Dual health insurance claim: A lot of people in India get health insurance from their office. It is easy because the company gives it as part of the job. But many people also buy their own health policy on the side. They do this because office insurance may not always be enough when a big medical emergency happens. A company plan can have limits. It may cover only a fixed amount, may not allow every kind of treatment or it can also stop when a person leaves the job.
Experts say both policies can help in one hospital bill, but there are rules. Siddharth Singhal, Head of Health Insurance at Policybazaar, explained, “If the claim amount exceeds the sum insured under a single policy, one can claim the balance amount from the other policy.”
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How the claim works?
The process is not very hard, but it must be done properly. Vineet Gupta, Head of Product Development at ManipalCigna Health Insurance, said the total money paid by both insurers together cannot be more than the real hospital bill. He also made it clear that the same medical cost cannot be claimed two times.
So if a person has a hospital bill of Rs 10 lakh, and the office policy covers Rs 5 lakh, that first policy can pay that part. Then the remaining Rs 5 lakh can be asked from the personal health policy. For the second claim, the person has to give the hospital papers, original bills if needed, and the claim settlement paper from the first insurer.
This system can really help families during a costly treatment. But people must remember one very important thing. Both insurance companies must be told that there is another policy. This is where many people make a mistake. Singhal warned, “Non-disclosure of a parallel policy is one of the most common reasons claims get rejected,” he said.
Use the office cover first
Experts also say it is usually better to use the company insurance first. The reason is simple. That policy is paid for by the employer, and it usually ends when the person leaves that job. A personal health plan stays with the policyholder for the long term if the premium keeps getting paid. Gupta said, “Many individual policies offer renewal benefits such as no-claim bonuses or premium discounts for claim-free policy years,” he said.
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Gupta added, “While the corporate cover offers immediate protection, an individual policy provides long-term continuity, portability, and flexibility to meet personal and family health needs over time.” Maintaining both policies is a wise strategy in today’s era of rising medical costs.
Common Pitfalls And Claim Rejections
- Non-disclosure: If you do not tell the second insurance company that you already used the first policy, your claim may get rejected.
- Duplicate claims: If you try to get paid twice for the same hospital expense, the second insurer can refuse the claim.
- Incomplete documents: If bills, discharge papers, or the first insurer’s settlement certificate are missing, the second claim may not go through.
- Late notification: If you inform the insurance company too late, it can create problems and may lead to rejection.
- Policy exclusions: The second policy may have its own limits, caps, or rules, so it may not pay the full remaining amount.
