Will my office policy cover maternity costs?

—Name withheld on request

Typically, group health insurance policies offered by employers carry a sub-limit for maternity delivery claims. There could be a separate limit for normal and cesarean delivery. So, your eligibility amount would depend on the type of delivery and the sub-limit.

You can claim for your maternity expenses from both policies. The aggregate of the two limits would be the total sum assured for you. However, the maximum you can claim would be the actual expenses incurred by you. If the total expenses are reimbursed by one policy, then you cannot make the same claim with the other insurer.

Generally, it is difficult to make concurrent cashless claims. So, you can avail cashless in either of the policies and make a reimbursement claim with the second policy.

In case both the insurers are on the hospital cashless panel, then choose the insurer with a higher limit for cashless. Once you are discharged from the hospital, you can submit the final settlement letter of the cashless claim along with all other treatment papers to the second insurer. Do submit the original receipts of the payments made by you.

Also, apart from the maternity claim, you should ensure to add your newborn baby to the policy. Unlike individual insurance, most group insurance policies cover the newborn immediately after birth, without any waiting period. This is a critical cover.

In case of any complications to the newborn, the policy covers the medical costs. The time window to enroll the newborn is usually within 30 days of birth. Often, new parents ignore this, due to maternity leave or lack of awareness. This can create issues later at the time of claim, if any.

Abhishek Bondia is principal officer and managing director at SecureNow.in.

Updated: 03 Jul 2023, 11:02 PM IST