How to make a claim

Your first step is to arrange to see your GP who will refer you on to a specialist if appropriate.

• If the GP gives you an open referral – meaning they do not name a particular specialist – we can help you locate someone suitable to oversee your care.
• If the GP gives you a named referral, let us know who you have been referred to and we can check to make sure that they are someone we are able to cover in full for you.
• Please be aware, we are unable to provide cover for GP referred scanning or testing – this is considered primary care – however, we can step in once it is necessary for you to be referred to a consultant.

Once you have a referral in place, give us a call. We will have a chat with you about your medical condition; we may be able to approve your treatment over the phone, but may also need to request medical information from your GP in order to assess the eligibility of your claim first. We’ll be able to confirm this when we speak to you.

We may need to know about your medical history regarding the condition you are claiming for.

If a medical information form is required, once this has been sent to us by your GP, we will review the information and contact you with an update.

Once your claim is agreed, you can then go ahead with your treatment. We just ask that you keep us up to date with the progress of your care, so we are able to confirm any additional treatment will be covered in full.

If you have treatment at a hospital or day-patient unit that’s not in the hospital list, we will only pay 60% of the charges from that hospital or day-patient  unit as long as they charge up to the normal rates published and charged by that hospital or day-patient unit. You will be responsible for paying the remaining charges.