Health Insurance Claims
When in doubt, always call GasanMamo on 21 345 123 or email [email protected]
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.
This procedure applied for both claims that are submitted online or at any of our offices.
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 diagnostic tests, one must also submit a copy of the report/ results.
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 full refund plans, you are most likely eligible for a direct settlement facility. This will be confirmed by your claims advisor once you have made contact.
How to submit a claim
You can submit a health insurance claim through our website in 3 easy steps.
- Your policy details
- Your claim details
- Claim documents clearly visibly scanned or photographed. The documents to be uploaded must include:
- Claim Form – front and back
- Invoices / Receipts – claim settlement can only be done against receipts
- Diagnostic Test results if applicable – such as blood tests, x-rays and ultrasounds
- Any other relevant document to your claim if applicable
In light of the current situation claim payments can only be made via SEPA bank transfer directly into the claimant’s account so please make sure to provide us with your IBAN details when submitting your claim. If bank details have already been provided you are not required to submit these details again, unless you want to make any changes. Please note that we can only make payments into euro accounts.
Please keep all claim documentation until your claim is settled. We reserve the right to ask for the original documentation and failure to provide such documentation may jeopardize or delay the payment of your claim.
Claims must be submitted within 3 months from the date of treatment.
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.
- All charges must be fair and reasonable.
- Further details on how to claim may be found in your policy booklet
- Fair & Reasonable Fees