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

Every Individual, after a certain age, starts thinking about his heath and how to save money for medical treatments and regular health checkups to lead a healthy life. Mediclaim policies or Medical insurance policies provide monetary compensation for any hospitalization cost incurred for the insured person/group of person. A particular part or the complete medical expenses under different categories like doctor’s fees, medicine cost, pathological test, OT expenses etc. are reimbursed by the insurer to the insured person.

Benefits of Mediclaim Policy

  • Mediclaim policy can be used for not only hospitalization expenses but also it does cover expenses related to OPD checkups, any critical illness or sudden health issues, accidents etc.
  • With the evolution of cashless society, there are many insurers who provide cashless settlement option.
  • The premium for the Mediclaim policies is exempted from income tax payment.

Different Types of Mediclaim Policies Available in India

There are both individual and group medical insurance policies provided by the Mediclaim companies in India. Most of the employers provide this facility to their employees under medical allowances to protect the life of the employees and to save their earnings.

  • Individual Policies: If you buy an individual Mediclaim policy for yourself, then any unforeseen hospitalization expenses would be reimbursed by the insurer within the sum assured amount for the policy. The premium for the policy always depends on the amount assured to be reimbursed.
  • Unit Linked Health plans: This plan combines an investment element with health insurance plan and a certain amount is paid at the end of the term of the insurance. The return on the policy is directly proportional to the market performance because of its investment component. This policy is best for people who can take and afford the risk which is associated with the product.
  • Family floater Policy: This is a group Mediclaim policy which covers entire expenses for hospitalization of any family member within the specified sum assured of the insurance policy. It is better for families because the premium is comparatively lesser than individual policies and everyone can share the coverage provided by the policy.

Buying Multiple Mediclaim policies

Health and medical expenses are always a concern and since medical treatment is getting way better with technological innovation and improvement, the cost of the treatment is also on a rise. To afford better health facilities one need to spend lump sum amount and that is a lot of pressure on the earning member of the family, both physically and mentally.

It is always advised to purchase Mediclaim policies so that your medical expenses are reimbursed by the insurer and you need not worry about spending huge amount during the time of medical crisis.  To get an adequate cover for all the health expenses, many policyholders purchases more than one Mediclaim policies. Moreover, employers provide for the Mediclaim policies for their employees. Though it is better to have multiple medical policies but the procedure of claiming money when you have multiple Mediclaim policies has to be understood as there are some rules prescribed by IRDAI on the same.

Ways of Claiming Mediclaim policies 

Payment by single Insurer: If your claim value is not exceeding the sum assured of your Mediclaim policy, you can approach your insurer to reimburse the amount. The contribution clause will not be effective in such case. For example, if the medical bill is amounting to INR 2 lac and one of your Mediclaim policy’s sum assured is INR 4 lac. You can get full reimbursement of the expenses from this insurer only.

Combining two personal policies: The contribution clause affects when the claim amount is big and has to be shared by multiple policies. For example, you can combine two of your policies (let say) policy A and Policy B whose sum assured amount are 2 lac and 5 lac respectively when the medical expenses are INR 6 lac. The medical expenses will be proportionate in the ratio of 2:5.

Combining group and personal reimbursement policies: When you have a group Mediclaim policy offered by your employer and one individual policy of your own, you can also apply the contribution clause if the medical expenses are exceeding the sum assured of one or both the policies.

The current rules of IRDAI prescribe that contribution clause will affect only when a number of medical expenses exceed the sum insured by the insurer you are claiming the money from.

Conclusion

Health insurances are little neglected in India as most of the policyholder prefers life insurances over health insurance. But in reality, health insurance is as much important as life insurance. You can purchase different Mediclaim policies but always be assured of the amount being adequate or not for your medical expenses. The claim from multiple Mediclaim policies involves rigorous documentation which is quite a headache for a person dealing with medical problems of himself or his family. It is better to go for one single Mediclaim policy with a huge amount as sum assured if possible.

Harjot Singh Narula

Harjot Narula is founder and CEO of ComparePolicy.com, an IRDAI approved insurance web aggregator focussed on selling online insurance for companies. Harjot has more than a decade of experience in software development and has also spent 5 years in US working for the mortgage and risk management industry.

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