Intro Price! Get Pixwell WordPress Magazine Theme with ONLY $59

How Do We Claim Health Insurance From Two Companies?

You may have more than one health insurance plan to cover the cost of your medical care. You may have this problem for several reasons, one of which is that you have purchased additional coverage elsewhere in addition to the group insurance that your employer provides.

You might also have an older policy, where you could buy a secondary insurance plan to obtain a higher level of coverage. A third possibility is that you have two separate policies: one that protects your parents and another that safeguards your partner and your offspring.

Method for submitting multiple claims at once –

The Insurance Regulatory and Development Authority (IRDAI) modified the regulations in 2013. Before implementing these changes, every health insurance plan contained a contribution clause. If a claim is filed, each insurer must contribute an amount proportional to their share of the sum assured.

Because of the changes that were made, the process is now much less complicated. The contribution clause will not apply if the health insurance claim amount is less than the sum assured. However, the clause applies to claims that are higher than the amount that was insured. However, you can select the insurance provider from which you will file your initial claim.

  1. Claims not paid in cash:

When dealing with claims of this nature, you only deal with one insurance provider and obtain the settlement summary from them. After everything is finished, you will need copies of all the bills notarised. After that, you are free to approach the second company to claim reimbursement of the remaining amount.

  1. Reimbursement claims:

The fact that the insurance company pays the patient’s medical bills directly makes cashless claims a valuable and convenient option. Despite this, a few healthcare facilities must adhere to such protocols. In addition to the claim application form, you must send in all original documents (the copies of which will be kept by the insurer).

Documents needed to make reimbursement claims –

When you are hospitalised and intend to file claims under multiple medical insurance policies, you are required to notify all the different insurance companies that you are doing so. After this, you can select the company on whose behalf you will make the initial claim. The following is a list of the original documents that need to be attached to the claims form to be considered complete.

  • Invoices, as well as receipts
  • Discharge forms
  • Diagnostic tests
  • Prescriptions
  • if there are any films or slides

When filing for health insurance benefits claim, it is recommended that you select the insurer provided by your employer because the procedure will be completed more quickly. You must obtain multiple copies of the documents above from the hospital that have been authenticated.

The first company will provide a claim settlement summary; this summary must be provided to the subsequent insurer to file the claim for the remaining amount. Your claim for health insurance may at any time be turned down, as this is always a possibility. You didn’t tell the insurer about any other policies you had when you bought this plan, so this happened. Alternatively, the claim could be higher than the amount stipulated in the contribution clause.

Because of the steadily increasing medical care cost, adequate health insurance plan is necessary. On the other hand, purchasing a higher level of coverage under a single plan is recommended instead of buying a smaller amount of coverage under multiple policies.

 * Standard T&C Apply

# Visit the official website of IRDAI for further details.

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