Health Insurance Claims
When in doubt, always call GasanMamo on 21 345 123 or email firstname.lastname@example.org
Completing a claim form
The first and most important step in the claims process is to ensure that you submit a completed claim form. It is very important to disclose as much information as possible so as to avoid unnecessary delays. Please ensure that you complete all the relevant sections of the claim form and sign and date the declaration on the back of the form. More importantly, you should also ensure that your doctor/s complete all the fields in the relevant sections of the claim form.
Claiming for out-patient treatment
When claiming for out-patient treatment, you are requested to submit a completed claim form together with the original receipts of your treatment. Credit card payment slips are not acceptable. Please ensure that the receipt states your name and the date of treatment and that it is signed and/or stamped by the doctor or clinic. In the case of multiple expenses, a receipt should contain a breakdown of the costs involved and when claiming for laboratory investigations, one must also submit a copy of the invoice or test results to show which tests have been carried out.
Claiming for day-patient or in-patient treatment
Before receiving day-patient or in-patient treatment, it is very important that you contact one of our representatives to confirm your level of cover. Our team will be able to guide you through the process so that you may rest assured that the claim is being handled appropriately. If you are insured under one of our Key or International Plans, you are most likely eligible for a direct settlement facility. This will be confirmed by your claims advisor once you have made contact.
Important points to remember
- All medical treatment must begin through a General Practitioner. The only exceptions to this rule are for consultations with gynaecologists in the case of women, paediatricians in the case of children up to the age of 13 and ophthalmologists.
- All claims must be submitted within 3 months of the date of treatment. If you expect your treatment to exceed the 3 month period, please contact one of our representatives.
- Only original claim forms and receipts will be processed. We will not make any payments against copies.
- All charges must be fair and reasonable.
- Further details on how to claim may be found in your policy booklet
- Fair & Reasonable Fees