Can We Use Multiple Health Policies for a Single Claim?


You Can Use Multiple Health Policies for a Single Claim

Wondering, Can we use multiple health policies for a single claim? The gruesome COVID-19 pandemic has forced people to know the importance of medical insurance which was underrated by many till years back. Many individuals required hospitalization or emergency treatment when the pandemic was at its peak. Even after 2 years, we reside with COVID-19 and based on the experts; the country is once more facing the fourth wave of the deadly pandemic. Individuals who have comorbidities may have longer hospitalization to combat COVID-19 or some other diseases. At the tip of the day, it is advisable to pay a humongous hospital bill in your/your relations’ treatment.

But when you might have multiple medical insurance policies, then it’s possible you’ll stay relaxed to some extent under medical contingencies. A medical claim policy will cover your hospital expenses without compromising the treatment. If you might have multiple medical insurance policies, they are going to not only enhance your coverage but additionally show you how to to avoid wasting a piece of cash by utilizing several advantages. As a policyholder, you might be free to make use of various policies, including group medical insurance policies out of your employer, a person medical insurance policy and your first top-up health policy to assert a single hospitalization bill.

But certain terms and conditions you need to follow before making a claim of policy.

To deal with the rising healthcare inflation and medical costs, a policyholder can buy various medical insurance policies from different insurance firms within the country. This may be very much applicable when the policyholder needs a better sum insured amount which may’t be fulfilled by a single medical insurance policy.

While purchasing two indemnity policies, a policyholder can select the most effective cashless mediclaim policy under which he/she desires to initiate the claim first. In case your claim amount is way above the sum insured under the policy on which you initiated the primary claim, then you definitely can claim the remaining amount from the second policy.

While purchasing a medical insurance policy, every policyholder must fill out proposal forms where the insurance firms ask for disclosure of any existing policy. Should you purchase two different policies from different insurance providers, then you need to intimate each firms regarding your medical insurance policies. Else the insurance company has every right to reject your claims as non-disclosure of policies because of the violation of the insurance contract.

Medical insurance firms often need this information as most policies follow a contribution clause. In keeping with the clause, if an insured person holds multiple policy, then all his/her medical insurance policies will contribute in equal proportion to the sum insured to settle a claim.

To make the policy purchase process facile and utilize the advantages of multiple medical insurance policies, the Insurance Regulatory and Development Authority of India (IRDA) has refurbished the principles and regulations. Before 2013, the IRDA mentioned that the entire healthcare expenditures needed to be shared by the insurance providers based on the sum assured by them. This known as the ‘Contribution Clause’ in the sector of medical insurance. But this clause is eliminated and now, a policyholder can go to any one in every of the insurance firms to settle the claim.

Can We Claim Health Insurance from Two Corporations?

Should you hold an employer medical insurance and one personal medical insurance policy, then it’s possible you’ll think “can we claim insurance from two firms?” You will definitely claim from multiple insurers. You could initiate a claim from the primary medical insurance provider towards all of your healthcare expenses. Now, collect the summary of the claim settlement, attach the hospital bills and go to the second insurer to settle the remaining expenses.

Claim Settlement Process From Two or More Policies

In case your initiated claim amount is lower than the sum assured, then it’s possible you’ll raise the claim under a single policy. But when hospital expenses surpass the sum assured of a single policy, then you definitely can raise the claim within the below-mentioned ways.

Cashless Claims

Under the variety of claim policy, it’s possible you’ll get cashless treatment facilities if you happen to are admitted to an empaneled hospital. You’ll be able to initiate the claim with one insurance provider and get the claim settlement summary. After receiving all these, now submit the claim settlement summary and attested hospital bills to the second insurance company. Approach the second company to settle your claims in the shape of reimbursement.

Reimbursement Claims

Under some medical emergencies, it’s possible you’ll have to admit to a hospital which just isn’t included within the network of your insurance provider. Under this scenario, it is advisable to go for the reimbursement method to settle your claim. First, it is advisable to pay the bill out of your side after which get a reimbursement form out of your insurer. Together with the claim form, it is advisable to submit all imperative documents including the varied test reports, bills for medication, the  discharge summary etc. After reviewing your claims and documents, the insurer will settle the claim amount.

Things to Keep in Mind Before Going for Two Health Insurance Policies

  • Check the co-payment clause and deductibles before choosing medical insurance policies. Under the co-payment clause, the policyholder must pay a certain percentage of the claim. For deductibles, your insurance company can pay the remaining amount after deducting a hard and fast amount.
  • Check the older policy first, as your waiting period and pre-existing exclusions is likely to be accomplished before utilizing it.
  • If you might have a person policy and an employer’s health policy, utilize the employer’s policy first. Since the claim settlement process is quicker and faster for group policies.
  •  Should you hold two policies with cashless facilities, the hospital will give you this feature just for one policy and ask you to pay the remaining amount and get it repaid from one other insurer.
  • Select cashless policies first as you don’t have to pay anything out of your side after which, utilize the second policy to reimburse the extra amount.

Though there is no such thing as a restriction regarding purchasing the variety of medical insurance policies, the experts suggest buying two medical insurance policies that provide adequate sum insured amounts (one base policy and a top-up). This will likely show you how to to keep away from unnecessary confusion on the time of the claim settlement process.


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