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How to make claims with multiple health insurance policies?

How to make claims with multiple health insurance policies?

With the escalating cost of healthcare facilities across the country, an increasing number of people are opting for multiple health insurance policies. People have these policies in the form of a family floater plan, corporate mediclaim policy, critical illness cover, individual health plan, or top-up plans. However, despite having multiple insurance policies determining which one to use first in the event of a medical emergency might be difficult. Today, let us look at factors to consider while making a claim in case you have multiple health policies.

When you own two indemnity health insurance plans

Indemnity plans reimburse your actual medical bills within the chosen sum insured of the policy. Never submit a claim for the same medical bill from two different indemnity plans. Doing so will result in the rejection of your claim application. To receive your claim successfully, here’s what you can do:

First, submit the claim under one indemnity plan, and if the claim amount is within the sum insured limit, the insurer will process your claim immediately. In case the claim amount exceeds the sum insured amount, use your other indemnity plan to raise the claim for the balance amount only.

Consider co-payment and compulsory deductibles

Co-payment is the portion of your claim amount that you must pay from your pocket. Similarly, the deductible is the fixed amount where the insurer is liable to pay only if the claim amount exceeds the compulsory deductible amount. If you have multiple health insurance policies, compare the claim amount to the total sum insured of all your medical plans. Go through the co-payment and compulsory deductible clause. When making a claim, choose the mediclaim insurance plan with the lowest required deductible component and the least or no co-payment provision.

Deciding between corporate mediclaim policy and individual health insurance

Corporate medical policies have their own set of advantages and disadvantages. They are available to the employees until they are part of the said organisation. If you have both a corporate mediclaim policy and an individual health insurance plan, always choose a plan that has an easier claim process. If your individual health insurance allows you to claim on their mobile app, go for it. A corporate plan may need you to email your documents, and you can choose to claim under it if you have the time at hand.

Deciding between individual and family floater plan 

If you have both an individual and a family floater plan, deciding which one to use first can be challenging. You must consider various things before arriving at any decision. Check to see whether any of the other covered family members in the family floater plan has a separate health plan to their name. Also, consider the sum insured amount of other family members’ individual health insurance plans. Filing a claim under a family floater plan instead of an individual plan is advisable only if the claim amount is not too high. This is because a higher claim amount could deplete the family floater plan’s overall sum insured, leaving other covered members unprotected in the event of a medical emergency.

Deciding between comprehensive and top-up health insurance

This one’s an easy choice. Your super top-up plan comes with a deductible clause. So you should either use a comprehensive policy or bear the expenses from your own pocket up to the deductible portion. This is because, under top-up plans, the insurer is liable to pay only when the expense exceeds the deductible portion.

Deciding between an indemnity plan and fixed benefit health insurance

Indemnity plan reimbursement is associated with your actual medical expenses, whereas a defined benefit plan pays out based on the occurrence of a specified medical illness such as cancer, regardless of actual medical bills. Under a defined benefit plan, the insured is free to use the lump sum amount as they deem fit. In case you own both the policies and your medical condition qualifies for both, file your claim simultaneously using both the policies.

To Conclude

 When you have multiple health insurance, you are bound to come across the above-mentioned situations at some point or the other. By evaluating your need and going through the pointers mentioned in this article, you can easily raise your claim request. However, when choosing among an individual plan, family floater plan, and fixed benefit plan, don’t forget to consider continuity benefits such as no claim bonus in health insurance.

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