How to make a claim

Claiming medical treatment

Urgent claims

General claims

1. Your doctor refers you to a consultant or specialist

   Before you see the consultant please call us and ask to speak to one of our specially trained claims advisers. Have your policy number ready (you'll find it on your membership certificate).
   We will ask you the following questions about the condition you require treatment for:
   • What is the name of the condition you are suffering from?
   • When did you first become aware of the symptoms?
   • When did you first see your doctor about this condition?
   • Has your doctor suggested any treatment?
   • What is the name of the consultant and hospital where the consultation will take place?
   • When is your treatment due to take place?

2. Confirmation of cover

   We will let you know if we need more information or if we can accept your claim straight away. We will also tell you if there are any restrictions on your policy that may apply to your claim. Once accepted, we will confirm your claim to you in writing.
   
   

3. Your consultation appointment

   Take your acceptance letter with you as proof of approval of your claim. Your consultant will advise you if further treatment is needed.
   
   If outpatient treatment is recommended you can arrange this without contacting us again. Please refer to your policy document for full details of your outpatient benefits.
   
   If your consultant recommends in-patient or day-patient treatment, please call us so we can confirm that both the hospital and the treatment are covered by your policy.
   
   

4. Your stay in hospital

   We will write to the hospital to confirm your stay is covered and send you a copy to take with you when you go into hospital. The letter will contain all the information the hospital will need to ensure your claim is dealt with quickly.
   
   When you leave hospital please settle any personal expenses yourself and ask the hospital to forward any invoices for your approved treatment directly to us.
   
   

5. After your hospital stay

   If you need further treatment our claims advisers will be happy to help you.
   
   Please remember that we can only pay for treatment that is:
   • for an acute medical condition, or the acute periods of a long-term medical condition
   • carried out by a consultant to whom your doctor has referred you and who is recognised by us, and
   • covered by your particular policy.

If you have an excess on your policy

• Send any invoices you receive to us, unpaid
• We will deduct the excess from any invoices we pay and then write to you to confirm what you need to pay yourself
• Please do not send a cheque for the excess amount to us as this may delay payment

Contact numbers

• General claims enquiries - Please refer to Contact us
• Travel claims - Tel: 0845 602 3001
• Dental claims - Tel: 0845 602 3886
• Critical Illness and Personal Accident claims - Tel: 0845 602 3650
• Fax - for all claims: 0845 602 3633

Normal opening hours