Tag: health insurance

IDFC FIRST Bank debuts FIRST Private Infinite Card, India’s first standalone metal debit card, BFSI News, ET BFSI

Banking & Finance

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Mumbai (Maharashtra) [India], December 1 : IDFC FIRST Bank today announced the launch of FIRST Private Infinite, the country’s first-ever standalone metal debit card, in partnership with Visa, the global leader in digital payments.

FIRST Private Infinite is a lifetime free card designed specifically for customers who are part of the Bank’s FIRST Private program, a premium savings and wealth offering. The FIRST Private program offers an unrivalled banking and investment experience to customers and comes with a range of exceptional investment, banking, lifestyle and wellness benefits.

A statement black card, FIRST Private Infinite is crafted from hybrid metal with details etched in silver, created to deliver an exclusive payment experience. True to its top-of-the-line proposition, the benefits of FIRST Private Infinite debit card are specifically curated for premium cardholders and include complimentary domestic and international lounge access for cardholders and companions, unparalleled insurance coverage, a road assistance program and access to golf courses across the country.

Amit Kumar, Head – Retail Liabilities, IDFC FIRST Bank, said, “Metal cards are preferred by customers given their distinctive look and feel. Our FIRST Private Infinite debit card adds luxury and style to our customers’ payments experience. It is crafted to stand out fresh and aligns with the exclusivity of the FIRST Private program. As the industry’s first metal debit card, FIRST Private Infinite takes our cards portfolio to the next level of quality and excellence.”

T R Ramachandran, Group Country Manager, India and South Asia, Visa said, “At Visa, we are delighted to partner with IDFC FIRST Bank on their affluent debit proposition – the FIRST Private Metal debit card. A set of carefully curated benefits and experiences across travel, health & insurance, dining, entertainment and lifestyle, coupled with the power and promise of the Visa network and brand, is sure to resonate with affluent Indian consumers and households. We eagerly look forward to the launch and scale-up of this innovative card offering.”

IDFC FIRST Bank offers a comprehensive digital savings account solution that includes a seamless online account opening process, video KYC and a new age digital platform for mobile and netbanking with easy-to-navigate user interface. The Bank’s digital wealth management solutions are available to customers on the mobile app and netbanking platform which offer unique features such as a ‘Consolidated Investment Dashboard’.

Created in 2018 by the merger of renowned infrastructure financing institution IDFC Ltd. and leading technology NBFC, Capital First, IDFC FIRST Bank, with a balance sheet of Rs. 1,72,502 crore, has provided over 30 million loans in its combined history and serves customers in over 60,000 villages, cities and towns across the length and breadth of the country. In a short time, the Bank has expanded to 599 branches, 185 asset service centres, 720 ATMs including 99 recyclers and 630 rural business correspondent centres across the country, a next-generation net and mobile banking platform and 24/7 Customer Care services, and is incrementally growing digitally. IDFC FIRST Bank is committed to bring high-quality banking at affordable rates to India. The Bank also offers technology-enabled corporate banking solutions.



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Niva Bupa aims ₹5,000 cr gross written premium by 2023-24

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Niva Bupa Health Insurance Company Ltd (Niva Bupa), a standalone health insurer, on Monday said it aims to achieve a gross written premium (GWP) of ₹5,000 crore by 2023-24.

This timeline is now one year ahead of the FY 24-25 period earlier indicated – for achieving the ₹5,000 crore GWP milestone – by the senior management in an interaction with BusinessLine in July this year.

Given the strong growth seen in the last 24 months, the company is now looking to close the current fiscal with GWP of ₹2,700 crore against the earlier projected level of ₹2,500 crore.

Niva Bupa, which was formerly known as Max Bupa Health Insurance, also said on Monday that it wants to bring as many as 10 million people of the country under the ambit of health insurance by the end of FY23-24.

Targets covering more people

This standalone health insurer’s MD & CEO, Krishnan Ramachandran, had in July indicated to bring 10 million people under health insurance by 2024-25.

Niva Bupa, which is currently having a presence in 350 cities, will further increase its presence to over 600 cities by FY23-24, it said on Monday.

