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What are the Ways to Get Maximum Claim from Your Health Policy?

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Published on September 12, 2022. EST READ TIME: 3 minutes

It is true that medical science has come a long way over the years. But at the same time, healthcare costs have gone up incredibly. In absence of health insurance plans with adequate coverage, all your savings can go into footing medical bills.However, many times, policyholders have noticed that despite having a great plan, the amount that gets sanctioned for a claim is not the amount they have spent at the hospital. It can be a frustrating experience. So, how do you get the maximum claim from your Mediclaimpolicy? Read on to know.

Ways to Get the Maximum Claim

1. Claim from multiple policies:

With multiple health insurance plans, you get maximum claim. If the medical expenses are more than the sum insured of the first health policy, you can claim the balance amount from the second insurance provider. As a result, you can get all or most of the expenses covered. One more advantage of having more than one policy is that if the sum insured of one policy gets exhausted in one claim, you can raise claims from the second policy during the policy tenure.

2. Restoration benefit:

If you have a Mediclaim policy of INR 5 lakhs and the sum insured gets exhausted in one claim, what will you do if there's another hospitalisation during the same policy year? With restoration benefits, the insurer will refill the same sum insured which can be used during the same policy period. However, this benefit is offered only once during the policy tenure.

3. Sub-limits:

To get the maximum possible health insurance claim amount, do not opt for any sub-limits like room rent capping, deductibles, etc. In such cases, a part of the claim amount needs to be paid by you.

4. Buy policy when you are young and healthy:

All health insurance policies come with a waiting period of 2-4 years. This waiting period is ailment-specific and for pre-existing diseases. Any claims raised during this period will lead to rejection. So, it is wise to purchase health insurance when you are young and healthy so that you can complete the waiting period. For instance, there is a waiting period for diabetes and if you are diagnosed with diabetes 4 years after buying the policy, all your expenses will be covered.

5. Do not hide any information:

At the time of buying a health insurance plan, be honest while disclosing your medical history. If you have been diagnosed with any medical condition before purchasing insurance, inform the insurer. Hiding any information with the assumption of getting maximum claim will not work because if the insurer finds out about your pre-existing condition, your claims will not only get rejected but will also lead to cancellation of the policy.

6. Renew on time:

Your health insurance claim will be settled only if the policy is active. If you forget to renew it on time and there’s an emergency, you will not get a single rupee from the insurance provider. Timely renewal is key to getting your claims settled.

Conclusion

Health insurance, no doubt, is an absolute necessity today, otherwise you will need to shell out your savings on hospital bills.A health plan protects you financially in case of an eventuality, but what if you don’t get the entire amount that you have spent on hospitalisation expenses? To avoid these hassles, it’s important that you read the terms and conditions of your health insurance plan carefully before purchasing it and keep the above tips in mind.

Disclaimer: The above information is for illustrative purpose only. For more details, please refer to policy wordings and prospectus before concluding the sales.

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