You can claim from both corporate and personal health policies, but here’s how to avoid rejection and maximise your coverage in case you spend beyond the available limit.
Many people get their health insurance through their workplace, but some also maintain an individual policy for extra protection in critical times. Even though corporate policies are convenient, they often have limitations like coverage caps, treatment restrictions, or lapsing when you change jobs. Siddharth Singhal, Head of Health Insurance at Policybazaar, explained in a Mint report, “If the claim amount exceeds the sum insured under a single policy, one can claim the balance amount from the other policy.”
However, he highlighted that both insurers must be informed about the other policy. “Non-disclosure of a parallel policy is one of the most common reasons claims get rejected,” he said.
Vineet Gupta, Head of Product Development at ManipalCigna Health Insurance, clarified the process: the total reimbursement across both policies cannot exceed the actual hospitalisation costs, and the same expense cannot be claimed twice.
For example, if your hospital bill is Rs 10 lakh, and you have Rs 5 lakh coverage under a corporate policy and Rs 5 lakh under a personal plan, you can first use the corporate policy to cover Rs 5 lakh. The remaining Rs 5 lakh can then be claimed from your individual policy. All original bills and the settlement summary from the first insurer must be submitted to the second insurer.
Gupta advises exhausting the corporate cover first, as it is employer-funded and ends when you leave the organisation. “Many individual policies offer renewal benefits such as no‑claim bonuses or premium discounts for claim-free policy years,” he said.
Common Pitfalls And Claim Rejections
Experts note that the second claim may be partially or fully rejected due to:
Non-disclosure – Failing to inform the second insurer about the first claim.
Duplicate claims – Attempting to claim the same expense twice.
Incomplete documents – Missing bills or settlement certificates.
Late notification – Not informing insurers promptly.
Policy exclusions – Different sub-limits or caps may reduce coverage.
