My wife and I both have corporate insurance from our employers. A few days ago she delivered the baby and the hospital bill was about 1.5L. The hospital in our city (Rainbow) isn't in my wife's TPA network, so I planned to use my policy for the cashless part (maternity limit 70k) and claim the remaining amount from my wife's policy (limit 75k).
But when I asked for the E‑Card, the TPA told me that maternity claims are only allowed if my wife is already listed as a dependent on my policy. I can't believe I missed adding her – I thought her own cover would be enough, or that the fine print "self + spouse + 3 children" meant she was automatically covered.
Now I can only claim up to 75k from my wife's insurance and have to pay the rest out of pocket.
Is the marriage certificate enough proof to file a claim on my policy?
Anything else I can do?
TL;DR – Didn't add wife as dependent, so can't claim maternity expenses on my insurance.
You have to add her as a dependent first; then the company will pay the premium and she'll be covered. At the very least, add your wife and the newborn for future claims.
Have you entered your spouse's details in the corporate portal? Usually the insurer pulls that info directly and generates the E‑Card. If they need a separate declaration, you might hit a snag. Talk to the TPA and keep HR in the loop – they often help corporate members sort these issues.
Everyone, please read your corporate insurance policy carefully.
Add your wife and child to your policy, and also add the child and yourself to your wife's policy. This is usually allowed during the renewal window (around March‑April).
Add your wife as a dependent, get her E‑Card generated and then try to claim. Check your policy – there's typically no cooling‑off period for adding dependents. You can still claim reimbursement up to 30 days after discharge.
Lesson learned: never ignore those policy emails.
My corporate policy is up for renewal next week and the beneficiary addition window is open. I'll make sure to fill in the details and submit them.
The last day to do this is Monday.
Add your wife and child to both policies now.
Then try to argue your case – sometimes the first‑level claim gets rejected but a higher‑level reviewer approves it.
You know you slipped up. Talk to the corporate team – the person who liaises with the insurer. Depending on how helpful they are, there's often some wiggle room. The broker might also be able to help. Worth a try – nothing to lose now.
Ignorance might be bliss, but not when it costs you money.
One more thing – if both insurers have sub‑limits, you usually can't claim the same expense from both unless it's a top‑up arrangement. So you won't lose much by sticking to one policy.