While you can have multiple health insurance policies at the same time, you cannot make multiple claims across different companies for the same health expense or bill. That is, the maximum amount you can get from all the insurance companies together is the same as the amount you have spent. If your medical bill is more than the sum insured of one insurance policy, then only you can claim the balance amount from another company.
In the year 2013, the Insurance Regulatory and Development Authority of India (IRDAI) made necessary changes in the rules. Before these amendments in the rules, every health insurance plan had a contribution clause. At the time of claim, each insurance company used to contribute an amount in equal proportion to the sum insured. The amendment in the rules made the claim process easier. Now, if the claim sum is less than the insured, then the contribution clause is not applicable. However, if the claim amount is more than the sum insured, then this contribution clause is applicable. You can also decide for yourself which insurance company you want to claim first from.
(Read more: Policyholder's Responsibilities during Claim Settlement)
Cashless claim
In the case of a cashless claim, you file a claim with a company and the company settles the bill directly with the hospital. If the claim amount is more than your sum insured, then you can claim the remaining amount from another company. For this, you first have to pay the remaining amount yourself at the hospital. Then you will have to take a claim settlement summary from the first company. You will also need to take attested copies of all the bills. After this, you will have to claim a reimbursement from the other company for the remaining amount.
Reimbursement claim
A cashless claim is more convenient for the insured, as the insurance company settles the bill with the hospital itself. Despite this, it is not necessary that you would be getting treatment in a network hospital of the insurance company. In such cases, you have to first pay the hospital bill yourself and then claim reimbursement with your health insurance company. For reimbursement, you need to submit the claim application form to the insurance company along with all the original bills and hospital documents (these will be retained by the insurance company).
(Read more: Free look period in health insurance)