Claims

How to make a claim

If somebody is in trouble right now, stop reading and call the assistance number on the policy certificate. That one call is what gets treatment authorised and, on a large bill, gets the hospital paid directly instead of billing you. Everything else on this page can wait until afterwards.

In an Emergency

Four steps, in this order

1. Call the assistance line

The number on the policy certificate. It is staffed around the clock, wherever you are.

2. Get treated

Never delay care for paperwork. Treatment first, admin second.

3. Keep everything

Itemised invoices, receipts, discharge notes, prescriptions, the lot.

4. Submit the claim

Send it complete. Half a file sits in a queue until the rest turns up.

The Detail

What actually happens

Why the assistance call matters so much

Every policy we place comes with a 24-hour assistance line, and it is not a customer service desk. It authorises treatment, decides whether a hospital gets paid directly, and arranges transfers or repatriation where those are needed. Skip it and you can end up personally liable for a bill the insurer would otherwise have settled at source.

If the situation is genuinely urgent, get treatment first and call as soon as anybody reasonably can — from the waiting room, or from another country on the patient’s behalf. That is normal and it does not prejudice the claim.

What to keep

Claims stall on missing paperwork far more often than they are refused outright. Collect as you go rather than reconstructing it later.

Itemised invoices from every provider — not a card receipt or a statement balance
Proof of payment for anything you paid yourself
The discharge summary or the physician's report
Prescriptions and pharmacy receipts
Ambulance and diagnostic invoices, which often arrive separately and late
The policy or certificate number, and the date coverage started

Photograph everything before you hand it over. Hospitals and clinics do not always keep copies, invoices go astray in the post, and a claim reopened six weeks later is far easier to rebuild from photos on a phone than from memory. It costs nothing and it saves the file more often than you would expect.

Direct billing or reimbursement

For a large admission, the assistance line will usually set up direct billing with the hospital so the insurer pays at source. For smaller costs — a walk-in visit, a prescription, a diagnostic — you generally pay and claim it back. Reimbursement commonly takes a few weeks from a complete submission, and the deductible comes off the amount paid.

What we do

The claim itself belongs to the insurer’s claims administrator, and the decision is theirs — we cannot overrule it and we will not pretend we can. What we do is practical: tell you which number to call, check the submission is complete before it goes in, explain the clause the insurer is applying, chase a file that has gone quiet, and help build an appeal if one is worth making.

Call us, or use the contact page, and have the policy number to hand.

Before a claim ever happens

Two things prevent most declined claims, and both are decided before departure. Declare every medical condition honestly, because a non-disclosure can void the whole policy rather than just the part relating to that condition. And check the stability period on the plan you choose, since that single number is what most refusals turn on.

Not bought yet? Start at Super Visa insurance or visitors to Canada insurance.

Claim not moving

Send us the file. We will chase it.

If a claim has gone quiet, been part-paid or been refused and you do not understand why, send it to a licensed agent here. We will read the wording being applied, tell you plainly whether it looks right, and push the administrator where there is something to push on.

Talk to an agent

Questions about claims

Get treatment. Nobody expects a phone call before an ambulance. Call the assistance line as soon as somebody reasonably can — from the waiting room, or on the patient’s behalf from another country. Insurers are used to that and it does not void anything.

Both happen. For a large admission the assistance line will usually arrange to pay the hospital directly, which is the main reason to call them first. Smaller costs — a walk-in visit, a prescription — are normally paid by you and reimbursed afterwards.

Commonly a few weeks from a complete submission. Incomplete paperwork is what stretches it: a missing itemised invoice or an unanswered medical questionnaire will stop the file until it arrives. Send everything at once and it moves faster.

The two usual reasons are a pre-existing condition that was not stable during the insurer’s stability period, and something that was never covered — routine care, a checkup, an elective procedure. See pre-existing conditions for what stable means.

No, and anyone who says otherwise is overselling. The claims decision is the insurer’s. What we can do is make sure the submission is complete and correct, explain the wording being applied, chase a file that has gone quiet, and help you appeal with the right evidence.

Usually yes, but the deadline is real — most policies give a limited window from the date of treatment. Do not wait until you have every document. Open the claim, then send the rest as it arrives.