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Health and safety

Insurance Claims Queries

a. What do I need to consider when claiming for maternity expenses?

The claiming procedure applicable to your policy will be described in your Benefit Guide.

If you are under one of our standard International Healthcare Plans, the general claiming procedure described in these FAQs will apply to pre-natal care claims too, where pre-natal care is included in your cover.

For the delivery, however, you will need to obtain our pre-approval via submission of a Treatment Guarantee Form (available here). Please complete and submit it 4-6 weeks before the estimated delivery date to allow our Medical Team to confirm cover and arrange for direct billing (where possible) with your medical provider of choice.

In case of an emergency, don’t worry: just obtain your medical assistance and call us within 48 hours of the emergency, to inform us of the hospitalisation. We can get the Treatment Guarantee Form details over the phone when you (or your medical provider, or a family member – if you are unavailable to talk on the phone) call us.

Please note that we may decline your claim if pre-approval is not obtained: full details of our Pre-Approval process can be found in your Benefit Guide.

You can access your Benefit Guide via MyHealth Digital Services. Simply login via browser or use the MyHealth app, click on “My Policy” and select your Benefit guide in your “Documents” tab.

 

b. What do I need to consider when claiming for orthodontic treatments?

The claiming procedure applicable to your policy will be described in your Benefit Guide.

If you are under one of our standard International Healthcare Plans, the general claiming  procedure described in these FAQs will apply to orthodontic claims too, where orthodontic treatment is included in your cover.

Please note that we will only reimburse the costs you incurred after treatment has taken place.

This means that, if you are paying for your orthodontic treatment in instalments, you can submit your claims monthly or quarterly (depending on the payment frequency you have agreed with your medical provider).

Please make sure that the invoice includes a description of the treatment received and the treatment dates for the period invoiced.

You will need to send us some supporting information to show that your treatment is medically necessary and therefore covered by your plan. The information we ask for may include, but is not limited to:

  • A medical report issued by the specialist, stating the diagnosis (type of malocclusion) and a description of the patient’s symptoms caused by the orthodontic problem.
  • A treatment plan showing the estimated duration and cost of the treatment and the type/material of the appliance used.
  • The payment arrangement agreed with the medical provider.
  • Proof of payment of the orthodontic treatment.
  • Photographs of both jaws clearly showing dentition before the treatment.
  • Clinical photographs of the jaws in central occlusion from frontal and lateral views.
  • Orthopantomogram (panoramic x-ray).
  • Profile x-ray (cephalometric x-ray). 
  • Any other document we may need to assess the claim.

You will find the “Orthodontic treatment” definitions and any applicable exclusions in your Benefit Guide, if you wish to check the level of cover provided to you under your policy.

You can access your Benefit Guide via MyHealth Digital Services. Simply login via browser or use the MyHealth app, click on “My Policy” and check your Benefit guide under the “Documents” tab.

 

c. What do I need to consider when claiming for “In-patient cash benefit”?

If this benefit is included in your policy, we will pay you a specified amount (indicated in your Table of Benefits) per each night you spend in hospital, up to a specified maximum number of nights per Insurance Year, where the hospital treatment you are receiving is free of charge and covered within the terms of your plan. Please note that this benefit is payable only after you are discharged from hospital.

To claim the “In-patient cash benefit”, please follow the general claiming procedure described in the question above regarding “How do I claim for medical expenses that I have already paid for to my medical provider?”

Note that you also need to attach your admission/discharge notice from the hospital when you send your claim to us (via MyHealth Digital Services). The admission/discharge notice must specify the number of nights spent in the hospital and the treatment received and it must confirm that the treatment received was free of charge.

 

d. How quickly will I be reimbursed for eligible out-patient treatment?

Please note that the claiming process (including our Service Level Agreement) may vary depending on the product available to you and on the type of insurance contract. We therefore advise you to check your Benefit Guide to confirm the claiming process applicable to your policy.

For example, if you are covered under one of our standard International Healthcare Plans, (and as long as your claim is submitted with all relevant details, documentation, invoices and receipts within six months after the end of the Insurance Year) we will aim to process your claim within 48 hours.

Please note that without the diagnosis, we cannot process your claim promptly, as we will need to request these details from you or your doctor. To help us processing your claim in the quickest time possible, please ensure to include the diagnosis, an eligible copy of each invoice and any supporting documentation on your claim.

You can submit your claims via MyHealth Digital Services online or via app and then follow the status of your submitted claims by logging in to your account.

Please note that we will email or write you to advise when your claim has been processed; if you have submitted your claim via post or email, we will also include a settlement letter and a Statement of Accounts.

Payment instructions are sent to our bank at the same time of claim processing, but please note that it can take up to 10 working days for the payment to reach your bank account (as this depends on the bank’s international transaction timelines).

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