Newsletter
CONSENSUS ON DOUBLE-INSURED MEDICAL CLAIMS
Disputes often arise over the payment of medical insurance claims to individuals who have pur-chased more than one policy. The Ministry of Finance (MOF) recently stated that where a consumer buys multiple policies from the same insurance company, the insurer must not require the insured to provide original receipts for medical expenses in support of claims, unless this requirement is reasonably reflected in pre-mium rates.
The issue of double insurance involving more than one insurer was previously addressed by the MOF when it reviewed the Standard Terms for Hospital In-Patient Medical Insurance. At that time the MOF imposed a requirement that where an individual purchases multiple policies from different insurance companies, and where the insurers were given prior notice and did not re-fuse coverage, then in the event of an insured event occurring, all insurers must honor claims, and may not insist on the insured's providing original receipts.
The MOF's Department of Insurance (DOI) states that with regard to the situation referred to above, insurers have now largely gone over to calculating payments by multiplying the relevant daily hospital indemnity rate by the number of days of hospitalization.