Even though insurers have simplified the claim settlement procedure by providing a cashless facility, there is a slight difference if you want to claim under two health insurance policies. How, then, would you go about making a claim against each?
If you have two policies and the claim's value is less than the coverage offered by any of the plans, you may use any plan to cover it. However, according to experts, if you have two health insurance plans, you should submit a claim to your health insurance plan first, and if the amount of your claim is more extensive, you should submit a claim to another policy you have.
So, Can We Also Use Our Medical Insurance from Two Different Companies?
Yes.
One may submit claims for medical and health insurance from two or more organisations. The policyholder must be aware of certain requirements and procedures before making a claim.
For instance, Mr.Jeet has two health insurance policies for a combined total of INR 3 lakh and INR 2 lakh. For the treatment of his hernia, he spent ten days in the hospital. As a result, the cost of his hospitalisation increased to INR 3.5 lakh. He claims INR 50,000 from his second health insurance company and INR 3 lakh from his first health insurance company when it comes time to pay the hospital fees. However, his second claim was denied, so he must pay out of pocket.
He requested an explanation from the insurer because he was disappointed. Mr.Jeet was unaware that the additional policies needed to be disclosed to the two health insurance providers. If you don't, your claim can be dismissed.
Like Mr.Jeet, many policyholders are unaware that they must disclose their health or insurance policies to every company from whom they were purchased. The policyholder must complete the proposal forms, where the health insurance provider requests that they be acknowledged along with other current plans.
The Contribution Clause - This statement is necessary because insurers can include a contribution clause in a claim settlement. This clause typically applies when a sizable claim must be split among many insurers. According to the clause that the insurer invoked, each insurer bears a percentage of the claim burden based on the quantity of coverage authorised. Therefore, if you have a health insurance plan of INR 1 lakh and INR 2 lakh, respectively, and a claim for INR 2.5 lakh, the claim would be paid in a 2:1 ratio.
Everything regarding claiming health benefits and obtaining medical insurance from two firms is covered in this article. Please carefully read the entire document before submitting any claims.
How Can We Submit Claims to Two Different Health Insurance Providers?
When a medical emergency arises, the policyholder has flexibility in the number of claims due to access to two or more health insurance policies. Most people are aware of how to submit a claim for health insurance. However, doing so when filing claims for two different policies can occasionally be challenging.
If your health insurance claim is smaller than the sum insured, you can only make one claim under a single policy. However, the policyholder has two options for filing a claim if the amount exceeds the total sum insured of all applicable policies: Cashless claims and reimbursement claims.
Cashless Claims
The policyholder receives cashless hospitalisation when submitting a claim for cashless health insurance at any network hospital. In this situation, the policyholder has to file a claim with his primary health insurance provider and obtain a summary of the claim settlement. Once verified, the policyholder needs to present the second health insurance provider with the hospitalisation bills to request the remaining balance.
Reimbursement Claims
The cashless payment method is standard today, but in an urgent situation, the hospital where you are admitted is not a network facility for the health insurance carrier. In this situation, the policyholder must first pay the hospital fees before requesting reimbursement from the insurance.
After paying the hospital bill, the policyholder must complete a claim form and send it to the health insurance policy company with all documents and statements, such as lab tests, discharge papers, x-rays, medications, etc. After reviewing the paperwork, the insurer will reimburse you for the cost.
The insured must also provide a claim settlement summary if he is making claims to different insurers.
Conclusion
It's crucial to invest in a health insurance policy that will cover your medical treatment costs in the event of a sudden medical emergency so you can quickly access the best healthcare services. The policyholder is free to purchase different health insurance plans and decide which one will be used when it is necessary.
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