We recognise that the health of you and your family is of the utmost importance and navigating health issues can be a stressful experience.
Rest assured that we are dedicated to supporting you throughout the claim process, ensuring your claim is addressed with care, attention, and efficiency to help ease your concerns during this difficult time. We care about your health and want to make sure you're back on your feet as soon as possible, so we’ve made the claims process simple.
Submit your claim in 3 easy steps:
1Talk to your GP
Visit your GP and explain your symptoms. If they advise that you need to be referred, request a copy of their letter as an open referral letter.An open referral letter is a referral by your GP addressed to the type of specialist or consultant you need to see, instead of a specific named specialist or consultant.
|
2Make a claim
Go to your secure online login area, click "Make a Claim". Complete the claim form and upload a copy of your open referral letter. Once we have received your claim form and referral letter, we will contact you to discuss the next steps.Please note, if you attend any treatment prior to authorisation by us, this will be at your own financial risk. |
3We'll make the payment
If your claim is approved we will notify you and provide you with an authorisation code, which the provider of the private treatment will need.After you have received your eligible treatment, please ask for invoices to be sent to us directly. If you need to pay anything on the invoice, such as an excess, we will contact you.
|
Pre-Treatment Information:
- Before seeking any treatment, it's crucial to familiarise yourself with your policy and the coverage you've purchased. Different policies offer varying benefits and limits, including access to different types of hospitals and treatments.
- There may be times where we need to request further information from your GP in order to progress your claim. If required, we'll contact you to advise of the next steps.
- Fraudulent Activity: note that any attempt to falsify health records constitutes fraud. Suspected fraudulent activities will be rigorously investigated and, if necessary, reported to the relevant authorities. Engaging in fraud will not only affect your claim but also impede your ability to purchase insurance from any insurer in the future.
Important Note: About Pre-existing Conditions
- Understand that pre-existing conditions are typically not covered under most insurance policies. (Please see our pre-existing conditions upgrade with our pre-defined list of conditions or our underwriting options for further details).
- Insurance aims to offer protection against unforeseen health issues, not conditions already known before policy purchase.
- We may need to review your medical records to ensure the claimed condition is not pre-existing.
Further Help & Information
If you have any questions, please do not hesitate to contact us, we are here to help.
Go to your Secure Client Login Area.
Enter your Customer Reference Number and password to access your account that was set up when you purchased your policy. if you don’t remember your password, you can reset your password from the login screen.
If needed, we will request your medical records from your General Practitioner (GP).
Please inform your GP and provide the necessary authorisation to release your medical records. We will supply you with a Data Subject Access Request form or you can download this via your Secure Client Login Area, which you will need to complete and provide to your GP.
This step is standard practice in private health insurance to confirm the authenticity of your claim.
Certain policies or underwriting types may be exempt from medical record reviews or have diverse terms regarding pre-existing conditions.
For precise information about your specific coverage, review your policy documents or reach out to your Customer Relations Co-ordinator.
After submission and providing the required documents, your claim will undergo validation checking and processing.
Stay updated by monitoring your account for the claim status or receive a notification from us.
If any further documentation is required, we will be in touch to let you know. You will be informed of any requests or information sent to your online log in area.
