Abu Dhabi Health Insurance Claims

Treatment received as part of an Abu Dhabi Health Insurance plan requires the policyholder to submit a claim to the insurance company for reimbursement against the costs of the treatment.

The claims process is a very important part of the relationship between an individual and an insurance company. Understandably, policyholders will wish to work with insurance companies who can provide a claims resolution service which is hassle free. With this in mind, Abu Dhabi Health Insurance has opted to work with insurance companies which place a strong emphasis on providing a customer friendly claims service.

At Abu Dhabi Health Insurance, we have also committed ourselves to assist our clients submit their claims in the shortest possible time. With a dedicated team of in-house advisors working as part of a claims team, we liaise directly with the insurance company on your behalf and are able to keep track of your claim throughout the entire claims process. With our client’s interests as our main motivating factor, we will work to ensure you receive a swift response to your claims application.

Types of Health Insurance Claims

A variety of claims can be made under an Abu Dhabi Medical Insurance plan and we strongly advise clients to be fully aware of the procedures and processes involved when making a claim, all to ensure you receive a swift reimbursement of your medical costs. The most frequent types of claims made under an Abu Dhabi Health Insurance policy include:

In-Patient Emergency Treatment Claim

Should you suffer from an accident that requires you to be transmitted to a hospital or medical facility for emergency treatment, you may not be able to contact your insurance company prior to any treatment being received.

While most insurance companies will, in the case of emergency treatment, cover the cost of emergency medical charges directly with the facility that provided treatment, you may on occasion have to settle the medical costs yourself and then apply to the insurer for reimbursement as part of a claim.

Planning ahead is always worthwhile and it is advisable to have a plan in place should you require emergency treatment. This plan of action can involve you or your next of kin contacting the insurance company while providing the medical facility with your Abu Dhabi Medical Insurance plan. This will ensure a smooth reimbursement of the medical costs.

In-Patient Health Insurance Claim Treatment Guarantee

If you require regular In-Patient medical treatment at the same medical facility, it is common practice for your insurance company to request a Treatment Guarantee Form in advance of your first scheduled in-patient appointment.

The Treatment Guarantee is the used by your insurance company to liaise directly with the medical facility in question to ensure all medical treatment you receive and the associated costs are paid in full.

General Out-Patient Claims

Common practice for individuals who receive out-patient medical treatment is for the policyholder to cover the full cost of treatment and then to submit a claim against those costs. There are a number of ways a holder of an Abu Dhabi Health Insurance policy can be reimbursed and generally you can choose your preferred method of repayment.

Out-Patient Direct Settlement

Most of the insurance companies that work with us at Abu Dhabi Health Insurance provide a direct settlement service for the costs of out-patient treatment.

This service involves a number of medical facilities with whom the insurance company has an agreement in place to directly provide payment for costs any of its policyholders may incur while using that facility. The major advantage of this option is that you only need to submit your insurance policy to the facility in advance of receiving treatment to ensure your insurance provider settles the medical costs on your behalf.

Common Issues with Health Insurance Claims

Although we work hard to make sure all Abu Dhabi Health Insurance claims are processed as quickly as possible, we understand that individuals that are making their first medical insurance claim encounter some general problem areas. With our dedicated in-house claims team and our unparalleled expertise in the medical insurance industry, we act on your behalf to help complete the claim procedure and ensure reimbursement of your medical costs.

The two most common problem areas in relations to a claim application are Incomplete paperwork and Pre-existing medical conditions.

Incomplete paperwork

The biggest impediment to the swift resolution to a claims procedure is the incomplete or incorrect submission of the paperwork required by the insurance company. This documentation includes the invoices, receipts, doctor’s letters and any official paperwork relating to the medical treatment you have received. Submitting the full batch of documentation will assist you in a speedy reimbursement of your Abu Dhabi Medical Insurance claim.

Advisors working within our on-site claims team will help you collate this paperwork and review it to ensure it has been completed correctly before forwarding it to the insurance company.

It is also advisable to retain copies of your claims documentation and to ensure that it is easily retrievable should it be required in the future.

Pre-existing medical conditions

Abu Dhabi Health Insurance plans typically exclude a pre-existing medical condition from their coverage options. Please click Pre-existing medical condition insurance for more information.

Claims submitted for a pre-existing medical condition that have been excluded from coverage within the policy will be refused. We advise all clients to be mindful of the coverage levels and benefits available to you within your Abu Dhabi Medical Insurance plan before you submit a claim application.

Abu Dhabi Health Insurance Quote

Additional information on the claims procedure with an Abu Dhabi Health Insurance plan can be received by contacting one of our advisors now. Furthermore, by completing the short form section at the top of this page, you can request a free Abu Dhabi Medical Insurance quote.