How To Make Claims On Multiple Health Insurance Policies?

The inflation of medical costs further triggers the need for policies with higher sum-assured or even multiple healthcare policies to counter the same. Moreover, since insurers are often reluctant to extend policy coverage limit beyond a certain sum depending on different aspects, having more than one health insurance plan in place can help in this regard.

Nonetheless, purchasing different policies is one thing, but using them judiciously to reap the benefits is more important. Moreover, individuals should also be aware of the correct process to file a claim, without which one may end up without the desired settlement amount.

A brief guide on making multiple health insurance policy claims

Here are the steps that one needs to follow while making a health insurance claim for multiple policies –

1. The first step to follow here is to intimate the insurance providers during hospitalisation.

2. Afterwards, select the company where you will file the first claim and complete the process. Also, ensure that you have attached all the required bills and necessary documents.

3. The insurance provider will issue a statement regarding this matter and the settlement.

4. After this, you need to gather extra attested copies of bills and other documents from the hospital as per the number of companies you are filing a claim with.

5. Once the first insurance company settles the claim, move to others and follow the same application process. Additionally, do not forget to attach the claim settlement summary and attested copies of documents. Also, furnish a cover letter explaining the previous claim and enclose documents associated with it.

Individuals can then repeat this process if they plan to raise health insurance claims with other companies. Nevertheless, policyholders need to keep the essential documents in line to avoid facing any issues during this process. They can make a checklist of it to avoid such complications.

Documents required for health insurance claim

• Claim form duly filled

• Medical certificate

• Diagnostics reports

• KYC details

• Hospital discharge papers

• Hospital bills and doctor’s prescriptions

These are some ‘must-have’ documents to complete an insurance claim process. However, insurers may also ask for additional documents like patient history, previous medical bills, etc., in certain cases.

Having more than one health insurance policy can offer multiple benefits, and a successful claim can aid individuals to get reimbursed for their expenses without any hassle. Nonetheless, they need to learn about the contribution clause to avoid facing any complications during the claim.

Contribution clause – a point to know while buying multiple health insurance policies

During the purchase of a health insurance policy, the proposal form contains a section to disclose the details of any existing insurance plans. Using this facility and not disclosing the right details can cause complications during the claim process.

The presence of a contribution claim makes this process mandatory. It states that if an individual has more than one health insurance policy, all insurance providers will share the settlement amount equally in the event of a claim. They will follow a ratio as per the sum assured of their respective policies. Moreover, insurers reserve the right to enforce this clause, so it is essential to follow proper guidelines.

Here is an example to simplify this process –

Suppose you have a Bajaj Allianz health insurance policy of Rs.2 lakh and another one of Rs.3 lakh from any other provider. Now, in the case of an Rs.1 lakh insurance claim, you will receive Rs.33,333 from the first one and Rs.66,666 from the second one. You can follow the above mentioned steps to complete this process.

IRDA has recently revised this clause, and now individuals can skip the process of informing about a claim to every insurance provider. They can only notify any one to initiate this process. Furthermore, a point to remember about this clause is that it is not applicable where benefits are fixed in nature and have no connection with treatment expenses.

Irrespective of the jargons of this contribution claim, one can still benefit from having access to multiple health insurance policies.

Benefits of having multiple health insurance plans

• In case one insurer rejects a claim, access to another policy will provide coverage against it.

• Access to multiple insurance policies also enables users to avail a diverse portfolio of benefits. For instance, you have a policy that has no coverage for diagnostics tests, but you have also purchased a Bajaj Allianz health insurance policy offered by Bajaj Finserv that provides this facility. Hence, all your healthcare expenses are covered.

The benefits of health insurance policies in the current world cannot be stressed enough. Along with safeguarding policyholders' financial interest, its bouquet of additional benefits makes it easier to access required healthcare services without any delay.