“We are overwhelmed with the growth seen in the last 24 months. We are aggressively expanding our direct and digital partnership with massive regional expansion helping us to maintain rapid growth. We are fully committed to accelerating the adoption of health insurance across the country, making quality healthcare more accessible to the people,” Krishnan Ramachandran, MD&CEO, Niva Bupa said.

Niva Bupa is a joint venture between Fettle Tone LLP (an affiliate of True North Fund VI LLP), a private equity firm, and the Bupa Group, an international healthcare company. True North owns 55 per cent shareholding in Niva Bupa, while Bupa owns 44 per cent equity stake. This standalone health insurer is increasing its footprint pan India through its bancassurance partnerships with 15 banks.

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We remain optimistic on growth, says ICICI Lombard CEO

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With the merger of Bharti AXA’s non-life business complete, ICICI Lombard General Insurance is excited about the business opportunities it has brought. In an interview with BusinessLine, Bhargav Dasgupta, Managing Director and CEO, ICICI Lombard outlines plans for the company post the second wave of the pandemic. Excerpts:

What is the strategy for the second half of the fiscal, especially with the merger of Bharti AXA’s non-life business?

We remain optimistic. For us the focus was in terms of getting the integration done. We got the approval and we had three working days to make it effective. It has gone smoothly. We are now working as a team. The reorganisation also has happened. Apart from that, there are a lot of business opportunities that we remain confident about. We believe health will be a big opportunity, we think motor will come back, and our corporate lines are doing well.

What’s the roadmap going forward post the Bharti AXA transaction?

Bharti AXA’s non-life business is around 20 per cent of our size as a company. As part of the transaction, we diluted about 7.3 per cent of our company. There are two things that we are looking at in terms of business, apart from people integration. One is the operational synergies. Over the last 12 months since we announced the deal, we’ve done a lot of preparatory work. Next three-to-six months we want to implement some of those things. The second is the revenue synergy and that is visible in terms of our quarterly numbers. We believe there is an even bigger opportunity with their distributors to give them new products. Some of these partners can sell more products in more markets. There is a scope for growth.

Are you re-entering the crop insurance segment?

We are already back in crop insurance because Bharti AXA was writing crop insurance. We will have the crop business, but as a percentage of our overall business, it may be relatively low. For the whole year, it will be about five per cent of our business. We want to stay invested and see how it goes for a couple of years before we take a decision on it.

We had a concern in crop insurance at two levels — one the reinsurance terms became very unfavourable. The underwriting aggression was also a bit high. And some of the challenges were in terms of the ground level implementation of the scheme on the crop cutting. Now, improvements has happened on all of these, so we’ll have to observe it.

As an industry, we are paying 18 per cent GST for health insurance, which is extremely high compared to global standards. The GST rate could be reduced to 5 or 12 per cent Bhargav Dasgupta MD and CEO ICICI Lombard

Motor segment continues to be very weak right now. Is that a concern?

There is an interesting dichotomy in motor, which has three components – private car, two-wheeler and commercial vehicles. In private cars, there is demand but there are supply-side constraints in terms of chip shortage.

On the two-wheeler, there is no supply-side issue but there seems to be a demand constraint at this point in time. It’s very unusual. We are hopeful that this festival season, the two-wheeler demand will pick up.

Motor third-party insurance rates have not increased. Is that another concern?

That is of course a concern because typically, the regulator would look at the actuarial data and give a price increase every year. It had issued an exposure draft in February-March of 2020, which had talked about a price increase about 7-8 per cent on a portfolio basis. That did not take place because of the pandemic-induced lockdown. This year, again, we had the second wave, so there was no price increase. In the meantime, there have been some judgments from the Supreme Court, which has increased the cost of claims. It’s an area of concern. We as an industry, need a price increase.

Any wish list for the Budget?

One wish list is for the budget, the other is for the GST Council. As an industry, we are paying 18 per cent GST for health insurance, which is extremely high compared to global standards. The GST rate could be reduced to 5 or 12 per cent. It’s been reduced to 12 per cent for commercial motor policy. Something similar on the health will be one ask that the industry has had for a long time. And a linked issue is the input credit for corporates as when they buy health insurance, they also don’t get that benefit.

