How to Claim

Claiming under your policy is simple

How to make a claim for a Medical Procedure (Hospital Treatment Plan and Access Hospital Treatment Plan)

• Call us on 0114 250 2000 before you have treatment.
• We will then send you a claim form.
• Complete Section 1 of claim form and ask the specialist who thinks that treatment is necessary to complete either Section 2 or 3.
• We will then assess your claim and, if it is approved, give you a budget of money to spend.

If you choose to have private treatment:

Assuming your claim has been approved we can:

• Pay the hospital on your behalf when your treatment takes place.
• Pay the full budget directly to you after treatment is complete on receipt of the relevant invoice(s).

If you choose to have NHS treatment:

Assuming your claim has been approved we will:

• Pay you (or your employer) the full NHS budget directly after treatment is complete on receipt of the completed claims form. 
  

How to make a claim for Specialist Consultations, CT, MRI and PET Scans  (Access Hospital Treatment Plan) 

• Call us on 0800 012 2008 before you have any treatment.
• We will send you a claim form.
• Complete Section 1 of claim form and ask the specialist who thinks that treatment is necessary to complete either Section 2 or 3.

If you choose to have private treatments;

Assuming your claim has been approved we can:

• Pay the claim on your behalf when your treatment takes place.
• Pay the claim directly to you after treatment is complete on receipt of the relevant invoice(s).

If you choose to have NHS treatment

Assuming your claim has been approved we will:

• Pay you (or your employer) the full NHS budget directly after treatment is complete on receipt of the completed claims form.

Tips when making a claim:

1. You should always have your treatment pre-authorised and never simply assume it will be covered. For example if you had private treatment without checking with us first and submitted a claim afterwards you would be fully liable for any costs of your care if for any reason we were to decline the claim.

2. We sometimes require a report from your GP. Please remember to state on your claim form whether you wish to see any report before it is viewed by us.

3. A very good way to use your private care budget for medical procedures is to arrange a fixed-price package. A fixed-price package provides an all-in price for your care and lets you know the cost in advance. With the help of our treatment sourcing service we can provide a helping hand to negotiate with hospitals to ensure that the budget you have available is used most effectively. Please call our Customer Helpline on 0114 250 2000 for more information.