We hope that you have taken considerable care to choose an insurer and to understand what you are covered for and, almost more importantly, what is not covered. Next you need to know what you need to do to make a claim.

Most insurers send new customers a document explaining how to claim but, by the time you want to do that, the insurer’s advice document may have been lost.  Keep the insurer’s telephone number and your policy number readily to hand.

In almost all cases when you are ill you will see your GP first. Your GP may want you to have tests or to see a specialist right away – but that’s the wrong way to go about it. The last thing you may think about is getting authorisation from your insurer but you must and do tell your GP that you have private medical health cover.  Remember that before you see a consultant and before you have any tests privately, you must seek authorisation from your insurer or you may have your claim refused.

Once you have been given your claims reference number, it is most important to give that number to the hospital accounts staff where you are to receive treatment or be given tests.

Your insurer might turn a ‘blind eye’ to a breach of the strict terms of your policy and allow your claim to go through, but many will not. Getting in touch with your insurer at the earliest opportunity is therefore extremely important.

If you have followed the correct procedures and your claim is still rejected or you feel you have got good cause for complaint then there are other routes you can follow. See: ‘How to Complain about your Insurer’


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