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Hospital & Surgical Insurance Claims Guide

Normal Procedure

  • Notify your broker / insurer as soon as possible.

  • Your broker / insurer will forward to you a copy of a claim form.

  • Submit to broker / insurer the required documents:-

    • Claim form duly signed and completed.

    • Medical Report duly signed and completed by the attending physician.

    • Original bills and receipts incurred in respect of the hospitalization.


       

In a case where a Managed Care Organization is involved
 

  • Notify the Managed Care Organization (MCO) immediately.

  • The MCO will validate if the condition is covered by the policy and the best option for the required treatment.

  • A letter of guarantee would be forwarded to the hospital by the MCO (hospital deposit is not necessary).

  • Upon discharge from the hospital, the MCO will take over the settlement of validated medical bills.

  • Any ineligible or excess expenses must be paid by the Insured upon discharge.