Claim Settlement Process of Multiple Family Floater Health Insurance Policies

2 min read

We humans always find pleasure in quantities, our mantra being ‘more the merrier’. Who is satisfied with only one of anything? Even in case of health insurance plans we tend to hold more than one policy to ensure a comprehensive coverage. With the medical costs touching the roof, holding multiple plans is even recommended by experts. So, yes, when you talk about a family floater health plan too, you can have more than one insurance plan in place to cover your family’s health insurance needs.

Multiple floater plans are beneficial because there is a lower chance of exhausting your Sum Assured if there is another policy at your disposal. Given the rising healthcare costs and level of under-insurance in health covers, it would be advisable to go for additional protection plan.

So far so good, but what about making a claim? This might seem the trickiest part. However, the claim settlement process of multiple policies is actually very simple. Here’s how it works:

  • You have the freedom to choose any insurer to get your claim settled if the claim amount is well within the chosen Sum Assured limits. For instance, if you have two policies of Rs.2 lakhs and Rs.3 lakhs each and the claim amounts to Rs.1.5 lakhs, either of the insurers can be approached to get the claim settled.
  • If the claim, instead, amounts to Rs.4 lakhs, you can avail cashless facility from your Rs.3 lakh policy and bear the remainder from your pocket. When the claim is settled, you should collect from TPA the Claim Settlement Summary, Discharge Form, and attested copies of all medical bills and submit them to the other insurer for reimbursing the excess claim you bore. After the relevant documents are processed, the amount is reimbursed.
  • If you are aware in advance the claim amount is likely to exceed the Sum Insured under each of the policies, you can inform both TPA’s beforehand about sharing of the cashless benefit or inform 2nd insurer of the likely claim for residual amount.
  • If the policy type is same, in certain cases, first insurance company can directly approach the second insurance company for the additional expenses.

So, having multiple policies is a good tactic and when you know the claim procedure, your health insurance experience becomes even better.

However, recently, insurance companies have come up with something even better. Instead of opting for two family floater plans, it makes a lot more sense to take a Top Up Health Insurance Plan along with your existing Family Floater Plan. That way, the aggregate premium paid would be lesser than 2 family floater plans and hence can provide higher coverage as well.

Choose wisely!

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Gayatri Prabhu, Head-Digital Business at Mahindra Insurance Brokers Limited (MIBL) is one those few digital leaders who has the width and depth that is required to execute an ROI driven holistic digital strategy. She cuts through the noise, identifies the critical levers and leads her team to successful execution of the defined strategy. Her core mantra to win new and retain existing customers is: understand the consumer behavior and craft experiences around it.

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