Two health insurance claims

fjon · 22-10-2021 11:54am #1

Hypothetical question:

In the past both myself and my partner had health insurance through our employers, both of which covered spouses and kids.

Both policies would pay out 50% for things like GPs and dentists.

Would it have been possible to use one policy to pay 50% of a bill, and the other for the other 50%?

I imagine this is not allowed, but just wondering?

We cancelled one of the policies as there was no point in having two.

AngryLips · 22-10-2021 12:36pm

Not allowed

Jim2007 · 22-10-2021 3:37pm

Definitely not, it is in fact a criminal offence.

Furthermore, you are usually required to inform the companies that you are double insured so that each company get to contribute to the 50% claim, so each would pay 25% or so.

coylemj · 22-10-2021 3:39pm

https://www.boards.ie/discussion/comment/118057504#Comment_118057504

Technically there is no overlap. One policy covers half the expense, the other policy covers the other half. You are not recouping more than you paid so where is the problem?

Just spotted Jim's response above. If you are only partially covered under an insurance policy, surely it's possible to take out a policy 'B' to cover you 100% i.e. the excess which is not covered under policy A. Isn't that what you do when you buy car rental excess insurance?

Jim2007 · 22-10-2021 6:07pm

https://www.boards.ie/discussion/comment/118058690#Comment_118058690

Not unless a policy specifically says you are entitled to do so. Since the same underwriter often ends up cover the risk, they will exclude such a double risk and that is passed down. I worked on the design of AI systems to seek out such cases back in the day...in fact one of the features of our system was that we could handle the various tricks of the Irish market - combinations of Irish names and place names.

23-10-2021 10:52am

https://www.boards.ie/discussion/comment/118059284#Comment_118059284

That's nice. Where are you getting the customer data from other companies?

Jim2007 · 23-10-2021 1:03pm

https://www.boards.ie/discussion/comment/118061845#Comment_118061845

Why do you think you need data from other companies? You don’t care what risks they are taking on.

coylemj · 23-10-2021 5:58pm

Jim2007 said: Not unless a policy specifically says you are entitled to do so.

But in post #3 you said it was 'definitely not' possible.

Is it the case that, with no overlap, it is possible to spread the cover for the same risk over two policies? Both policies underwrite part of the risk but not adding up to more than 100%.

I don't understand why you're claiming that the OP is 'double insured'. Isn't it simply the case that he has two policies, each of which covers half his exposure? He cannot claim back more than the expenses that he incurs. So he is fully insured. No?

Lenar3556 · 24-10-2021 11:24pm

https://www.boards.ie/discussion/comment/118058682#Comment_118058682

We would need to see the detail of what is being proposed, and the terms of the individual policies. In fairness there is no suggestion in the OP’s post that he is intending on committing a fraud.

There could potentially be opportunity for some additional reclaim of subsidies for certain treatments etc, where the total value is not exceeded.

However, Any benefit is likely to be minimal and a fraction of what you or your wife are paying in BIK on two policies.

25-10-2021 1:22am

https://www.boards.ie/discussion/comment/118062329#Comment_118062329

One assumes that the OP was insured by two different companies, your "AI" isn't going to catch that.

FishOnABike · 25-10-2021 8:58am

https://www.boards.ie/discussion/comment/118069476#Comment_118069476

Many underwriters use different trading names to target different segments of the market, so what may appear to be different companies could just be different faces of the same underwriter.

fjon · 25-10-2021 5:50pm

Just to be clear:

For a time me and my wife were covered by 2 separate policies from the 2 biggest health insurance providers. When one was up for renewal we cancelled the "less good" one to save money on BIK and because we didn't need 2.

When I was recently charged a ridiculous €280 for a 15-min consultant visit I just wondered if we still had the two policies I could claim 50% and 50% from each.

Interesting to see the conversation that has arisen from this.

Two health insurance claims

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