Can I avail cashless facility from two TPAs at the same time?

I have an employer’s health insurance policy offering maternity benefit of up to 50,000. My spouse is also working and is eligible for maternity cover of another 50,000 from her firm’s health insurance policy. While third-party administrators (TPA) for these policies are different, is it possible to avail cashless facility from both TPAs?

—Name withheld on request

Generally, it is difficult to get multiple cashless requests for the same claim due to two reasons. First, insurers want to ensure the total claim amount does not exceed your total eligible expenses incurred. So, the second insurer would want to review the total bill amount and the final settled amount of the first insurer before reimbursing up to a maximum of the residual amount. Second, insurers seek to retain original bills and receipts to prevent the policy holder to claim the same amount twice. For cashless claims, hospitals send original documents directly to the insurer. To simplify the process, it is recommended to process a cashless claim with the first insurer and claim reimbursement from the second insurer for the residual amount. At the time of discharge from the hospital, the first insurer will provide a final settlement letter detailing the total bill and the amount paid by you. Submit this note along with medical papers, and original receipts for the residual amount to the second insurer.

A life insurance company launched a term life insurance with a unique proposition as it has bundled the life cover with the regular pension scheme. However, we need to pay double the premium amount compared to simple term life insurance. Should one buy such a plan?

—Name withheld on request

A term insurance plan and a pension plan are meant to solve two different types of risks of a policyholder. A term plan pays a lump-sum to the nominee of the policyholder in case of the latter’s untimely and early death. This helps the nominee maintain their usual lifestyle, even in the absence of income support from the policyholder. The policyholder does not get any maturity or survival benefits. With age, the need for a term cover comes down, because by the time one is old, they would have saved enough and paid off most of their financial liabilities.

A retirement plan will help a policyholder maintain a lifestyle post-retirement when the active income-earning period is over. During the deferment period, the pension plan accumulates a corpus. On retirement, the corpus is used to buy an annuity that provides regular income support during the retirement period and substitute the policy-holder’s active income. Therefore, it is far better to maintain two separate plans for the two objectives, as it would give you greater transparency on the amounts eligible under both objectives. It is also likely that separate plans would be more cost-effective for you.

Abhishek Bondia is principal officer and managing director at

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Updated: 01 Jun 2023, 11:19 PM IST

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