On the Budget, we respect the fact that there are a lot of fiscal constraints and that the Finance Minister wants to streamline the personal benefits. But within the benefit pool that is there, if there could be some increase for health insurance and something for home insurance, in terms of tax breaks. It won’t be very expensive for the exchequer, but it will be a good nudge for people to buy insurance.

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Is HDFC Ergo Optima Secure value for money?

Personal Finance

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The outbreak of the pandemic along with the rising incidence of lifestyle-related illness has not only highlighted the importance of having health insurance but also having sufficient cover (amount).

Additionally, a health policy should not only cover hospitalisation expenses but also offer other benefits including OPD, daily cash benefit in case of hospitalisation, restoration of sum insured (SI) in case of claim and no claim bonus (NCB).

HDFC Ergo has recently introduced one such product, Optima Secure. Here is a review of the product features.

What’s on offer

The SI under the Optima Secure policy starts from ₹5 lakh and goes up to ₹2 crore. It provides all basic covers like other health policies such as hospitalisation expenses including day care treatment expenses, AYUSH treatment, home healthcare (domiciliary hospitalisation), organ donor expenses, pre and post hospitalisation expenses, and cumulative bonus benefit.

The policy also covers the cost of preventive health check-up on each continuous renewal of the policy.

The highlight of Optima Secure is that it offers a cover of more than the base SI (cover amount) to all policyholders.

The ‘Secure’ benefit of the plan offers additional coverage amount equivalent to 100 per cent of the SI.It also offers a ‘Plus’ benefit, where on policy renewal, the policyholder receives 50 per cent of the base SI, irrespective of the number of claims made.

It also provides Cumulative Bonus benefit, where the base SI increases by 10 per cent for every claim-free year subject to a maximum of 100 per cent of the base SI.

Then there is an automatic Restore benefit. Under this, in the event of complete or partial utilisation of the base SI, the plan offers to restore it fully. This is irrespective of whether the secure or plus benefit or the cumulative bonus SI is utilised.

Let’s understand this with an example. Say Joe’s base SI is ₹10 lakh. As soon as he purchase the policy, he gets the Secure benefit. So his SI stands at ₹20 lakh (10 + 10). If the restore benefit is considered, then his total SI stands at ₹30 lakh during a policy year.

Additionally, Optima Secure also offers daily cash benefit for shared room (₹800 per day, maximum of ₹4,800), air ambulance service, and e-opinion for critical illness.

The policy also offers two add-on covers (riders) for additional premium – my: health critical illness cover up to ₹5 crore and my: health hospital cash benefit .

Our take

HDFC Ergo’s Optima Secure offers more than sufficient health cover for a policyholder and one can consider this plan only if you are looking for additional cover (amount) over and above the base SI.

The benefit of additional SI comes handy during medical emergencies and for those with existing medical conditions in the family.

Also, the plan doesn’t have any sub-limits or SI capping including for day care procedures, ICU or intensive cardiac care unit, road ambulance services and on modern treatments such as oral chemotherapy and stem cell therapy, unlike some health policies. For instance, HDFC Ergo’s Optima Restore plan has a sub-limit on road ambulance service of up to ₹2000 per hospitalisation.

But keep in mind a few points. One this Secure benefit is available only once in a policy year and does not carry forward to the next policy year. Even the automatic SI Restore feature is available only once during the policy year.

Two, though in most cases, the hospitalisation expense requirements are often met with the additional SI offered under Optima Secure, there are products in the market such as Max Bupa’s ReAssure plan and Care Plus plan from Care Health Insurance that offer restore benefit multiple times in a year.

Three, under Optima Secure, the NCB (cumulative bonus) benefit increases 10 per cent each claim-free year but there are products in the market which double the NCB or increase it 50 per cent for each claim-free year up to a maximum of 100 per cent of base SI.

The ReAssure plan from Max Bupa increases the same by 50 per cent for each claim-free year. Manipal Cigna’s Pro Health plan offers guaranteed increase in SI by 10 per cent up to 200 per cent (of base SI ) every year irrespective of the claims

And lastly, while Optima Secure offers comprehensive coverage, it may appear slightly expensive compared to other products in the market.

