How do I make a claim?
Much of the sections on this site detail the process of signing up to private medical insurance and the benefits that will come with it. But what do you need to do to actually make a claim on your insurance? This section will outline what you need to do, from visiting your GP right though receiving a bill from the private medical practice.
Unless you are admitted to A&E due to a medical emergency (where you will be taken to an NHS hospital) then any form of medical treatment is going to start with a visit to your GP. This is because your GP will be the one to refer you for any of the tests or treatments that you may receive.
From the GP to Insurance Company
If your GP refers you to a particular specialist and you are seeking this privately you will then need to phone your insurance provider. This must be done in advance of receiving any treatment as the insurance company will usually insist that you do so and they will also need to inform you as to whether or not the treatment is covered by your private medical insurance.
Paper Work
If your claim is eligible – for example, your policy covers out-patient procedures and this is what you require – then you can make your claim after your GP has referred you to the relevant specialist. The claim will be a form and is split into sections for you to fill out and for your GP to fill out. The former will include standard details such as your name and date-of-birth, as well as your insurance policy number, whilst the GP section will be concerned with your medical condition and related factors.
The Process Continues
As the process continues your insurance company will provide you with the guidance you need to follow through with your claim, including where, when and how to send forms and, ultimately, how they will pay. When your specialist refers you to treatment you will sometimes be given the bill yourself, whereas sometimes they will send it straight to the insurance company.
Things to Remember
It should be noted that your GP may charge you to sign your PMI claim form and this is not covered by the insurance. However, you will not be able to make a claim without your GP signing.
Perhaps the most important advice is to stay in contact with your insurance company throughout the process.