Health Insurance

POSTED BY anil kumar ON December 25, 2012 12:51 pm ONE COMMENT

Hi,

I’m having Apollo munich health policy of 5lac and recently my employer has taken apollo munich policy for employees of 2lac.

Pl’s advice how i can redeem above at time of emergency.

One reply on this article “Health Insurance”

  1. It is definitely possible to make claims from two individual mediclaim policies. In your case one is your and one is group, So best is to check with the group insurer is they will entertain a partial claim made with an individual policy. Probably prudent to check with the individual insurer as well..

    In case of cashless claim, a long hospital stay will likely exhaust one policy and the other can be called upon. However it would be best to inform both insurers about the hospitalization (sudden or planned as per the rules of the policy to avoid problems).

    Reimbursement is a little more tricky. Here also the hospitalization has to be notified to the insurer as per rules (sudden or planned. Planned probably before hospitalization). The copies of all documents has to be sent to one insurer and originals to the other clearly explaining partial claim is being from (I am assuming this will arise only when expenses is higher than one policy) both.
    The insurers may confer with each other and agree to pay some % of the total claim each (you are likely to get full amt if claim, is legitimate)

    This is why it is most crucial for you to ascertain if group insurer will accept partial claim.
    My guess is yes but it may reimbursement claims a bit. Best to check from both insurers

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