Medical Reimbursement - Whether Allowed If Mediclaim Benefit Is Availed - CiteHR
Ukmitra
Business Development, Employee Relations,
Pon1965
Construction
Deepakmendiratta
Health Insurance ( Mediclaim ) - Policy Design,
Ashnig1
Service
+2 Others

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Dear all
I have mediclaim policy and also entitled to medical allowance (reimbursement) from company also.
can i claim reimbursement from my company by showing xerox copies of doctors bill. As original bill are with mediclaim company and claim is not settled yet.
is company justifiable in not allowing me reimbursement on xerox bills, wat they need is that expense is incurred for which i am claiming reimbursement.
Mediclaim may or may not get settled and moreover mediclaim is my personal arrangements.
Awailing your expert opinion
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Dear Himanshu,
Good Case.
1. If your company has Medical Reimbursement health benefits, they will need the orginal Bill. Photocopy of bill is not acceptable. This is done so that an employee does not double claim the same from company as well as Insurance company, thereby avoiding fradulent claims. I am sure you are honest, but that's the book rule.
2. If your Mediclaiom company does not reimburse you or partly reimburse you, you can alsways then submit the orginal bill to your company for your reimbursement, as the Insurance Company will return all the original to you. So don't worry.
Hope that is helpful.
Ukmitra
@ UK Mitra
But Mediclaim is a seprate contract with insu. co to indemnify the loss and for which premia is paid.then where is matter of double claim.
From co i ask for my right.
and from insu co. it is my indemnity contact, which is a solicited facility and Premia is paid
Well my friend prima fascia, you cannot claim insurance from two Insurance company on same bill. Its termed "fraud" in Insurance world. In your case Your company is insurance company for you.
Regards
Ukmitra

Hi All,
My company dont have Group Mediclaim policy right now. I was hospitalized for 5 days. Can i claim my medical expenses from my present company.?
Would appreciate your urgent reply on the same..
@ Himanshu: Fundamentally the contract of insurance does not allow for profiting from insurance. You cannot be indemnified, in total / absolute amounts, for an amount exceeding the loss incurred. With this in view, increasingly the insurance companies now do not alow any claims to be passed when documents in whole or part are presented as photocopies.
@ Vinod Pawar: As long as you had some health insurance policy as on the date of admission to the hospital, then you will be covered under the benefits of health insurance cover. This is assuming that the treatment was for an ailment which is covered in the scope of the policy. If you share some more details of the hospitalisation, I may be better able to respond to your request.
Regards, Deepak
Subject Matter Expert - Health Insurance
Deepak@hii.co.in
If company does not have mediclaim and if an employee meets with an accident while coming to working general shift, what will be the liability(if any ) on the company/
Understand what is mediclaim and Medical Allowance.
Mediclaim is for Hospitalisation. The insurance company pays it on behalf of you or reimbursing as per the limits prescribed in the policy.
Medical Allowance - This is for domiciliary treatment. Reimbursements upto Rs.15000/- is not taxable on production of original bills.
If you don't have mediclaim policy, you can claim the hospitalisation expenses under Medical allowance upto the limit of Rs.15000/- p.a.
Hope it is clear to you.
Pon
Hi All,
I have a health cover from my company for me and my wife. I would be applying for the maternity claim through my company's health policy. The expenditure incurred was Rs. 1L but the maximum claim I can apply for is Rs. 75k in case of maternity. But, my wife is also a working professional and she has a health cover in her company as well. Since my company is not able to cover the entire amount, can I somehow merge the policies so that I can atleast get back what I have spent?
Regards,
Ash
Yes, you absolutely can. This is what we call Partial claim settlement under one policy and balance under another. Do reach out in case you need specifics on how to get this done Deepak
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