Leveraging multiple health insurance policies: Maximizing coverage when hospital bills exceed policy limits

Insurance rules in India allow a policyholder to split their treatment expenses over any number of insurance policies.

Below are some common scenarios where a policyholder can use multiple health insurance policies for hospitalization expenses.

• You got cashless in one policy but the sum insured got exhausted. Your bill is much more than the sum insured, so you end up paying some cash out-of-pocket. You have another 1-2 policies. This remaining unclaimed amount can be claimed from your 2nd or 3rd policy as well.

• You claimed from the first policy. You have sufficient sum insured and the bill is also not more than the sum insured. But there is a copay (co-payment clause) in your policy for 5-50%. You have another policy. This copayment amount you can claim from your other policies. You claimed from the first policy and you have an adequate sum insured. But unfortunately, you ended up paying a significant part of the bill in cash because of proportionate deduction. This happens when you get admitted to a hospital room whose per day rent is more than the allowed rent limit in your policy. In that case, if you have another policy in which the allowed room rent is more than the limit defined in your first policy, you can claim this proportionate deduction amount in your second policy.

• You claimed from your first policy and the sum insured exactly covered the hospital bill. Now you have pre and post-hospitalization bills also remaining to be claimed. You can claim those bills from the second policy.

To understand the Proportionate Deduction, understand the Room Rent Limit in Health Insurance Policy.

Just to clarify the converse of it as well. You cannot get paid in two health policies if either one has settled your treatment expenses completely.

There are two parts to the problem:

• People don’t know whether they can claim the same treatment expenses from two policies or not.
• What would be the process to claim from two or more health insurance policies?

In the sections above, we have tried to highlight scenarios where your multiple insurance policies will come in handy in covering your treatment expenses. We hope it was helpful.