For instance, under Optima Secure, for a ₹10 lakh cover for a family (husband and wife; 30 years), the premium works out to ₹19,106 (including GST) per year.

Under Max Bupa’s ReAssure, the premium is around ₹11,321 (including GST) per year.

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Demystifying restore benefit in health insurance

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Since the outbreak of Corona virus many people have filed health insurance claims, resulting in partial or complete exhaustion of their sum insured (SI) or health cover amount. While the claim would have reduced the policyholders’ SI, most health policies in the market come with a built-in back-up option. In other words, insurers fully reinstate the original SI once it is exhausted. This means after the entire cover amount is used up in a policy year, there will still be a cover available to the extent of the SI.

The reinstatement of SI feature is also known as restore, recharge, refill or reload feature across insurers and is available in case of hospitalisation. But there are minor drawbacks to this feature. Here is all what a policyholder should know about this benefit.

How does it work

Almost all health insurers offer to refill your original health cover amount post a claim but the process varies across insurers.

A restoration of SI in your health policy can happen in two ways. One, an insurer refills the used-up portion of SI only after complete exhaustion of the policy amount. Say suppose, your health cover is ₹10 lakh and during the policy period you utilise the entire amount. Then, the refill feature come into play and reinstates your cover up to ₹10 lakh, which was your original SI. But if you claim only ₹5 lakh in this scenario, your SI stands at ₹5 lakh only. For instance, policies including Manipal Cigna’s Pro Health Insurance plan, Activ Health from Aditya Birla Health insurance, ICICI Lombard’s Complete Health insurance and Star Health’s Star comprehensive plan offer this benefit.

Two, there are some policies in the market which offer to reinstate the cover even if there is partial utilisation only. That is, if you claim ₹5 lakh out of ₹10 lakh (SI), then the SI is reinstated up to ₹5 lakh and your total health cover is ₹10 lakh post the claim. Policies that offer this feature include Max Bupa’s Go Active, HDFC Ergo’s Optima Secure plan, Arogya Supreme plan from SBI General and Lifeline plan from Royal Sundaram General Insurance.

Take note

While with the restoration feature, you and your family will never run out of health coverage during any policy year, policyholders should be aware of three key points.

One, typically, the restore benefit is available only once during a policy year where 100 per cent up to base SI is reinstated after complete or partial exhaustion of base SI. If there are multiple claims during the policy year, then the restore benefit may not help. However, there are a few policies in the market that offer unlimited restoration benefit during the policy period if you exhaust your health cover completely or partially. Care Plus plan from Care Health Insurance, Max Bupa’s ReAssure plan and Manipal Cigna’s Pro Health Insurance plan are a few examples.

Second and one of the most important points to remember is that, an insurer reinstates the SI and the same will be available only for subsequent claims. That is, if you make a claim for ₹5 lakh for heart-related ailments (SI is ₹10 lakh), the insurer will restore ₹5 lakh that you have claimed but it can be utilised only on your next claim and not for your current claim. So, even if you exhaust ₹10 lakh and the total claim amount works to ₹12 lakh, the balance ₹2 lakh has to come from your pocket. This is because the ‘restored’ SI will be available from next claim onwards.

Also, most policies do not offer the ‘reinstated’ SI for the same illness for which you had made the claim in a policy year. Say, you have claimed for one specific heart-related illness, then the ‘restored’ or ‘reinstated’ SI may not be used for the same ailment by the policyholder. However, there are a few policies in the market such as ReAssure (Max Bupa) and Care Plus (Care Health Insurance) that do cover for the same illness subsequently.

And lastly, the restored or reinstated SI if unutilised during the policy year, expires. That is, it cannot be carried forward for next year. It will also not be considered for no claim bonus (a reward that policyholders receive from the insurer for staying healthy and not making any claim on the policy in a year) calculation.

In case you have an older health policy which doesn’t have a restore or refill feature, then you can consider migrating, though ‘restore’ benefit shouldn’t be your only criteria for policy selection. If the policyholder feels he/she is missing out on the new features such as restoration, then one can consider migrating or porting to a new policy. Indraneel Chatterjee, Co-Founder, RenewBuy says “The decision for migrating or porting should be based on three key factor – premium comparison, room-rent capping and co-payment clause. Only if these factors are favourable, one can check other features such as restore or refill”.

