Whether you have been insured for years or are new to your policy, it is important to understand the claim process. If you hold multiple health insurance policies, you have to be adept at juggling the different covers.
The insurance regulator has simplified the claim process by removing the contribution clause to a considerable extent. Earlier, with the contribution clause, you had to notify all your insurers who would contribute to the cover amount in the ratio of the sum assured. Now, you can approach any of your insurers to settle the claim. If you have two insurers – A and B who have a sum assured of Rs 2 lakh each and your claim amount is Rs 2 lakh – you can claim the amount from either of your insurers.
However, if your claim amount exceeds the sum insured of your single policy after factoring in deductibles and co-pay, you can then decide on which insurer to approach first. The insurer may use the contribution clause. So, if your claim amount is Rs 3.5 lakh and insurer A has a sum assured of R3 lakh, while insurer B has a sum assured of Rs 1 lakh, insurer A will reimburse about 80%-90% while insurer B will reimburse only 10% (i.e. Rs 50, 000) of the claim amount.
