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Claiming health insurance from multiple companies: How to do that

Subscribing to multiple companies helps people whose single policy's sum insured is insufficient to cover the full cost of medical treatment

Health insurance customers will face higher premiums as insurers implement hikes. HDFC Ergo General Insurance has recently raised premiums for its flagship product, Optima Secure. New India Assurance has also announced upcoming hikes across all its p

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Ayush Mishra New Delhi

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As medical treatment becomes increasingly expensive, health insurance has become a crucial investment. With a variety of health plans in the market, people wonder if they can purchase policies from more than one insurer.
 
You can have multiple health insurance plans, such as employer-provided coverage and a personal policy. You can claim from both insurers. To do so, first, file a claim with your primary insurance provider for medical expenses. Once the claim is settled, obtain the summary of the settlement, get the hospital bills attested, and then submit them to the secondary insurer to cover the remaining costs.
 
 
“When you have multiple insurance covers, the power to choose which insurance company to claim from lies with you. Further, upon exhaustion of the sum insured of the first policy, one can submit the claim to the other insurer for the remaining amount,” said Udayan Joshi, chief technical & claims officer at SBI General Insurance.
 
How to claim health insurance from two companies
 
As a customer with multiple health insurance policies, it is crucial to inform each insurer about your intent to make a claim. Reach out to them individually and provide all necessary details regarding your claim.
 
Gather all the required documents related to your medical expenses, such as bills, receipts, medical reports, and other relevant paperwork.
 
Choose which insurer you would like to approach first for claim settlement. This is known as the primary insurer. Go with an insurer providing better coverage for your specific medical expenses.
 
File the claim with your chosen primary insurer, following their standard process.
 
Once the primary insurer processes your claim, they will issue a settlement statement outlining the reimbursed amount. You can then move on to the next step.
 
With the settlement statement from the primary insurer, contact the other insurer(s) in your coverage. Submit the settlement statement and any necessary claim documents to initiate the claim with them.
 
The primary insurer and secondary insurer(s) may communicate directly to finalise the settlement. This ensures no duplicate payments are made, and the reimbursement is calculated based on the expenses already covered by the primary insurer.
 
After coordination, the secondary insurer(s) will process your claim for their portion of the covered expenses. You will be reimbursed for the remaining eligible amount according to their policy terms and conditions.
 
“To streamline the claims process, it’s advisable to intimate all insurers at the time of hospitalisation, maintain clear records of expenses, and comply with the insurance declaration requirements,” said Manish Dodeja, chief operating officer, Care Health Insurance.

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First Published: Jan 30 2025 | 6:47 PM IST

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