My husband and I each have a ₹10 lakh medical cowl offered by our employers. I’m pregnant and want to know the quantity that we are able to declare in direction of our hospital bills for the supply. Can we mix the covers from each the healthcare insurance policies and get cashless services for each?
—Name withheld on request
Typically, group medical insurance insurance policies supplied by employers carry a sub-limit for maternity supply claims. There might be a separate restrict for regular and cesarean supply. So, your eligibility quantity would rely on the kind of supply and the sub-limit.
You can declare on your maternity bills from each insurance policies. The combination of the 2 limits could be the full sum assured for you. However, the utmost you possibly can declare could be the precise bills incurred by you. If the full bills are reimbursed by one coverage, then you definitely can’t make the identical declare with the opposite insurer.
Generally, it’s troublesome to make concurrent cashless claims. So, you possibly can avail cashless in both of the insurance policies and make a reimbursement declare with the second coverage.
In case each the insurers are on the hospital cashless panel, then select the insurer with a better restrict for cashless. Once you’re discharged from the hospital, you possibly can submit the ultimate settlement letter of the cashless declare together with all different remedy papers to the second insurer. Do submit the unique receipts of the funds made by you.
Also, other than the maternity declare, you need to guarantee so as to add your new child child to the coverage. Unlike particular person insurance coverage, most group insurance coverage insurance policies cowl the new child instantly after start, with none ready interval. This is a crucial cowl.
In case of any problems to the new child, the coverage covers the medical prices. The time window to enroll the new child is normally inside 30 days of start. Often, new mother and father ignore this, as a result of maternity depart or lack of understanding. This can create points later on the time of declare, if any.
Abhishek Bondia is principal officer and managing director at SecureNow.in.
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Updated: 03 Jul 2023, 11:02 PM IST