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3 add-on health insurance covers to consider

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A health insurance policy plays a significant role in providing financial stability for an individual and his/her family at the time of medical emergencies. Typically, a health policy offers to cover hospitalisation expenses along with pre- and post-hospitalisation expenses, day care treatments (treatment procedures that require hospitalisation for less than 24-hours), and accidental injuries, among others. While it is important to have sufficient coverage amount at all times, sometimes a base policy may still not be enough to cover other expenses. You can then consider going for one or two riders/optional covers, depending on the need. Keep in mind that these add-ons involve payment of additional premium. Here are a few riders worth considering.

Hospital cash benefit

While a health policy takes care of hospitalisation expenses, you may still end up paying for certain charges while are still hospitalised. These expenses are usually inadmissible at the time of filing a claim, and include the cost of hospital gowns, gauzes, adhesive bandages and maintenance and housekeeping charges and conveyance charges. This is where the hospital cash or daily cash benefit comes in handy. It means, if the policyholder gets hospitalised, your health insurer will pay you a lump sum amount for every day of hospitalisation up to a certain number of days up to a maximum limit (varies with insurers). For instance, in ICICI Lombard’s Complete Health Insurance plan, the hospital daily cash made available is ₹3,000 per day for up to a maximum of 10 days of consecutive hospitalisation (minimum 3 days) for sum insured (SI) of ₹15 lakh and above. The daily cash limit is ₹2,000 per day if the SI is less than ₹7 lakh.

Most insurers including Tata AIG, ICICI Lombard, HDFC Ergo Health, Max Bupa, Bajaj Allianz, Star Health and Digit, offer hospital cash benefit as an optional cover for additional premium, while some insurers offer this as an in-built cover.

Tata AIG’s Medicare, for instance pays 0.25 per cent of SI up to a maximum of ₹2,000 per day of hospitalisation for shared room accommodation.

Critical illness

A critical illness (CI) cover is offered as a rider or as an optional cover by many health insurers. Under this, the insurer will make a lumpsum payment at the time of diagnosis, after which this cover terminates. Remember that, there is no restriction on the usage of the amount received. Primary breadwinners of their families, who don’t want to take chances on their health can consider this rider. Do note that the insurer will make payment only for certain diseases mentioned in the policy document and the payment varies across insurers and diseases. For instance, HDFC Ergo’s Optima Secure plan offers critical illness cover with SI of ₹10 lakh to ₹2 crore CI. Similarly, 100 per cent of the SI opted is paid out in case of Manipal Cigna’s ProHealth plan. Both policies also offer expert opinion if the insured requires it for the CI.

OPD benefit

Another rider cover to consider is OPD (outpatient department) where it covers expenses such as doctor’s consultation fees, pharmacy bills, dental treatment expenses and non-allopathic treatment. Most of the health policies offer OPD in-built in the policy but there are a few that offer this as an optional or add-on cover. Policies including ICICI Lombard’s Complete Health Insurance plan and Max Bupa’s Go Active offer in-built OPD cover while policies such as Activ Health from Aditya Birla Health and Care’s Care Freedom offer it as optional cover. Ideally those who go to the pharmacy or consult doctors often can go for an OPD cover.

But, if your plan already has OPD in-built there are other optional covers to consider. One is a maternity cover, offered by many insurers, which can be considered if a couple plans to have a baby.

Alternatively, reduction in waiting period cover can be opted. This comes in handy for those who are already suffering from pre-existing conditions such as asthma or diabetics. Generally, the pre-existing disease waiting period ranges from 2-4 years across insurers. With this rider cover, upon payment of additional premium, your waiting period of say, four years, will come down to say 1-2 years. You can also use the cover to reduce the maternity waiting period (usually 4 years), if the insurer offers it.

