I have an integrated medical insurance with riders for 100% cover at private hospital. Iam also provided with 100% medical coverage by company in government hospitals class A (i.e. if I'm hospitalised in private hospital, my company will reimburse me only up to the government hospital fees and I have to bear the differences).
Question:
How should i go about the claim process if I'm hospitalised in private / government hospital?
At the point of time u are register urself in hospital, u need to inform the hospital u are insured under which insurance company, in the system they can check and verify, it is apply for both private and government hospitals, but in case of they do not hav the system, then u can get a Letter of Guarantee LOG from the insurance company before u go to hospital. As long u hav those, basically u dont need to do anything, the hospital will settle the bill will the insurance company directly.
Then as there is a clause stated inside the private IP, it shall pay last, meaning that it will fully utilize ur company or other insurance benefit first before they cover the charges, eventhough they settled the bill with hospital first, but they will check and verify with ur company afterward to carry out the reimbursement themselves.
For instance, if u warded in private hospital, the insurance company pay first, then it will claim with ur company insurance afterward, as it is up to government A ward only, so that insurance company only can reimburse up to that limit and will responsible the remaining cost incurred.
In short, u actually no need to do anything.
