Multiple health policies? Here’s how to make claims

Wondering whether you can claim under more than one health insurance policy? Here is what you need to know.

As per Medi-claim insurance rules, you cannot make claims with two insurance companies for the same hospitalization. However, there are situations when you can claim from both companies.

Say, you have two health plans for a sum assured of Rs 1 lakh (A) and Rs 2 lakh (B). You have the right to choose under which policy you want to make the claim. You should weigh your options based on parameters such as cashless facility, if the chosen hospital is in the network, the sum assured, exclusions, specified limits and so on under both policies while making claim. If your medical bill is Rs 2.5 lakh, then you can make a claim under both the policies.

“If the amount of claim exceeds the sum insured under a single policy the policyholder shall have the right to choose insurers by whom the claim should be settled” states the Health Insurance Regulations, 2013.

It is advisable to mention the details of the other health plan when you claim with one insurer. The insurance companies have a contribution clause where all the policies will contribute in equal proportion to the sum insured.


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About the Author: Ranjit Borah