Here’s how to make a claim if you have multiple health insurance covers.
Deciding Between Two Compensation Plans
Indemnity plans are insurance covers that pay you for actual expenses within the total sum insured of the policy. You cannot claim for the same expense from two indemnity covers. “If you have two indemnity policies, you have the option to submit your claim under one of them first. If the claim amount is more than the sum insured under the first policy, you can claim the balance bill amount under the second policy. Can do it,” said Amit Chhabra, Head – Health Insurance, Policybazaar.com. If the expenses exceed the sum insured of one policy, you can claim the balance amount from the other cover.
Use a plan with no or minimal co-pay first: Before deciding which policy to claim first, you should assess the coverage offered by all the policies. “You must first consider the total claim amount as well as the sum insured available under various policies. Check the policy for any deductible or co-pay provisions. A percentage of the claim amount to the policyholder under the co-pay clause will have to be borne, whereas deductible refers to the fixed amount of deduction on the claim amount, over which the insurer will pay,” Chhabra said.
If it comes to deciding between a policy with or without pay, you can go for the latter. Chhabra said, “It is best to use the policy without co-pay or deductible as both these provisions require the policyholder to pay a portion of the claim amount either out of his own pocket or through another policy.”
Use Corporate Insurance Cover Before Individual
If you have both a corporate plan and an individual plan with the same sum insured, then saving the individual plan for a later stage is a better option. “If you have both an employer-provided policy and a personal policy, it is best to use the employer-provided policy first,” Chhabra said. Corporate plans are well-bargained insurance covers and generally offer better coverage and claim experience. Your personal plan will act as a reserve in case there is a subsequent job change.
Individual vs. Family Floater
When it comes to deciding between individual and family floater insurance cover, if the claim amount is high then it may be prudent to use an individual plan so that the family floater plan does not expire as it can cover other family members in case of emergency. can make it unsafe. ,
Comprehensive vs Top-up Plans
Super top-up plans come with a deductible clause, which means that the policyholder will either use another insurance policy or pay the expenses up to the deductible amount out of his own pocket. When the expenses exceed the deductible amount, the super top-up plan pays an amount in excess of the deductible up to the sum assured of the policy. Hence, it is easy to choose between the basic plan and the top-up or super top-up plan as the top-up or super-top-up plans come at a later stage as you need to use the basic plan first.
Simultaneous claim from indemnity, defined benefit cover
While the payout of an indemnity plan is linked to the actual expenses, the defined benefit plan pays the claim in case of a pre-defined illness with specific severity, no matter how much it may cost. Most of the critical illness plans and cancer covers fall under the defined benefit category. If you have both types of plans, you can claim using both types of policies together if the medical condition qualifies for it.