How can I split a large medical claim across insurers?

I have multiple health insurance policies from different insurers. In case of a large claim, how do I split it across insurers, and what documents are required for each?

Sarbvir Singh Joint Group CEO, PB Fintech: If you have multiple health insurance policies, start with the one offering the highest cashless coverage to reduce out-of-pocket expenses. For any uncovered amount, you can file for reimbursement with the second insurer by submitting the claim form, bills, discharge summary, prescriptions, and the settlement summary from the first insurer. If there is still some balance left, the third insurer can be approached similarly. That said, having multiple policies is usually not necessary. A single, comprehensive policy with a high sum insured is sufficient to cover most medical needs. The good news is that upgrading your sum insured from Rs 10 lakh to Rs 1 crore can cost just 10-15% more in premium. Given the minimal additional cost, it’s a smarter and simpler way to ensure you are well-protected.

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I have two health policies—an individual base plan of Rs 10 lakh and a group top-up plan of Rs 15 lakh, with a Rs 2 lakh deductible, for which I pay a Rs 4,500 premium. The top-up is due for renewal in two months. My bank now offers a top-up plan with a Rs 30 lakh cover and a Rs 3 lakh deductible at a lower premium of Rs 2,500. However, it’s a new policy with a 24-month waiting period for pre-existing conditions. Should I switch to the new plan?

Sarbvir Singh Joint Group CEO, PB Fintech: A retail health insurance policy guarantees lifelong renewability. It ensures you have adequate coverage well into old age, when health issues pose the most risk. While you can continue the former Rs 15 lakh group cover, it will be good to get an individual health policy with a high-value top-up for comprehensive protection. For instance, a Rs 1 crore top-up with a Rs 10 lakh deductible is a cost-effective way to secure significant coverage, typically available in the Rs 1,000–3,000 premium range, depending on factors like age and family size. If you are considering the new plan, you could look at its super top-up plan. Evaluate your options and ensure that long-term benefits outweigh the short-term savings.

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