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FAQ's Medical Insurance How are claims made?
FAQ's Medical Insurance How are claims made? | How are claims made? |
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| Frequently Asked Questions - Medical Insurance | |
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It is now an ABI (Association of British Insurers) “Code of practice” for all insurers, their agents and representatives, to recommend that all claims are pre-authorized. Many insurers are now making this a condition of the policy. The reasoning behind this is quite simple. If the claim is pre-authorized, then there can be no dispute between the claimant and the insurer, or any other party, about the non-payment of all or part of the claim. By the insurer pre-authorizing each claim, the claimant will know if all accounts will be settled, or if limits will apply. It will also ensure that a claimant will not attempt to claim for an excluded pre-existing condition. Therefore, only the insurer’s claims department can pre-authorise a claim. In order for a claim to be pre-authorized, the claimant must complete a claims form, within which their Doctor/Consultant can confirm the medical condition, and the dates on which that condition, or any related condition, first started. On receipt of the form, the insurer’s claims department will either authorize or decline the claim. Many insurers offer similar 'telephone based' option... |
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