How To File For A Claim When You Own Multiple Mediclaim Policies?

When it comes to planning for unexpected emergencies, health insurance is right up there as one of the most important and useful policies that you could ever buy. It helps us not only by taking care of hospital expenses and treatment costs, but also doctor’s fees, medicine costs, ambulance costs, expenses for investigations and other miscellaneous expenses during the pre and post hospitalisation period.

- Year round coverage for health related expenses for hospitalisation, surgery or other treatment as well as pre and post hospitalisation expense coverage.- Family floater health plans that can provide health insurance to your entire family with a single plan.- Cashless claim benefit wherein your insurer directly settles your hospital expenses without you having to pay a single penny to the hospital.- Your health insurance premiums are tax deductible under Section 80C of the Income Tax Act.

The main goal of a mediclaim policy is to carry the burden of your medical expenses. A lot of this depends on the coverage amount of your policy. For example, if your medical cover is for Rs. 3 lakh, in case your medical bill amounts to more than that, then unfortunately you will have to pay the rest from your own pocket. To overcome this obstacle, many people buy more than one mediclaim policy. A second mediclaim policy can be bought to overcome the deficiencies of your existing policy.In other instances, your employer may provide a group health insurance policy for you. But that alone may not be enough. And hence it is always better to get an additional individual health plan so that you can enjoy the benefit of both policies. Having said that, claiming multiple policies is not as straightforward as it looks. The IRDAI has laid down certain rules to claim multiple policies. Let us find out how you can smoothly claim multiple mediclaim policies.

Before we understand how to claim multiple mediclaim policies, we must first look into a special clause called the contribution clause which applies specifically when multiple mediclaim policies are concerned. The contribution clause states that multiple insurance policies must contribute in equal proportion towards the reimbursement amount. This is applicable only when the claimed amount is more than the assured sum of either policies.

Combining two personal policies

If your claim amount is Rs. 3 lakh and you have two policies with Rs. 1 lakh and Rs. 2 lakh health coverage respectively, then you can start by choosing any one of your insurers and file a claim. When claiming your policy it is important to disclose that you have another existing mediclaim policy. Once you do that, your insurer will apply the contribution clause and your claim amount will be settled using both your policies in equal proportion.

Combining a group policy with a personal policy

When making use of both an employer’s group policy as well as an individual policy, the same rules apply. You can get your claim settled using both policies if your claim amount exceeds the assured sum of either policies.

Thus, claiming multiple mediclaim policies can sometimes be confusing, but let this article act as a guide whenever you want to claim multiple policies. The most important thing to remember is that you must not in any case hide from any of your insurers that you have an additional policy. Doing so could result in a significant decrease in your reimbursed amount. Mention your existing policy details in your claim form and get the benefit of multiple mediclaim policies.

The information contained herein is generic in nature and is meant for educational purposes only. Nothing here is to be construed as an investment or financial or taxation advice nor to be considered as an invitation or solicitation or advertisement for any financial product. Readers are advised to exercise discretion and should seek independent professional advice prior to making any investment decision in relation to any financial product. Aditya Birla Capital Group is not liable for any decision arising out of the use of this information.