Question

Dear HR Professionals,

We have a staff who submitted a pre-hospitalization medical claim (within our claim limit) and at the same time submitted the same to his personal insurance. Would like to hear your view on such claim (double claim)?

IC

Reply 1

There is no way to double claim. There is only 1 original receipt. Personal insurance is always the payer of last resort. If your employee has submitted to his personal insurance to claim first (because of the faster claim process), he or she can later claim from the company group insurance to restore his personal insurance claim limit. So this way it is as though the personal insurance has not been activated, therefore preserving the personal insurance claim limit. You should ask your employee if this is his or her intention. You mentioned pre-hospital claim so I also assume the hospitalisation claim has already been settled too.

KS

Reply 2

You may demand the staff submit only the original receipt to process the claim.

Shirley

Reply 3

This is a kind of insurance fraud because medical expense can be claimed only once. If the company values integrity, then HR can impress upon the staff that the company takes a dim view of such practice.

AL

Reply 4

I do not think the employee can do that if both the Company and his personal insurance company requires him to submit the Original bill/invoice.

Jess