Multiple Health Insurance Policies? Here’s How to Make A Claim


In the purview of the increasing cost of medical treatment, it is paramount to have a health insurance policy. In India, quality treatment is easily accessible, but they all come at a price. That’s why many people opt for two policies, at times, two policies exist because the employer provides one, and they purchase the other. Additionally, health insurance also helps in tax savings. When you buy a health insurance policy, you not only get financial protection against the treatment cost but also you get tax benefits when you make a claim.

However, keep in mind that if you have two or more health insurance policies, they should not be identical in benefits. Ideally, one should be a holistic policy that will cover all sorts of basic treatments such as minor surgery or a daycare procedure. The other one should be ideally a critical illness policy so that you get the lump sum amount if you are diagnosed with the disease.

How to balance multiple policies?

Claim settlement – In case, the desired insurance policy does not give you the full claim or only partly settles your claim then according to the rules set by the IRDAI, you can claim the second policy. The IRDAI categorically mentioned that the insured could reach out to the second insurer, even if the sum insured is not exhausted in the first policy.

Sum insured exhausted – Suppose while claiming the bills from one insurance policy exhausts the limit of that policy. You have the right to request the remaining amount from the second policy if the bill is not entirely settled. This option was approved and is facilitated by the IRDAI.

Deciding on the policy – While claiming for a settlement, weigh the pros and cons of both policies. You must consider important things like a waiting period, No Claim Bonus advantage, Will it have a cumulative impact on the policy? Unless the circumstances are dire, and both policies have to be used.

If you have a group policy and a retail policy, always opt for the group policy, as that has no waiting period. Also, their range is considered to be wider than the retail policy, so it is better to begin with a group policy.

What is the process to make multiple claims?

The claim process in multiple policies too is same as regular policy claim. They are primarily divided into two categories:

Cashless Claims – In this case, you will go to a partner hospital of the desired insurer, produce the health card and settle your bills.

Reimbursement – In this process, you need to pay the hospital bills first and then you have to follow the process to make a claim. You will have to submit all the bills, and health documents supporting it and mention it in the application form.

In case of multiple policies, be aware of the underwriting and everything that your polices entail. Only after having clarity on the policies, you will be in a better position to make the necessary claim.