How to File Health Insurance Claims With Two Insurers?

The rising number of lifestyle diseases such as hypertension, diabetes, and stroke among young people is raising eyebrows across the world. Not having a family history of these diseases is no assurance that you will not get them. Being prepared for medical emergencies is the need of the hour, especially with the rising cost of medical treatments. A health insurance policy helps you do just that. One of the biggest benefits of mediclaim policy is that you do not have to worry about the cost of healthcare and can solely focus on treatment. 

Benefits of Mediclaim Policy

You can buy an individual health policy for each family member or a family package that covers you all. You may use an online health insurance calculator to understand how each policy will affect your budget. However, not having a policy will prove costlier in the time of need. Here are some benefits of With the cashless claim feature, the insurer directly settles the bill under your mediclaim policy:

  1. Financial coverage

Mediclaim policy covers the cost of treatment for a wide range of diseases.

  1. Cashless claim process

You need not worry about raising immediate funds to access quality treatment. At a network hospital, you can avail treatment without paying anything out of your pocket.

  1. Other benefits

Based on your plan, your insurance covers additional services such as the cost of online consultation, ambulance services, the cost of procuring an organ donor, preventive health check-ups etc.

  1. Alternative treatments

Your insurance also covers alternative treatments such as AYUSH and Naturopathy. Most mediclaim policies also cover pre and post-hospitalisation expenses to a certain extent. 

  1. Tax benefits

As per Income Tax Act, Section 80D the premium you pay towards your mediclaim policy allows for tax exemption to a certain extent. 

Having more than one mediclaim policy may prove useful in the event of a medical crisis. It not only offers flexibility in several claims and widens your coverage but also saves money in the long run. You must prioritise the best healthcare and treatment for important ailments when choosing health insurance and your mediclaim policy must cover your family under all circumstances. 

H2- Claiming Two Insurance Policies from Two Different Companies

You can claim insurance from two different insurers but you must inform them about having more than one mediclaim policy. Having two or more mediclaim policies prevent the situation where you may exhaust the coverage in the middle of the treatment or the policy term. Also, remember, you cannot claim insurance for an amount more than the sum assured, irrespective of the number of insurance policies that you have. 

However, if your treatment cost is more than the sum assured from one insurance, you can use your other insurance to pay the remaining amount. 

The Process to Claim Health Insurance from Two Policies

Claiming health insurance is easy. Here is a step-by-step guide to claim policies from two insurers:

  1. Use the health insurance policy with a higher sum assured to file your claim first. 
  2. Once you get the approval from the insurance company, receive the compensation, and get the settlement certificate from the insurance provider.
  3. Now, for the balanced amount in the bill, use the second mediclaim policy to make a claim. Submit the required documents and settlement certificate from another insurance provider.
  4. The second insurance company will review the documents and contribution clause and if all the information is valid, your claim will be approved.

So, filing insurance claims from two companies is no rocket science. However, remember to keep the insurance providers informed about other mediclaim policies you have to avoid last-minute claim rejection. 

Different Methods of Filing a Claim from Two Health Insurance Providers

You can raise a claim with multiple insurers by following one of the two methods:

  1. Cashless claims

This is the most useful and common method. With mediclaim policy, you get the benefit of cashless hospitalisation and treatment at network hospitals. By opting for treatment at a network hospital, you just have to raise a claim from first insurance and get the claim settlement certificate. Once you get that, approach the second insurer with a claim settlement certificate and hospital bills, and request a settlement for the balance amount. 

  1. Reimbursement claims

A reimbursement claim option comes in handy when your choice of hospital is not listed among the insurer’s network hospitals. In such cases, you must first settle the hospital bills from your own pocket and then file a claim for the reimbursement amount. The documents required are similar to those of cashless hospitalisation. Keep the original bills and reports such as X-ray reports, prescriptions, and discharge papers handy. Once you submit the documents to the insurance provider, they will be verified for authenticity and the insurer will reimburse the amount. When raising claims with multiple insurers, do not forget to submit the insurance settlement summary from the other insurance provider. 

Regardless of which method you use, you can always compare the claims by using any health insurance calculator available online. 

Reason for Claim Rejection

In many cases, claims from the second insurer are rejected. This is often because either there is a lack of paperwork, but mostly due to negligence. People often do not give full disclosure about having another mediclaim policy when applying for multiple policies. Usually, this is the biggest reason for claim rejection. 

Final Word

In times of unforeseen medical emergencies, getting the best-in-class healthcare at the right time is necessary. Investing in two different policies will certainly give you better and wider coverage for treatment expenses. As a policyholder, you have all the right to file a claim at two companies if you ensure the total amount claimed does not exceed the cumulative sum insured by the two companies. Disclaimer: The above information is for illustrative purposes only. For more details, please refer to the policy wordings and prospectus before concluding the sales.

Disclaimer: The above information is for illustrative purposes only. For more details, please refer to the policy wordings and prospectus before concluding the sales.

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