Can Insurer Cancel Coverage if you get a Disease New Bill?

With the rising number of covid-19 cases, more people are being admitted to hospitals and makeshift facilities. Individuals with co-morbidities may need to be hospitalized for longer periods due to covid and other diseases. This could lead to huge medical bills.

There is no reason to be concerned if you have multiple policies. Multiple policies can be used for one claim, including your employer’s group policy, your personal health policy, and your top-up policy.

We will show you how to do it and what terms and conditions to remember.

Multiple policies

“Keeping in view the rising medical costs, policyholders can purchase multiple health insurance policies across various insurers if they have a need to insure a greater sum than is covered under one policy,” stated Bhaskar Nerurkar (head, health claims), Bajaj Allianz General Insurance.

You can choose which policy you wish to claim the first, even if you have two indemnity insurance policies. You can claim the amount of the balance bill on the second policy if the claim amount exceeds the amount insured under the policy you made the first claim.

When you purchase health insurance, you must fill out proposal forms that ask the insurer for information about any existing policies. Naval Goel (CEO and founder of PolicyX), an online insurance aggregator, said that if the policies are from different insurers, both companies should be informed about the other. Nerurkar stated that this is crucial because your claim could be rejected if you don’t disclose policies.

This information is important for insurance companies as many policies include a contribution clause. This clause states that, if an insured person has multiple policies, all of them will contribute equal amounts to the insured sum in the event of a claim.

If you have two insurance policies covering Rs3 lakh and Rs4 lakh respectively and want to file a claim for Rs2 lakh each, you can choose one of these policies. If the total claim value exceeds Rs7 lakh, the insurers may choose to settle the claim at an equal amount to the insured sum.

Before you can go to the second insurance, you’ll need to get the claim settlement summary from the first insurer.

Keep these things in mind

First, you must consider the total amount of your claim and the amount insured on each policy. You should also check for co-payment or deductible clauses. The co-payment clause requires that a percentage of the claim amount be paid by the policyholder. While the deductible refers only to the amount of deduction the insurer will make on the claim amount above which it will not pay.

Because these clauses require policyholders to pay a portion of the claim out of pocket, or through another policy, it is a good idea to use the policy without a co-payment or deductible. Nerurkar said, “Check the older policy first as the waiting period is likely to have been completed and exclusions pre-existing in the older policy.”

It is advisable to choose the employer-offered policy first if you have both a policy from your company and an individual one. Nerurkar stated that claims settlement for group policies is often quicker and simpler. He said, “Once you choose your group policy, your no claim bonus on the individual insurance policy will be retained. This is an additional benefit to not choosing the individual policy first.”

If you have more than one policy with cashless facility the hospital might offer you the option to only pay one of them and then ask you to reimburse the rest.

Not all policies may offer cashless claims. Either the policy with cashless claims or the reimbursement claim can be chosen. For reimbursement claims, you will need to obtain the claim summary and certified hospital bills from the first insurer.

As you avoid having to pay out of pocket, it is a good idea to get the policy with cashless claims first. The surplus amount can then be reimbursed under the second policy.

There is no limit to the number of policies you can purchase in health insurance. However, experts recommend sticking to two policies with sufficient sum insured (one base and one top-up) to avoid confusion when it comes to settlement.