Private Medical Insurance Guide

9. How do I make a claim?

Apart from emergency admissions to NHS hospitals, all medical treatment has to start with a referral by your GP to an appropriate specialist.

You:
• Before you receive any treatment privately, you should call your insurance company to check that you are covered for the treatment that you will receive. In fact, some insurance companies insist that you do this.
• Your GP and your specialist will probably need to fill in and sign your claim form. Your GP may charge a small fee which will not be covered by your insurance.
• Your specialist may recommend tests, admission to hospital as an in-patient, or day-case treatment.
• Most hospitals and some specialists have their bills paid directly by the insurance company. Others will send the bills to you.

Your insurance company:
• Your insurance company will give you all the guidance you need, confirm what your cover includes and, if necessary, send you a claim form.
• Stay in contact with your insurance company, who will confirm that any treatment you plan to receive is within your cover.
• Your insurance company will tell you how they pay claims.

Remember, if you have chosen to pay an excess, you will still have to make that payment.

Private Medical Insurance Guide:

1. About this guide
2. What is private medical insurance?
3. How do I buy private medical insurance?
4. How do I choose the right cover?
5. What am I covered for? What does my cover not include?
6. What will affect my premiums?
7. Will I need to provide details of my health?
8. Will my cover be affected if I am disabled?
9. How do I make a claim?
10. How is private medical insurance controlled?
11. What if I want to change to a new insurance company?
12. Your private medical insurance checklist
13. Useful addresses