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Date : Feb 9, 2009

Question

# IN CASE AN INDIVIDUAL BUYS HEALTH INSURANCE FROM 2 INSURERS FOR e.g. 2 lacs cover from each. IN CASE OF AN MEDICAL EMERGENCY WHERE THE BILLS RAISED AMOUNT TO Rs 300000/- CAN A CLAIM BE MADE FROM BOTH -SAY 175000/- FROM ONE AND 125000/- FROM THE OTHER INSURER ?-

The claims are settled on a proportionate basis of sum assured. The companies will give claims of Rs. 1.5 lakhs each. Please look at the example below to understand it better.

Suppose from company A you have insurance of Rs. 3 lakhs and from company B you have insurance of Rs. 2 lakhs with total sum assured of Rs. 5 lakhs. In case of claim of Rs. 1 lakh company A will pay you Rs. 60 thousand (3/5 th of claim) and company B will pay Rs. 40 thousand (2/5 th of claim).

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