What happens to the health insurance policy after a claim is filed?
After you make a claim, the sum insured of your health insurance policy is reduced by the amount that has been paid out to you as compensation. Confused? Let’s take an example for better understanding.
Say you buy a medical insurance plan with a sum insured of Rs. 10 lakhs on the 1st of January, 2019. In the month of March, you meet with an accident (hypothetically speaking) and make a claim worth Rs. 2 lakh against your mediclaim policy. Now, for the rest of the policy tenure (April-19 to Jan-20) you have a sum insured of Rs. 8 lakhs remaining in your health insurance policy. As such, you can keep making claim against your health insurance policy until the sum insured is exhausted.
However, if you have opted for the reinstatement option, the sum insured of your policy will be restored to its original value (Rs. 10 lakhs) after you make a claim. Of course, the reinstatement feature needs to be added to your policy by paying a pro-rata premium.