This is a very common question which people ask me “can i claim my hospital bill from two separate insurance Company” ?
Normally this question comes from those people –
Who are already covered under group health insurance being offered by their employer and they also have taken a retail health policy separately.
Or
Even there are people who have two retail health policies.
So the answer to the question is “Yes, one can claim hospital bill from two separate companies”. But you need to understand the process for the same.
For Example: A person has two health insurance policy (one could be from employer and other could be a retail health policy or both could be two separate policy). Policy from Company A with sum insured of Rs. 3 lac and another policy from Company B with sum insured of Rs. 6 Lac.
He wants to undergo a treatment which will cost him Rs. 8 Lac. Now he can’t opt for the cashless benefit from both the companies at one go, so he has to choose first of all either of the one company from which he wants to take the cashless benefit . Lets assume he opts for the Company B and was paid for Rs. 6 lac.
Now, this person has to approach Company A for the balance payment of Rs. 2 lac, for which he has to submit the below mentioned 2 documents.
- Claim settlement letter from Company B saying what was the total Bill and how much(in this case its Rs. 6 lac) has been settled by company B
- Xerox copies of all the documents like bills, discharge summary etc. Originals will no longer be available as that would be lying with Company B
After getting the above two documents, Company A will understand that total bill was Rs. 8 lac and Rs. 6 lac has already been paid by Company B. So they will pay the balance bill of Rs. 2 lac.
Few Important things to be kept in mind:
1.This person would be taking pre authorization from Company B for the cashless benefit with the help of hospital.
2. At the same time, what he should also do is just intimate company A saying he is undergoing xyz treatment in a hospital and would be opting for the reimbursement and should take a claim intimation ID from company A. This is one of the most important thing which we forget. Many a times it do happen that when it comes to reimbursement, we tend to ignore giving intimation to the insurance company assuming anyway you will apply for the reimbursement, but that approach is wrong. Its always better to intimate in advance and get a claim intimation number. And at the time of submission of claim form,just mention that claim intimation number on the same.
3. In the above example, this person is going for cashless benefit from company B first and then opting for reimbursement from company A at a later stage. However, its the right of this person as to which company to approach first. He could have done otherwise also that is opting for cashless with Company A first and then going for reimbursement with the Company B later