As medical expenses continue to rise, comprehensive insurance coverage has become a necessity. Thus, many individuals purchase two critical illness insuranceplans to ensure they have the desired safety net.
But the question arises: Can you claim cashless healthcare insurance from 2 insurers at the same time? Where to start? What is the process? What are the things to consider while doing so? Do not worry; this article is here for you. This article will shed light on how to obtain cashless claims from two or more medical insurance plans simultaneously.
Can You Claim Cashless Healthcare Insurance From 2 Insurers?
Yes, you can claim cashless healthcare insurance from two insurers. This is possible due to the eradication of the Contribution Clause by India's Insurance Regulatory and Development Authority (IRDAI).
The ‘Contribution Clause’ in an insurance policy is a provision that comes into play when the same loss or damage is covered by multiple insurance policies. It ensures that the distribution of the payable claim amount is proportionate among all the insurers. This clause is designed to prevent the insured from profiting more than the actual loss incurred.
With the IRDAI’s move, you can now settle the claim by contacting any of the insurers. However, it's important to note that you cannot claim more than the sum assured through single or multiple medical insurance plans. If your claim is less than the sum assured, then you can initiate the claim under the single health insurance policy.
How Can You Make a Cashless Claim From 2 Different Healthcare Insurance Providers Against 2 Policies at the Same Time?
You should follow the following steps while filing a cashless claim from 2 different critical illness insurance providers simultaneously:
Step 1: Notify All Insurers
The first step is to inform all the insurance providers about the medical treatment as soon as possible.
Step 2: Provide the Necessary Documents
Submit all the necessary claim documents to each insurer. These may include medical reports, hospital bills, doctor’s prescriptions, and other relevant documents.
Step 3: Select the Primary Insurer
Decide which insurer you want to approach first. This will be your primary insurer.
Step 4: Initiate the Claim Process
File the claim with the primary insurer, providing all the necessary details and documents.
Step 5: Get the Settlement Statement
Once your claim is approved by the primary insurer, obtain the settlement statement. This document will detail the amount paid by the insurer.
Step 6: Contact the Secondary Insurer(s)
With the settlement statement from the primary insurer, approach the secondary insurer(s). Submit the claim along with the settlement statement.
Step 7: Insurers’ Coordination
The secondary insurer will coordinate with the primary insurer to understand the claim details and the amount already paid.
Step 8: Final Settlement
After reviewing the claim and coordinating with the primary insurer, the secondary insurer will settle the remaining amount against your health insurance policy.
How Can You Make a Cashless Claim From the Same Healthcare Insurance Provider Against 2 Policies at the Same Time?
You should follow the following steps to make a cashless claim from the same healthcare insurance provider against 2 healthcare insurance policies:
Step 1: Comprehend Your Coverage
Familiarise yourself with the terms and conditions of both of your critical illness insurance policies. Understand the extent of coverage, exclusions, and the claim process for each health insurance policy.
Step 2: Arrange Necessary Documents
Collect all necessary documents such as medical reports, hospital bills, doctor’s prescriptions, and any other documents required by your insurance provider.
Step 3: Lodge the Primary Claim
First, file the claim for your primary policy.
Step 4: Acquire Claim Settlement Summary
After your insurance provider processes your primary claim, obtain a settlement summary. This document should detail the medical services provided and the amount the insurance paid.
Step 5: File a Claim with the Secondary Policy
Submit the claim settlement summary for your primary policy and a new claim for your secondary policy.
Step 6: Monitor the Claim
Keep track of the claim status. The insurer may require additional information or documents, so be prepared to provide these.
Step 7: Examine the Reimbursement
Once the secondary claim has been processed, review the amount received. This should cover most of the remaining balance after the primary insurance payment.
Step 8: Request Clarification if Required
Don't hesitate to contact your insurance provider for clarification if there are any discrepancies or questions about the claim settlement.
Conclusion
When filing cashless claims from two critical illness insurance policies simultaneously, it's essential to understand the coverage of each health insurance policy. While it's possible to leverage benefits from multiple policies, it requires careful planning and coordination.
That is where Niva Bupa, the best health insurance company in India, comes in. With its comprehensive coverage and customer-centric approach, Niva Bupa simplifies the claims process, ensuring you receive the benefits you're entitled to without hassle. So, check their medical insurance plans today.
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