Can I Get Company Reimbursement with Xerox Bills if My Mediclaim Isn't Settled Yet?

Dear all,

I have a mediclaim policy and am also entitled to a medical allowance (reimbursement) from the company. Can I claim reimbursement from my company by showing xerox copies of the doctor's bill, as the original bills are with the mediclaim company and the claim is not yet settled? Is the company justified in not allowing me reimbursement on xerox bills? What they need is proof that the expenses were incurred for which I am claiming reimbursement.

The mediclaim may or may not be settled, and furthermore, mediclaim is my personal arrangement.

Awaiting your expert opinion.

Dear Himanshu,

Good case.

1. If your company has Medical Reimbursement health benefits, they will need the original bill. A photocopy of the bill is not acceptable. This is done so that an employee does not double claim the same from the company as well as the insurance company, thereby avoiding fraudulent claims. I am sure you are honest, but that's the book rule.

2. If your Mediclaim company does not reimburse you or partly reimburse you, you can always then submit the original bill to your company for your reimbursement, as the insurance company will return all the originals to you. So don't worry.

Hope that is helpful.

Ukmitra

@ UK Mitra,

But Mediclaim is a separate contract with the insurance company to indemnify the loss for which a premium is paid. Then where is the matter of double claim? From the company, I ask for my right, and from the insurance company, it is my indemnity contract, which is a solicited facility, and the premium is paid.

Well, my friend Prima Facie, you cannot claim insurance from two insurance companies on the same bill. It's termed "fraud" in the insurance world. In your case, your company is the insurance company for you.

Regards,
Ukmitra

Hi All, My company doesn't have a 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.

Hi Himanshu,

Fundamentally, the contract of insurance does not allow for profiting from insurance. You cannot be indemnified for an amount exceeding the loss incurred. With this in view, increasingly insurance companies do not allow any claims to be passed when documents, in whole or part, are presented as photocopies.

Hi Vinod Pawar,

As long as you had some health insurance policy on the date of admission to the hospital, you will be covered under the benefits of the health insurance cover. This is assuming that the treatment was for an ailment covered in the policy scope. If you share more details of the hospitalization, I may be better able to respond to your request.

Regards, Deepak
Subject Matter Expert - Health Insurance
Deepak@hii.co.in

Understanding Mediclaim and Medical Allowance

Mediclaim is for hospitalization. The insurance company pays it on your behalf or reimburses you as per the limits prescribed in the policy.

Medical Allowance

This is for domiciliary treatment. Reimbursements up to Rs. 15,000/- are not taxable upon the production of original bills.

If you don't have a mediclaim policy, you can claim the hospitalization expenses under the medical allowance up to the limit of Rs. 15,000/- per annum.

Hope it is clear to you.

Regards,
Pon

Hi All, I have health coverage from my company for both myself and my wife. I am planning to apply for a maternity claim through my company's health policy. The total expenditure incurred was Rs. 1L, but the maximum claim I can apply for in the case of maternity is Rs. 75k. However, my wife is also a working professional and has health coverage from her company. As my company cannot cover the entire amount, I am wondering if there is a way to merge the policies so that I can at least recover the expenses I have paid.

Regards, Ash

Yes, you absolutely can. This is what we call partial claim settlement under one policy and the balance under another. Do reach out in case you need specifics on how to get this done.

Deepak