Health

Important Tips for filing Claim with Multiple Insurance Policies

It is a general notion among people that they can buy only one health insurance policy. However, the truth is you can have any number of insurance policies. For instance, you can purchase a separate policy for your parents, and spouse and children.

Buying multiple policies to protect your family members is not the end, you must also know how to use them correctly and to your best advantage, especially when it comes to filing a claim. You cannot get compensation for the same expenses from multiple policies. If one policy is insufficient to cover the entire costs, you can use the other policy to get full reimbursement.

While buying a Mediclaim policy, typically, the proposal forms have a section where you must disclose information about your other existing policy. Failure to revealing the details will be considered as a violation of the health insurance contract terms. Also, if you don’t mention details of your other policy in the form, the insurer liability will be limited only to the sum insurer, and you would have to bear the rest of the expense from your pocket.

Here are a few crucial steps you must follow while filing a claim with multiple policies

  • The first step to initiate the medical claim process is to inform all the insurance companies immediately when you get hospitalised.
  • Choose the company from which you want to make a claim first, and get full information about their process and fill the claim form.
  • Attach the required medical bills and other related documents to support your claim.
  • When you file for a claim with the first insurance company, they will issue a statement that mentions they have received the documents and have settled the claim successfully.
  • You must get additional attested copies from the hospital as per the number of insurance companies you wish to claim.
  • After you receive compensation from the first insurance company, repeat the same process. Fill the claim form along with the necessary documents and the claim settlement summary from the first insurance company.
  • If you have carried out the claim process correctly, usually, the insurance company settles the claim within seven to ten days.

Knowing the claim settlement process for cashless and reimbursement claim

Cashless claim

You must fill the claim settlement form with the first insurance company and procure the claim settlement summary. Once this is done, you must get attested copies of the bills from the hospital and then approach the second insurance company for reimbursement of the balance amount. You must ask the hospital authorities to provide you with the details of the treatment cost and fill the authorisation form. The hospital will then send this form to the insurers, and then the insurance companies will settle the bill with the hospital.

Reimbursement Claim

Today, a lot of people tend to opt for a cashless claim facility as it eases the settlement process. But, if you seek treatment in a hospital that is not part of the insurer’s network, you cannot avail the cashless facility. In such cases, you must pay the bills from your pocket initially, and get the full amount (to the extent of the sum insured) reimbursed from the insurance company.

To get the compensation, you must submit the original bills to the insurer. The insurance company, after verifying the bills, they will reimburse the amount and will issue a letter of the settlement. If your first insurance company, does not cover the full cost, you can submit the letter of settlement along with the copies of the bills and other hospital-related documents to the other insurer and get reimbursement for the balance amount.

Considering the high cost of medical care, today, most people buy multiple health insurance policies to ensure financial protection against medical emergencies. If you have multiple policies, you must understand the terms and condition of each policy. This will significantly help you in expediting the claim process.