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Claiming Health Insurance Benefits from Two Policies?
- DetailsWritten by PolicyBazaar -
- Hits : 869 -
Modified 16 November 2016
Given the rising healthcare costs and medical expenses, people often find it difficult to manage with one health insurance policy. Therefore, there is an increasing trend, wherein to counter the inflation in medical costs, a large number of people are investing in more than one insurance policy. This also helps meet the need for higher sum insured.
Further, you might be compelled to buy a policy when the employer’s policy may not seem adequate. Alongside, you might also need to invest in another policy to include your spouse and children or even one for your elderly parents. While most people are aware of how to claim health insurance, it has been seen that making claims on two policies can be complicated task.
When Would You Need to Make Claims on Two Policies?
In the most common scenario, if your hospital bills exceed the sum insured by one policy, you will need to claim the remaining amount from the second insurance policy. Here, it is also important to mention that you need to inform the exiting insurance company about buying a second policy. If you fail to do so, your claim can be rejected or you can receive reduced claim settlement. It is imperative that both the insurance companies are aware of the other existing policy, so that there is no misrepresentation of facts from your end.
What is a Contribution Clause?
One of the most important reasons for making a disclosure when buying insurance is the contribution clause, as per which each insurance company has to pay a share of the claim. This amount will be based on the proportion of the sum assured for the claim. In some cases, the first company can pay the claim amount and subsequently it can claim a proportion of the amount as per the contribution clause from the second insurance company.
How to Claim Health Insurance Benefits from Two Policies?
Most people are aware of how to claim health insurance from one policy, but are not clear on how to claim health insurance benefit from two policies. For making claims from two insurance companies, you will first need to submit the bills and documents to the first insurance company. Also, you can make a mention of the amount of claim you want the company to pay for. Following the settlement of the claim, you will need to get the bills attested and submit the bills and the claim settlement summary to the second company for payment of the remaining amount.
Understand more: How to Make Claims on Multiple Health Policies
What to do When There are Cashless Claims?
With the rising advent of cashless claims, you will need to consider how to claim health insurance benefits on cashless policies as well. The first process is simple in which you make a cashless claim from one insurer and reimburse the remaining from the second insurance company. Besides, you can fill up authorization forms and the hospital will directly settle the bills with the two insurance companies.
When you have Different Plans from the Same Insurance Company:
Although taking two polices from the same insurance company is convenient in many ways as the claim process is less cumbersome and you will require lesser paperwork, but nonetheless, there may be different guidelines that will need you to make separate claims. So before purchasing plans, read the offer carefully to understand the terms and conditions stipulated by the insurer.
In case your claim is denied by one insurance provider, you can approach the second company for settling your claim as well. The best possible way to avoid any rejections and ensure a smooth claim process is to exercise transparency and make proper disclosures beforehand. It’s important that you carefully read about a company’s brand reputation and claim settlement policies before making a purchase. Making correct disclosures will ensure that you receive accurate premium rates with minimum hassles.
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