Can You Claim Health Insurance from Two Insurers?
Health Insurance

Can You Claim Health Insurance from Two Insurers?

With ever-rising medical expenses, owning a single health insurance policy may no longer be sufficient. Today, it may make sense to invest in multiple health insurance plans as they give you access to higher sums insured while covering your various medical costs comfortably. Plus, you do not have to worry about expenses in case of a long-term illness. While the IRDAI has clarified that you can buy more than one health insurance policy, many people wonder – “can we claim health insurance from two companies”? Read on to find out.

Can I claim medical insurance from two companies?

Yes, the IRDAI permits you to file health insurance claims with two different insurance companies for the same medical emergency or treatment. However, if you intend to do so, you must keep the insurance companies informed about any existing health insurance policies that you may have from other companies. You must also follow the necessary IRDAI-determined guidelines and protocols under which you can claim health insurance from two companies.

How to claim health insurance from multiple insurers?

It is quite easy to claim health insurance benefits from two or more policies. To help you gain a better understanding, here is a step–by–step process to claim health insurance from two companies:

  • Step1: File cashless claims or reimbursement claims for the insurance policy that has a higher sum insured.

  • Step 2: After the insurance company approves your request, receive the compensation, and collect a settlement certificate.

  • Step 3: Raise a health insurance claim with the second insurer to claim the balance amount. Provide the required documents and settlement certificate. The second insurance company will then review their contribution clause and approve your insurance claim if all the information checks out.

How to claim health insurance from multiple insurers – An example

Let’s look at a situation in which your claim amount is higher than the compensation amount offered by your first insurance policy. In that case, you can continue to raise claims with different insurers till you receive the compensation amount you seek. However, you cannot receive the full amount from every insurer. Here’s an example to help you understand better:

Suppose you need to raise a health insurance claim for Rs 15 lakh to pay your hospital bills. However, your first health insurance policy from insurer ‘A’ only offers compensation of up to Rs 10 lakh. You also have another health insurance policy from another insurer, ‘B’, which provides coverage worth Rs 10 lakh. How do you go about making a claim the right way? Firstly, you need to fill up a claim form for Rs 10 lakh with insurer ‘A’. Once insurer ‘A’ settles your claim, you can approach the second insurance company ‘B’ for the remaining Rs 5 lakh.

Here you must remember two things: one, you can only raise a subsequent claim after your initial insurance claims have been settled and two, in the example mentioned above, you cannot receive a compensation of Rs 10 lakh from each insurer as it will be considered as fraud.

Final Note

Now that you have the answers you need, you can use this benefit to your advantage. The claim-filing process typically remains the same, for all insurers. You must remember to assess the coverage benefits and terms and conditions of your health insurance policy before filing a claim.

Disclaimer: The above information is indicative in nature. For more details on the risk factor, terms and conditions, please refer to the Sales Brochure and Policy Wordings carefully before concluding a sale

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