1. Claiming mediclaim from two different insurance companies
A mediclaim policy is a reimbursement policy which means you can get back the money that you spend. Obviously, you cannot profit from such a policy. So the total amount you can receive on a valid claim will be restricted to the amount you have actually incurred.
Since you are maintaining two different policies from two insurance companies, they will pay the claim to you on pro-rata basis of the sum assured you have from both the insurance companies.
For example, if you have a mediclaim policy of Rs 1 lakh from company A and Rs 2 lakh from company B and the amount of claim is say Rs 90,000, then according to the 'Principle of Indemnity' company A will pay you Rs 30,000 and company B will pay Rs 60,000.
2. Can I take Mediclaim Policies from two different companies? What is the maximum health insurance cover a person can take? Is the waiting period covered under a health insurance policy for pre-existing diseases,etc., will also be applicable/admissible on another/additional mediclaim policy taken from another company? What will be the claim procedures for health insurance taken frm 02 cos?
Answer
You can always choose to avail 2 health insurance policies and if the limit of one gets exhausted, then you can claim the remaining amount from the other plan.
There is no maximum limit on the health coverage that one can avail. If the insurance company offers a Rs 10 lacs of individual coverage, then you can opt for the same as well. It entirely depends on the underwriter's decision whether you will get the policy or not.
There is usually a waiting periof of 3-4 years for all pre-existing diseases but other illnesses would be covered from day 1.
If you need 2 health insurance plans, it would be a better deal if you opt for one Health Insurance Plan and then a Top Up Plan, where there would be a deductible for the amount of your first plan. In this case, the prmeium would also be much lower than 2 individual policies.
A Top Up Plan provides for coverage of expenses arising from a single illness or disease in one year but only after the intial cover has been exhausted and the premium is usually much less than normal plans. A Super Top Up Plan provides coverafe of expenses for all illnesses in one year after the certain threshold level has been exhausted. This limit is called Threshold Limit.
The premium for a Top Up Plan or a Super Top Up Plan is usually much less than a full fledged Health Insurance Plan.
Bajaj Allianz Top Up Plan, Star Health Super Surplus Plan, United India Top Up Plan and United India Super Top Up Plan are some of the common Top Up and Super Top Up Plans that are available in the industry.
The premium for a Top Up Plan or a Super Top Up Plan is usually much less than a full fledged Health Insurance Plan.
Bajaj Allianz Top Up Plan, Star Health Super Surplus Plan, United India Top Up Plan and United India Super Top Up Plan are some of the common Top Up and Super Top Up Plans that are available in the industry.
3. My wife has taken a group mediclaim life policy of Rs 5 lakh from Oriental Insurance. She wants to take another group mediclaim policy for Rs 5 lakh. Can her cashless hospitalisation bill of Rs 4 lakh be settled under the second policy without affecting the first policy? — A DUTTA
If you have two health insurance policies from two different companies, the claim will be settled by both the companies in a rate proportion of the sum insured with each company. Instead of buying additional basic health policies you can consider a top-up policy like Star Health — Super Surplus Plan. Top-up plans cover the additional expenses over and above the sum insured in the basic policy.
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