You may not know how to claim your health insurance. Or maybe the process is complicated and makes you angry
We recommend that you keep this record, maybe one day it will be useful for you.
and for those of you who are having problems when claiming your life insurance
Here’s how to claim it and how much it will cost.
- Ask your doctor for a referral to a specialist if needed
- Find your policy number and contact details of your insurance company
- Contact your insurance company’s claims team or fill out a claim form online
- Get care from a health professional
- The insurance company will pay the bill for you directly
What you can claim for health insurance can pay for medical care including:
Looking at personal GP
Diagnostic tests and consultations
An appointment with a health specialist
Operations and other maintenance
Some medicines and equipment
Overnight or longer stays in private hospitals
Every insurance company has different rules about what they can pay for and what treatments and conditions they exclude. Some also allow you to add covers for certain things like physiotherapy and dental work.
How to make a claim
Find the information you need Check your policy document to find:
- Contact details of your insurance company
- Your policy or membership number
- Take note of the details you need to notify your insurance company, such as:
- Your illness or symptoms and when it started
- If and when you talk to your doctor
- What treatments your doctor recommends
Starting your claim You can book a medical appointment and start the process:
By calling your insurance company and asking them to refer you to a specialist.
Online, using your insurance company’s website. You will need an online account setup, which will allow you to initiate claims for some symptoms.
By visiting your DOCTOR, who can refer you to a specialist for treatment. Some insurance companies require an Open Referral letter from your DOCTOR, explaining what treatment you will need.
If your DOCTOR refers you for treatment, you will then need to contact your insurance company by phone or online. You can check they can cover your treatment and start the claim process.
They will send you any documents that you need to complete and ask for All the details they need.
how long will it take?
Once your insurance company agrees to cover your treatment, you can book an appointment immediately. You don’t need to wait for payment first.
- Ask them to book an appointment for you
- Book an appointment with a medical specialist yourself
Some insurance companies give you a pre-authorization number if you book the appointment yourself. You will need to give this to the private hospital, doctor, or medical professional you are using.
They have to send the bill directly to your insurance company, who will pay it for you.
Claim fee :
Your insurance company pays the bill for you directly to the care provider, but you may need to pay an excess. This amount is agreed upon when you issue your policy and is usually between £ 50 and £ 1,000.
You usually have to pay this amount directly to the care provider. For example, if your excess is £ 100 and you claim for the £ 300 promise, you pay £ 100 to the medical facility and your insurance company pays them another £ 200.
Most policies only make you pay this excess once per year, so if you claim for another £ 300 a year pledge, your insurance company will pay the entire amount.
Making a claim can make your premium more expensive when you renew your policy or take a new one next year.
This is because when you take out health insurance, the symptoms or illnesses that you claimed were previously recognized as preexisting conditions.
They can push up your premium costs next year, and policies from new insurers can even exclude coverage for pre-existing conditions.
What if your claim is rejected?
This can happen if your insurance company decides your policy does not cover the treatment you requested.
If this is the case, carefully check your policy documents to find out what your medical insurance covers.
If you think they should be able to afford your treatment, ask them why they rejected your claim and complain if you think they are wrong.
If you need treatment for something your policy doesn’t cover, you can: