How to Claim for Out-patient Treament
How to Claim for Out-patient Treatment
Medical treatment and services either in a doctor’s office / clinic which do not require your admission to a hospital as an in-patient are often referred to as out-patient treatment and should generally be paid by you, and then submitted along with a completed claim form to us for reimbursement.
To ensure that you are able to recover your costs from us as quickly as possible, we would recommend that the following steps be followed when making an out-patient claim:
As you will need to complete and submit a claim form to enable you to reclaim those eligible costs that you incur under your policy, please take a claim form with you on your first visit to your general practitioner or specialist.
For a downloadable copy of Medical Claim Form, please click here (insert .pdf link)
For a downloadable copy of Routine Health Management Claim Form, please click here (insert .pdf link)
Please complete all sections of the form (with the exception of “section E” which will need to be completed and signed by your treating doctor), dating and signing where indicated. In the case of physiotherapy and complementary medicine where treatment is dependent on recommendation from a medical practitioner, the medical practitioner must complete the medical certificate on the claim form.
Attach all original supporting documentation, invoices and receipts to the claim form (e.g. medical practitioner /physician invoices, pharmacy receipts with related prescriptions (if available), and post to the à la carte healthcare claims team at the following address.
ALC healthcare claims team
18B Beckett Way
Park West Business Campus
Nangor Road
Dublin 12
Ireland
If the amount you will be claiming is less than the policy excess under your plan, please remember to retain your claim form and all eligible receipts for the cost of treatment for each medical condition - do not destroy or dispose of them. Once your treatment costs exceed your policy excess amount, forward your completed claim form together with all your original receipts/invoices to us for reimbursement. Remember a separate claim form will be required for each person claiming and for each condition. Please ensure that you attach all original invoices. Photocopies, receipts and credit card slips cannot be accepted
Don’t forget to specify on the claim form the currency in which you wish to be paid; otherwise the benefit due to you will be paid in the currency of the invoice. Where a currency conversion is required, the rate will be that prevailing at the date of the invoice.
Please note that the incurred costs will be reimbursed within the limits of the policy and will be net of any policy excess shown on your Certificate of Insurance.
When submitting additional invoices in respect of an on-going medical or dental claim, you will only need to complete a continuation claim form.
For a downloadable copy of Continuation Claim Form, please click here (insert .pdf link)
High cost procedures
Where the cost of your out-patient treatment is likely to prove expensive, we may be able to arrange for settlement of your costs to be made directly to your doctor / medical facility, please contact us before the start of your treatment on T + 353 1 629 7140 . Please note that not all medical facilities may accept direct payment with even where the cost of treatment is expensive. In these instances you will still be required to settle the bill and submit a claim to us for reimbursement.
General claims information
All documents and materials (including but not limited to original accounts, certificates and x-rays) that we require to support a claim shall be provided without expense to us (including, if requested by us, a medical report from the insured person’s medical practitioner or specialist and details of the insured person’s medical history prior to any claim).
In cases where medical information is required by us for consideration of a claim but it is not available to us, it is the responsibility of the insured person to obtain such information from their current or previous medical practitioner, as appropriate. Claims may only be made for treatment actually given during a period of cover and benefit will only be available for expenditure incurred prior to expiry or termination of such cover.
An insured person must, without delay, give us written notification of any claims or right of action against any third party arising out of circumstances which gave rise to a claim under this policy and must continue to keep us fully informed in writing and take all steps reasonably required in making a claim upon that other party.
To the extent permissible under the laws of your country of residence, we shall be entitled to take legal action in any insured person’s name for our own benefit and claim for indemnity or damages or otherwise which relates to any benefits and costs paid or payable under this policy. We shall have full discretion in the conduct of any such proceedings and in the settlement of any claim.
Medical treatment and services either in a doctor’s office / clinic which do not require your admission to a hospital as an in-patient are often referred to as out-patient treatment and should generally be paid by you, and then submitted along with a completed claim form to us for reimbursement.
To ensure that you are able to recover your costs from us as quickly as possible, we would recommend that the following steps be followed when making an out-patient claim:
As you will need to complete and submit a claim form to enable you to reclaim those eligible costs that you incur under your policy, please take a claim form with you on your first visit to your general practitioner or specialist.
For a downloadable copy of Medical Claim Form, please click here (insert .pdf link)
For a downloadable copy of Routine Health Management Claim Form, please click here (insert .pdf link)
Please complete all sections of the form (with the exception of “section E” which will need to be completed and signed by your treating doctor), dating and signing where indicated. In the case of physiotherapy and complementary medicine where treatment is dependent on recommendation from a medical practitioner, the medical practitioner must complete the medical certificate on the claim form.
Attach all original supporting documentation, invoices and receipts to the claim form (e.g. medical practitioner /physician invoices, pharmacy receipts with related prescriptions (if available), and post to the à la carte healthcare claims team at the following address.
ALC healthcare claims team
18B Beckett Way
Park West Business Campus
Nangor Road
Dublin 12
Ireland
If the amount you will be claiming is less than the policy excess under your plan, please remember to retain your claim form and all eligible receipts for the cost of treatment for each medical condition - do not destroy or dispose of them. Once your treatment costs exceed your policy excess amount, forward your completed claim form together with all your original receipts/invoices to us for reimbursement. Remember a separate claim form will be required for each person claiming and for each condition. Please ensure that you attach all original invoices. Photocopies, receipts and credit card slips cannot be accepted
Don’t forget to specify on the claim form the currency in which you wish to be paid; otherwise the benefit due to you will be paid in the currency of the invoice. Where a currency conversion is required, the rate will be that prevailing at the date of the invoice.
Please note that the incurred costs will be reimbursed within the limits of the policy and will be net of any policy excess shown on your Certificate of Insurance.
When submitting additional invoices in respect of an on-going medical or dental claim, you will only need to complete a continuation claim form.
For a downloadable copy of Continuation Claim Form, please click here (insert .pdf link)
High cost procedures
Where the cost of your out-patient treatment is likely to prove expensive, we may be able to arrange for settlement of your costs to be made directly to your doctor / medical facility, please contact us before the start of your treatment on T + 353 1 629 7140 . Please note that not all medical facilities may accept direct payment with even where the cost of treatment is expensive. In these instances you will still be required to settle the bill and submit a claim to us for reimbursement.
General claims information
All documents and materials (including but not limited to original accounts, certificates and x-rays) that we require to support a claim shall be provided without expense to us (including, if requested by us, a medical report from the insured person’s medical practitioner or specialist and details of the insured person’s medical history prior to any claim).
In cases where medical information is required by us for consideration of a claim but it is not available to us, it is the responsibility of the insured person to obtain such information from their current or previous medical practitioner, as appropriate. Claims may only be made for treatment actually given during a period of cover and benefit will only be available for expenditure incurred prior to expiry or termination of such cover.
An insured person must, without delay, give us written notification of any claims or right of action against any third party arising out of circumstances which gave rise to a claim under this policy and must continue to keep us fully informed in writing and take all steps reasonably required in making a claim upon that other party.
To the extent permissible under the laws of your country of residence, we shall be entitled to take legal action in any insured person’s name for our own benefit and claim for indemnity or damages or otherwise which relates to any benefits and costs paid or payable under this policy. We shall have full discretion in the conduct of any such proceedings and in the settlement of any claim.
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