have multiple policies, the process to raise a claim can be quite different and a bit more complex than for a single policy. We provide an overview of the same in this article.

Raising a single claim on multiple health insurance policies 

Two scenarios can occur when you have multiple health insurance policies:

1. The claim amount is higher than the sum insured of a single policy you hold 

Sometimes, the costs of hospitalization and medical treatment can be quite high, exceeding the sum insured by either of your policies. In such a scenario, you would have to raise claims on both your policies and each would have to contribute with the right balance. * Ideally, you would have a primary policy and a secondary one. You can first raise a claim on the primary policy and claim a high amount. The balance amount would have to be claimed from the secondary policy. For instance, the claim amount is ₹5 lakhs, and your primary health insurance policy has a sum insured of ₹4 lakhs, while the other policy has ₹3 lakhs. Thus, you can claim ₹3 lakhs from one policy and ₹2 lakhs from the other one. *

2. The claim amount is lower than the sum insured

In this scenario, you can raise a claim on either of the health insurance plans you hold for your family since the sum insured would be lower than the amount you wish to claim. There would be no need for a contribution clause in such a situation.

What to keep in mind when buying multiple health insurance policies?

1. When you are buying more than one plan, you must inform the insurer about the previous policies that you have purchased. If you do not intimate the insurer about the same, it can be considered a violation of the terms. A claim can also be rejected if the insurance company finds out about the other policy during the claim process. * 2. To keep the premium of multiple policies stable and balanced, you can use a health insurance premium calculator. This calculator provides an estimate of the premium based on the information you provide, such as your age, gender, smoking habits, policy tenure, sum insured, and so on. 3. Regardless of the number of policies you are buying, you must ensure that each policy and insurance company meets the following parameters:
  1. Wide range of coverage and add-ons
  2. A high claim settlement ratio
  3. A supportive customer service feature
  4. 24X7 claim assistance service
  5. A large number of network hospitals

Should you buy multiple health insurance plans?

Paying premiums for two or more health insurance policies is not an easy matter. Hence, one must decide to buy multiple policies after going through adequate research. The most obvious reason to buy another policy when you already have one is if you are not getting enough sum insured under one policy. There are many reasons for this to occur. For instance, the underwriting principles of the insurer may not allow for a high sum insured if you are buying health insurance at an older age. You may also consider buying another health insurance plan if you are not getting sufficient coverage under one plan. Your family may be covered under one plan, but the diseases/medical events you want coverage for are available under an individual plan from another insurer. It may be a prudent decision to opt for the latter policy in such a situation. Reaching out to a financial expert can also be a great help. *   *Standard T&C Apply Insurance is the subject matter of solicitation. For more details on benefits, exclusions, limitations, terms, and conditions, please read the sales brochure/policy wording carefully before concluding a sale.  

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