The need to have distinctive medical schemes for different members of the family leads to customers buying more than one health insurance policy. A single plan may not offer sufficient cover to different sorts of diseases. While holding more than one policy is okay, experts say, customers should know how to use them to their best advantage.

“Customers with more than one policy have the choice to prefer the claim with any of the insurers. For instance, if they hold an individual health policy with some Insurer and a group health policy with other Insurer, they may choose any of it as per the need,” explains Prasun Sikdar, ManipalCigna Health Insurance Company Limited.

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However, choosing the group insurer first would make the process comparatively faster.

Policyholders should also understand the use of the contribution clause in this case. According to this clause, if a person holds more than one policy, all insurers should share the claim in equal ration as per the sum assured under the corresponding policies.

The insurer on whom a claim is made can enforce the contribution clause when the insured makes a claim, as per Policybazaar.

“The insurer is not required to notify all the insurers who would contribute the claim amount. In case, if the claim amount is less than the sum assured, the contribution clause is not applicable. It is only applicable when claim amount exceeds the sum assured,” explains Rakesh Goyal, Director, Probus Insurance, Insurtech Broking Company.

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It is on the insured to select the policy from where the first claim could be made.

“For reimbursement claims, the insured can claim for one insurer and procure the settlement summary. Once done, the insured can get the attested copies of all the medical bills and can get in touch with the second insurer for claiming the remaining amount,” Goyal elaborates.

In case of cashless claims, the insurer settles the medical bills directly. But if the hospital fails to follow the procedure, the insured needs to do the payment and later follow the claim process guidelines and submit all the required documents along with the claim application form.

Nevertheless, some experts say buying multiple health policies should be the last resort.

“One should first consider buying a top-up plan that offers extra security over the existing policy. This will be less expensive and also ease the claim process,” opines S Prakash, Managing Director, Star Health and Allied Insurance.

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