IMPORTANT INFORMATION
Documents Typically Required by Insurers to Process a Claim
- At minimum a completed Claim Form (sometimes signed by the doctor) and the original hospital invoices with a detailed breakdown. Copies of prescription are often required and sometimes copies of the investigation reports.
- Medical report for outpatient treatment, discharge summary for hospitalised patients are usually required. In case of surgery the Surgical Report is generally required
- Some companies request the photocopy of patient’s ID card/passport and of the patient’s insurance policy
Exclusions from most insurance policies
- Routine medical examinations and check-ups
- Dental care
- Vaccinations
- Treatment by vitamins
- Pre-existing and congenital conditions
- Test or treatment of psychiatric, psychological, mental or nervous disorders
- Pregnancy,
- Infertility, sterilisation, contraception
- Cosmetic procedures and plastic surgery
- Investigation and treatment of refractive eye defects such as near-sightedness and astigmatism, including refractive eye surgery, spectacles, monocles and contact lenses
- Venereal diseases and HIV/AIDS
- Professional sports and motorised racing accidents
- Sleep disorders, learning difficulties, behavioural or developmental disorders
- Injuries arising from unlawful/criminal acts
- Self-inflicted injuries
- Addictive conditions/disorders and alcohol, drug and solvent abuse
- Experimental or pioneering medical and surgery techniques.
Please note that this is just a general guide, and patients’ policies may include additional exclusions. On the other hand, annual health check-ups, dental care, vaccination and pregnancy care, etc. may be covered under their insurance plan. We advise that all patients refer to their policy documents for a specific list of exclusions and inclusions.
