There are many health plans available and today many individuals are opting for more than one health cover. Many individuals are covered by employers, but they look for stand-alone health covers, in case they lose their job. Many others, especially high net worth individuals buy more than one policy to increase their health cover costs.
Group policies are more relaxed in their cover for pre-existing diseases, but individual policies cover these diseases after the policy has been valid for 3-4 years. Sometimes when the group policy cover is exhausted the individual health plan can be a savior. When you have a pre-existing illness or a doubtful claim, a group insurance payout will be easier.
AdvertisementMany general insurance companies sell plans separately - fixed benefit plans, critical illness covers, personal accident insurance. Many times health plan covers are not sufficient as many offer a fixed sum in case of hospitalization. There are many advantages by having multiple health covers, but the individual should understand all the intricacies and technicalities in case they need to make claims.
It is better to inform insurance companies about existing health covers, as not only is it mandatory but a moral obligation also. Most people have a misconception about declaring existing policies because they feel it could hinder claims.
When you have an individual and a group plan, use the group plan first as it will not increase your premium at the time of renewal. Individual covers may be charged higher premiums after a claim.
When an individual has policies from two different companies, the payout would be settled according to the contribution clause with IRDA rules. When the operating principals of both policies are similar the claims would be divided between both the companies equally.
When you make a claim, you will have to submit original documents and a written request. Once the claim is processed by the first insurer, your TPA will issue a settlement statement to the second insurer along with certified copies of all the documents.
The companies will make the payments according to their norms especially for pre-existing illnesses.
A fixed benefit policy offers a onetime fixed sum for hospitalization. The policy holder can claim cover from both companies separately. Fixed benefit policies include critical illness cover. Different companies will have different benefits depending on the type of policy taken. When the TPA is the same for different policies, the claim settlement is easier.
Hannah Punitha (IRDA Licence Number: 2710062)
bankbazaar.com, 5th March 2013