# Can you claim on 2 health insurance policies?



## leesider (11 May 2011)

Hi,

My husband and I both have private health insurance ( different companies) provided by our employers.
For many receipts/expenses, we only get a portion (50% or less) back as part of our claim.
Can we claim for these again under the other health insurer?

I have the original receipts - they were returned to me after the claim.


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## callybags (11 May 2011)

Most definitely not.

Most insurance policies have a clause written into them ( Think it's called an average clause) whick basically says they will not pay out if the risk is covered under another policy.

Apart from that, it's fraud.


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## flossie (11 May 2011)

You cannot profit from any form of insurance. It is there to return you to the position you were in before, not better.

I believe that with private medical insurance, what you don't receive back from the insurance company you can claim it as tax relief using the MED1 form.


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## horusd (11 May 2011)

No. If you have dual insurance technically both insurers share the same liability, meaning 50% each.


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## pj111 (11 May 2011)

It is an interesting question though. The principle of indemnity that exists in insurance and is defined as _financial compensation, sufficient to place the insured in the same financial position after the loss as he or she enjoyed immediately before the loss occurred_. It usually applies to benefit policies such as car, household, motor etc, but Health Insurance is slightly different. They have some of the characteristics of indemnity in that they will pay benefits to the insured for medical treatment received. Where it's different is that you don't receive the financial benefit. It's the hospital that gets the payment. This also insures that the policy of not profiting from insurance is upheld as and the amount paid will never exceed the cost of the treatment. 
  Where it's interesting though is what if, on an Out-patient claim,  each policy entitles you to claim say 50% of your G.P bills. If you claim from 2 policies, technically you are not profiting but simply being '_placed_ _in the same financial position as before'!_ 

The other interesting thing is the principle of contribution which arises when there is more than one valid policy in place. Contribution allows an insurer the right to call upon other insurers liable to the same insured to share the cost of an indemnity payment, but so long as the indemnity is not more that 100% of costs I'm not sure there is an issue!! I'd have to look it up.

I would suggest you thread carefully however. Everyone is entitled to health insurance, regardless of age, sex, health etc. However there is one way you can lose it. Be found guilty of fraud! I will look into it.

_Patrick._


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## leesider (12 May 2011)

Thanks for your responses. As the OP pointed out, I am not trying to profit by claiming on the second policy - merely trying to claim for the other 50% that has not been refunded


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## NovaFlare77 (12 May 2011)

Leesider, just to check - are you saying that both you and your husband have two health insurance policies each (e.g. he's listed on your cover with Insurer A, and you're listed on his with Insurer B). Or are you saying that your employer pays for your cover with one insurer, and his employer pays for his cover with another insurer?

If it's the former, then the earlier posts pretty much cover it the current position regarding out-patient cover. There may also be an issue when you or your husband make a claim for a hospital stay, as both insurers will only cover a proportion of the costs, meaning you would need to make two hospital claims. Otherwise you could be in breach of the insurer's rules. That may also get complicated if the two plans don't offer similar benefits.

If it's the latter, then a claim can only be made by customers of that insurer. So if your husband is not named on your policy, then he can't claim from your insurer for his costs, and vice versa.


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## leesider (13 May 2011)

NovaFlare77 - both my husband, my daughter and I are all covered on both health insurance policies provided by our employers. They were 2 different plans/companies that offered different benefits but in hindsight now since we are both paying BIK on them it seems like a waste of money. I am pregnant (going private) and due to the instability in the jobs market, we were trying to hedge our bets and ensure that we retained health insurance coverage should one of us loose our jobs.


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