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

Every Individual, after a certain age, starts thinking about his health 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 people. A particular part of the complete medical expenses under different categories like doctor’s fees, medicine costs, pathological tests, OT expenses, etc. are reimbursed by the insurer to the insured person.

Mediclaim policy is just to give you leverage in hospitalization expenses, if you are worried about your health then you should opt for a health policy. And after buying a health policy, if it doesn’t seem enough for you then you are free to buy a mediclaim policy but you should know one thing, health policy also covers hospitalization expenses. If you are buying a mediclaim policy for, any specific disease or any accident-related problem. Then you are good to go, in accident cases or for any specific disease, mediclaim is a good option and such scenario.

Benefits of Mediclaim Policy

The benefits of the mediclaim policy are quite impressive and had a wide range of benefits. From Hospital expenses to OPD expenses, everything will cover by the mediclaim policy. Apart from services, you will get a cashless hospitalization offer that’ll make things easy for you, every insurance companies have a long list of network hospital around the globe. No one knows about tomorrow, in this situation your decision you buy the policy is best for you.

  • Mediclaim policy can be used for not only hospitalization expenses but also does cover expenses related to OPD checkups, any critical illness or sudden health issues, accidents, etc.
  • With the evolution of a cashless society, there are many insurers who provide cashless settlement options.
  • 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 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 a 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 that covers entire expenses for the 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 needs to spend a 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 amounts during the time of medical crisis.  To get an adequate cover for all the health expenses, many policyholders purchase more than one Mediclaim policy. Moreover, employers provide 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 

Before buying a mediclaim policy different from the insurer, you need to know how to claim for both insurance policies when you need it most.

Payment by a 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 a 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’s say) policy A and Policy B whose sum assured amounts 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 the 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 a little neglected in India as most the policyholder prefers life insurance 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 whether the amount is 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 a sum assured if possible.

Sonia Nagpal

Sonia Nagpal is an Insurance Specialist. She has more than 25 Yrs of experience in sales, Marketing and Corporate Alliances.

One thought on “How To File For A Claim When You Own Multiple Mediclaim Policies?

  • August 15, 2020 at 10:10 AM
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    Mam i was covered under group mediclaim policy for 8 years when i left the company it was discontinued any after 2 months i purchased family health optima insurance plan.
    My question :
    1. Should i wait for 30 days to avail any treatment or there is no waiting period since i was under group policy for 8 continous years.
    2. Some disease treatment require 24 months and some require 48 months waiting period should i follow the same.

    pls clarify

    Reply

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