6 min read
Updated on Sep 27, 2022
In these times of ever-rising medical care costs, it only helps to have more than one health insurance plan from different insurers. It helps save money and also increases the coverage of the plan. Here we talk about the process to raise claims from multiple mediclaim policies.
Health insurance is one of the most valuable assets of a person today. With several illnesses surrounding us and hospitalization costs touching the peak, health insurance is what can help in difficult times. That too, when you have the advantage of availing more than one insurance plan from different sources, the benefits only increase multi-fold.
Multiple health insurance policies mean increased coverage for the policyholder. This in turn means that in case one policy coverage gets exhausted, you can still rely on the other to get your hospitalization costs covered.
As stated above, it helps to buy multiple health insurance policies to avail more benefits from mediclaim. Here’s when you can consider buying plans from different insurers:
Yes! You are free to claim your hospital bill costs with more than one insurance provider, if you feel that one plan may not be able to adequately cover the expenses. However, note that you cannot raise the same claim with two different insurers.
In other words, you cannot settle the same medical claim with two insurance companies at the same time. You would first need to settle the hospitalization bills with one provider up to the total coverage limit. You can then approach the second company for the remaining settlement, if so needed.
Before we proceed with explaining the process of raising claims from more than one insurance company, let us take a quick look at the Contribution Clause in health insurance which existed before 2013.
The Insurance Regulatory and Development Authority of India (IRDAI) had earlier mandated all the concerned insurance providers to share the total amount for claim-settlement proportional to the sum assured by each plan. This was the usual norm before 2013 and was known as the Contribution Clause.
After 2013, the IRDAI introduced a change in the clause to help policyholders receive benefits from multiple insurance policies. Now, the insured has the free will to approach either of the two or more insurance providers to settle the medical claim, as per their choice or preference.
However, as per the new guidelines, the policyholder can only file a claim with one insurance company at a time and not parallely with both for the same claim. This means that you would first need to raise the claim with one health insurance provider to cover the costs for the treatment up to the coverage amount assured under the plan.
The insurer would then issue a summary of the claim-settlement process. You need to submit this summary, along with an attestation of the hospital bills, to the second insurance company for settlement of the remaining costs, if any.
Also, in case of two insurance policies – individual and employer-sponsored, it is always advisable to get claims settled with the company-sponsored health insurance first before using up your individual cover.
Also Read: Steps to Fill Health Insurance Claim Form
There are two simple ways to claim your medical care costs from health insurance if you have purchased more than one plan with different insurers:
Also understand that you would need to approach more than one insurance provider for claim-settlement only if your claim amount is more than the sum assured under a single health insurance policy. If the hospital bills can be easily settled under one plan, you can raise a claim with just one insurer.
Now let’s learn about how to raise claims if your medical costs to be covered are more than the sum assured under a single plan and you need to approach more than one insurer.
As stated above, in the reimbursement method of claim-settlement, you need to settle the hospital bills first and then request the insurer to reimburse the amount later. Your insurer would ask you to submit a few essential attested documents in this case for claim settlement. These include:
Health insurance is one of the biggest advantages in the hands of an individual, helping them to cover the ever-rising healthcare costs in the country. It is particularly helpful during an emergency need for hospitalization. What also helps in this case is raising claims with more than one insurer to increase your coverage scope and receive more benefit from health insurance. Find out the best health insurance in India on PayBima and be worry-free for any emergency.
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