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10 25HEALTH INSURANCE EXPLAINED  
   
     
 
 
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Making a claim for health insurance  
   
How to claim on you health insurance policy

As soon as you know that you are likely to claim, and before you commit yourself to paying for treatment, check that your policy covers you (if in any doubt telephone your health insurance company) and get a claim form from the insurer.

It may be a condition of your policy that you have to get your medical insurer’s consent to treatment before it begins but even if not, it makes sense to get written confirmation that your treatment will be covered.

Cost Estimates

If possible, it is helpful to send your insurer an estimate of the costs of treatment together with an estimate of possible hospital charges.
Most medical insurance companies operate a telephone call centre claims helpline - use it to get advice on how to claim.
Check which bills will be met directly by the insurer, and which you will have to pay for and claim back.

Claim Form

If at all possible, get hold of a claim form before the initial medical consultation takes place so that the consultant can sign the form on your first visit.
Keep a detailed record of all visits, letters and telephone calls to both your insurer and your GP.
After treatment, send your claim form in promptly since some insurers refuse to meet claims received six (sometimes three) months after the date treatment started.

Getting a disputed claim resolved - complain!

If you are dissatisfied with the level of service you have received from your private medical insurer, or the policy has paid less than you claimed for and you cannot understand why, contact your health insurer.
The Health Insurance policy booklet will tell you who to contact.
If you get nowhere with your insurer’s complaints procedure, you can take your complaint further.via the insurance ombudsman initally.

 

 

 

 

   
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