Hospital cash can pay for inadmissible medical expenses

Critical illness cover offers lumpsum payment

OPD benefit is useful to pay for doctor’s consultation fees, non-allopathic treatment

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Max Bupa Health Insurance rebrands as Niva Bupa

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Max Bupa Health Insurance Company Ltd, which is now rechristened as Niva Bupa Health Insurance Company Limited, has rebranded itself as ‘Niva Bupa’, Krishnan Ramachandran, MD and CEO, Niva Bupa has said. This stand-alone Health insurer will look to complete its brand transition by December this year.

This new brand identity of ‘Niva Bupa’ comes in the wake of change in shareholding pattern, with the exit of Max India and entry of Private Equity firm True North in 2019. True North now owns 55 per cent, while Bupa owns 44 per cent in the new legal entity Niva Bupa Health Insurance Company Ltd.

Also read: Max Bupa Health Insurance and Axis Bank enter into a Bancassurance partnership

“The decision of the new brand name was based on a survey and in-depth interviews with millennials and middle-aged customers. The term Niva is derived from a Sanskrit word that means ‘Sun’ — a symbol of hope, source of energy and positivity.” Ramachandran said.

“Following the shareholder transition of Max Bupa from Max India to True North in 2019, we are ready with our new brand identity as Niva Bupa. The new brand will stand at the intersection of financial services and healthcare to fulfill the needs of the people in India. The health insurance industry is poised for a monumental growth, and we will take our new brand identity to our customers with a renewed promise of protection and care. Our core purpose and brand ethos will remain unchanged,” Ramachandran added.

He said that under the new brand Niva Bupa, the standalone health insurer will continue to expand its digital and network presence.

Business goal

Ramachandran said that the company expects to become a ₹2,500 crore company by the end of this fiscal and is eyeing ₹5,000 crore Gross Written Premium (GWP) by FY25. Niva Bupa will bring over 10 million people in India under the ambit of health insurance by FY25, he added.

“The company grew at 41 per cent overall last year and this year in Q1 our growth has been in excess of 90 per cent. We have been able to grow with our suite of products and services. We want to serve our customer needs in these times so I would say, one brief highlight of the journey has been around growth”, Ramachandran told BusinessLine.

He said that the company had opened 50 new offices this year. Niva Bupa plans to take the total count to over 200 offices across the country in the next two years.

The company is currently engaged with over 70,000 agents across the country and has about 13 bank partners, who distribute its products through about 30,000 branches.

Public listing

On plans to take Niva Bupa public, Ramachandran said that there are no immediate plans to go to the public markets. He highlighted that the shareholders — True North and Bupa—are committed to bring the required growth capital.

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Max Bupa Health Insurance and Axis Bank enter into a Bancassurance partnership

Banking & Finance

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Max Bupa Health Insurance, a standalone health insurer, has entered into a bancassurance partnership with Axis Bank, the country’s third largest private sector bank. This partnership will help provide comprehensive health insurance solutions to Axis Bank’s employees and customers.

The tie-up will enable millions of Axis Bank customers across 4,500 plus branches to gain access to quality healthcare solutions through a range of health insurance products offered by Max Bupa.

Also read: FREO partners with HDB Financial Services to offer lending solutions

Max Bupa Health Insurance will offer indemnity as well as fixed benefit products, and their customisable variants to the diverse customers of the bank across the country. Axis Bank also has an existing health insurance tie-up with Aditya Birla Health Insurance.

A bancassurance is a relationship between a bank and an insurance company that is aimed at offering insurance products to the bank’s customers.

Satheesh Krishnamurthy, Head – Private, Premium Banking & Third-Party Products, Axis Bank India, said in a statement, “We are happy to partner with Max Bupa to offer customisable variants of bespoke plans to our customers across the country. The health insurance products in collaboration with Max Bupa are tailored to suit the needs of every customer and ensure that our products are always at the right place, at the right time and at the right price.”

Also read: FinMin may favour CSR monies to flow into Social Impact Bonds

Krishnan Ramachandran, MD & CEO, Max Bupa Health Insurance said, “We are excited to announce our first banca partnership of this fiscal with the third largest private sector bank in India. The alliance with Axis Bank is a significant push towards our growth plan and will allow us to extend our reach to millions of Axis Bank’s customers across network, especially in these pandemic times. The alliance with Axis Bank will also fortify our position as one of the most successful partners in the BFSI domain in times to come.”

