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Group Health Insurance Cover

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If the insured has multiple policies, claim will be divided among all

MOST organisations these days offer group health insurance to their employees.


But, it is important to buy a personal health insurance too. This will ensure continued health cover for you and your family even if you change jobs. But, in case one is required to make a claim in case of hospitalisation, how does multiple insurance work?


Can an individual claim hospitalisation expenses from more than one company? The answer is yes and no. While, it possible to claim from more one company for the same hospitalisation, but one cannot claim more than the expenses incurred. Health insurance policies or mediclaim, as they are popularly known are mostly offered by non-life insurance companies. So, in case something happens and the insured has multiple health covers, the claim will be divided among all insurers, depending on the sum assured.

Group health insurance schemes are pretty wide in terms of coverage and features. For instance, pre-existing illnesses, maternity are instantly covered, which most individual policy covers after a waiting period. Ideally, at the time of buying additional cover; you must inform your company if you are already covered under any other health insurance policy.

So, is it beneficial to buy multiple policies? The answer is subjective. One can have multiple policies from different companies, depending on an individual's healthcare needs. For ex ample, one may take multiple policies to cover many illnesses or take policies from different companies to make sure hospitalisation is cashless.

Many life insurance companies have become aggressive player in the health insurance category.


Most life insurance companies are offering comprehensive health insurance and also offer riders that give health-related benefits even to critical illness. But life insurance companies that offer benefit pay out products. So in case of hospitalisation, you can claim from both non-life and life insurance companies. Life insurance company pay sum assured once the event occurs, irrespective of the expense incurred.

"One should not think about stocking up instead.


Instead, he/she must make decision based on their needs. Instead of buying many policies, it is better to buy a health policy that insures the maximum number of illnesses. One can opt for the second insurer, if the highest cover provided by the first company is not sufficient," said an official of Life Insurance Corporation of India (LIC).

Technically, there is nothing wrong in having different policies, as claim settlement is usually smooth. At the time of settlement, insurance companies ask for true copies of all hospitalisation documents, such as discharge cards.

Advantage of having a health insurance cover from a non-life insurance company and a life insurance company is that you can claim from both the companies separately. Issuers of fixed benefit policies usually do not insist on original hospitalisation documents.

Happy Investing!!

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You can write back to us at PrajnaCapital [at] Gmail [dot] Com

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