Claim Reimbursement Procedures

If you choose to visit a non-network licensed medical facility within your geographical scope as per your benefit schedule, you will be required to pay the bill and file a reimbursement claim for eligible expenses. Please ensure that you follow the mandatory requirements:

1. Take a copy of the Reimbursement Form.
2. Bring the Reimbursement Form with you and ask your doctor to complete it.
3. Pay the bill and request an itemized invoice detailing the cost of each individual service.
4. For hospitalization and same day procedures, please ask your doctor for a complete medical, surgical report and discharge form.
5. Sign the declaration on the Reimbursement Form and make sure you include your mobile telephone number and bank account details (if any). Attach all original receipts, invoices and other relevant documents.
6. Keep a copy of all of the documents for your own records and for checking claim payments.
7. Deliver all the requested documents to any of the company branches or your sales agent within one month from the date of treatment, and receive your money (if any) within one month.
   

Additional Information

• Reimbursement is limited to a maximum of 30 days per prescription.
• Eligible claims submitted for reimbursement are paid by cheque addressed to the policy holder or transferred to the policy holder’s bank account including claims of dependents.
• Remember to check your invoices before leaving your provider to ensure that all services mentioned in your bill were conducted.
• Claims from outside the providers network are subject to a maximum of 80% reimbursement of preferred provider price lists unless in cases of emergency.
• Dental & Optical claims will be on reimbursement basis only.