The partnership between Axis Bank and Max Bupa Health Insurance comes at a time when people recognise the significance of health insurance to cover medical emergencies. The pandemic has reinforced the need for health insurance, making it indispensable in both tier-1 as well as tier-2 and -3 cities. The focus of this alliance will be on customer-centricity, product innovation, digitisation and execution, fuelling growth for the next phase.

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How to claim from multiple health plans

Personal Finance

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Since the outbreak of pandemic last year, many individuals have considered purchasing a health policy for self as well as for family. While having one health policy with sufficient cover based on individual or family needs is adequate, many end up having multiple health policies. Usually, as policyholder you will have a group cover from your employer and an individual health cover (as the group cover offered may not be sufficient) or in some cases, it can be two separate policies from different insurers. At the time of claim, if you are among those individuals with two or more health policies, here is how you should go about the claim.

One by one

Almost all insurers have wide hospitals under their network to make cashless facility hassle free for the policyholders. Barring a few scenarios, including certain treatment or diseases not covered by the policy and treatment taken in a non-network hospital, your health policy should be able to meet the hospitalisation expenses for you (cashless). But irrespective of the number of policies, you can make one claim at a time only, be it cashless or reimbursement. This is because insurers require policyholders to submit the original bills while filing a claim.

Suppose you have two health policies and you want to have cashless under both, then you must indicate to the hospital or the TPA about this. Many insurance experts suggest that it is better to exhaust the sum insured of one policy before claiming from another. Priya Deshmukh Gilbile, Chief Operating Officer, ManipalCigna Health Insurance, says “In case of a cashless claim, with the same TPA, the co-ordination for two or more policies become easier. Even if the TPAs are different for the policies held by policyholder, cashless can be done. The approval letter from the first insurer has to be submitted to the second insurer for the remaining claim amount”

However, there could be practical difficulties when it comes to cashless claims from multiple insurers. According to Indraneel Chetterjee, Co-Founder, RenewBuy “While cashless facility from multiple policies is doable by TPA/insurer, there could be a little struggle in terms of co-ordination between the TPA, insurer and the hospital due to incremental operational work.”

Hence you can also plan your claim (medical expenses) part cashless and part reimbursement. Suppose you have two policies of ₹5 lakh each and your expenses work out to ₹6 lakh. In this scenario, up to ₹5 lakh, the hospital/TPA will co-ordinate with the insurer. For the balance amount of ₹1 lakh, you as policyholder need to submit the bills given by the hospital along with discharge summary (which will mention the claim covered) to the other insurer for reimbursement. It could help you have a smooth claim procedure and avoid unnecessary delay at the time of discharge or while starting a treatment.

Keep in mind

While having multiple health policies has its advantages, there are a few points to keep in mind, when making a claim, in order to reap the maximum benefits.

One, you should go for the policy which has minimum or no co-payment (where policyholder agrees to pay a certain percentage of medical expenses and the balance paid by the insurer) or sub-limits (refers to the limits for a certain medical treatments or diseases in a policy) clauses. This is so that the difference between medical bills and claim amount (settled by insurer) is low. If you have to choose between a group cover and an individual health cover, then go for group health insurance first. This is because, the benefits of no-claim bonus remains intact.

Two, it is important to disclose to each insurer about the multiple policies you hold, if specifically asked in the proposal form at the time of purchase of health policy. The non-disclosure of the other policies may affect at the time of claim as it is a breach of (insurance) contract and insurer have the right to reject or not settle your claim. However, not many insurers ask for this disclosure these days.

Lastly, while there is no cap on the number of health policies that you can buy, the premium amount you shell out for every renewal could be high for all the policies. Amit Chhabra, Head Health Insurance, Policybazaar.com says “For policyholders it is better to have a base policy and then have top-up plans from the same insurer, as it will work out to be affordable and for easier claim, instead of having separate policies from different insurer. ”

Exhaust sum insured of one policy before claiming from another

Divide claim into cashless, reimbursement

Have base policy and top-up plan from the same insurer

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