Is It Possible to Raise a Claim From Two Health Insurance Companies?

The answer is yes. It’s likely that you have many health insurance policies to cover your medical costs. One explanation could be that you have supplemental coverage beyond what your employer’s group insurance programme offers. As an alternative, you can already have a policy and decide to add a second insurance plan in order to obtain higher coverage. The fact that you have two policies—one covering your parents and the other your spouse and kids—could be a third factor.

Process for making several claims

Regulations were modified in 2013 by the Insurance Regulatory and Development Authority (IRDA). Visit the official website of IRDAI for further details. Every health insurance plan had a contribution clause before these changes. Each insurer will contribute an amount equal to the proportion of the sum guaranteed in the event of a claim.

The process of how to claim health insurance is now simpler and easier as a result of the changes. Now, the contribution condition is not applicable if the claim amount is smaller than the total insured. However, the clause is applicable to claims that are greater than the amount insured. However, you are free to pick the insurance provider from whom you submit the initial claim.

  1. Claims without cash

You submit a claim for such claims to one insurance provider and obtain the settlement summary. You will require attested copies of each bill after everything is finished. Next, you can make a claim for the remaining amount’s reimbursement with the second business.

  1. Claims for reimbursement

Because the insurance provider pays the hospital bills directly, cashless claims are practical. Nevertheless, some hospitals do not adhere to these protocols. Here, you must first make the required payment before beginning the health insurance claim process. The claim application form must be submitted with all original papers.

The paperwork required to submit refund claims

Whenever you submit a claim under more than one medical insurance policy, you must notify each company separately at the time of hospitalisation. You can then decide which business you want to submit your initial claim to after you compare health insurance obtained by you. The list of original papers that must be submitted with the claims form is provided below.

  • Receipts and bills
  • Dispatch documents
  • Diagnostic procedures
  • Prescriptions
  • Films and slides, if any

It is crucial that you obtain several attested copies of the aforementioned papers from the hospital. The first business will offer a claim settlement summary, which must be given to the following insurer in order to submit a claim for the remaining money.

It’s possible that your health insurance claim will be rejected. This can be due to you failing to tell the insurer about any current coverage when you purchased the policy. In contrast, the claim may be greater than the contribution clause limit.

The following are some typical inquiries that a policyholder has regarding health insurance claims:

  1. How long does the policyholder have to file a claim for health insurance?

Generally, you can choose a health insurance policy after 30 to 45 days, depending on the provider.

  1. How many times can a policyholder use their health insurance in a calendar year?

Multiple times, until the full amount of the money insured. The number of claims, however, has been restricted by many insurers.

Final Reflections

The policyholder is free to purchase numerous health insurance plans and decide which one will be used when it is necessary. The policyholder retains the right to file a claim with two firms, but must ensure that the total of the real expenses of the treatment cannot exceed the amount filed with the two health insurance companies.

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