How to make a claim on your policy

We want to ensure that should you ever need to make a claim against your policy, the process is as smooth and hassle-free as possible. In order to ensure that you receive the best possible service from ALC Health, please follow the guidelines outlined below in the event of you or one of your dependants requiring treatment.

Please read these carefully and in conjunction with the other sections of your policy wording

PLANNED IN-PATIENT & DAY-PATIENT TREATMENT

To help us process the direct settlement of your medical expenses in a timely manner, please follow the guidelines below. If you have any questions, please contact our helpline on + 353 1 629 7014.

You are requested to contact our Medical Services Department at least FIVE working days prior to admission. This will allow us to arrange the preauthorisation of your treatment and will also ensure a smooth admission process.

Please send a fully completed Treatment Request Form at least FIVE days prior to treatment ensuring that your Medical Provider and Doctor complete all questions in sections 4 and 5, by:

Scan and email to medical.services@allianzworldwidecare.com

Fax to + 353 1 653 1780 or

Post to à la carte healthcare claims,

Medical Services Department,

Allianz Worldwide Care,

18B Beckett Way,

Park West Business Campus,

Nangor Road,

Dublin 12,

Ireland.

Failure to complete this form fully will delay our ability to authorise your treatment as we may have to revert to you or the medical provider for further information.

The Treatment Request Form can be downloaded below.

EMERGENCY ADMISSIONS

While pre-authorisation is not required in advance of emergency treatment, we should be informed within 48 hours of the event to ensure that no pre-authorisation penalty is applied. This will give us the opportunity to arrange the direct settlement of your hospital bills, where possible, and will ensure that your claim can be processed without any delays.

Please note that our Helpline can accept Treatment Requests over the phone if treatment is due to take place within 72 hours. Please have as many details as possible ready to give over the phone, including the contact details of your doctor.

OUT-PATIENT TREATMENT

Please follow the guidelines below to help us process your claims promptly and efficiently.

Out-patient treatment is generally paid for by the patient at the time of receiving treatment and the costs incurred are then recovered from us.

We recommend the following steps in making an outpatient, dental or routine management claim:

Whenever you visit a medical practitioner, dental practitioner, physician or specialist on an out-patient basis, please make sure you take a Claim Form with you.

Fill in the section that is assigned to you, then date and sign the Claim Form. Make sure that your medical practitioner, dental practitioner, physician or specialist provides all relevant medical information in the specified section and then dates, signs and stamps the Claim Form.

Attach all original supporting documentation, invoices and receipts to the Claim Form (e.g. medical practitioner/physician invoices) and post to à la carte healthcare claims team details as follows:

à la carte healthcare claims,

Medical Services Department,

Allianz Worldwide Care,

18B Beckett Way,

Park West Business Campus,

Nangor Road,

Dublin 12,

Ireland.

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.

Remember a separate Claim Form will be required for each person claiming and for each condition.

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.

Claim forms

Within your policy document folder you will find a Medical Claim Form and a Continuation of Claim Form. A Claim Form will also be enclosed for Dental Treatment if you have selected this benefit.

For a downloadable copy of our Claim Form, please click below

When you have downloaded and completed your claim form, please forward along with all supporting documents (original invoices etc) to our claims team at: -

ALC Health Claims Team

18B Beckett Way

Park West Business Campus

Nangor Road

Dublin 12

Ireland

T + 353 1 629 7140

F + 353 1 630 1306

Eclaims@alchealth.com

All claims should be submitted to us with a fully completed claim form, original invoices and receipts and all other supporting documentation within six months after the end of the period of cover.

Before you make a claim, it is important to ensure that your policy covers the treatment you are seeking (e.g. dental, evacuation & repatriation etc). Our experienced Helpline advisors will be happy to assist with any queries you may have. (for contact information, please use the details shown above. These can also be found on you claim form or membership card.)

A fully completed form will allow us to make an efficient assessment and prompt payment of your claim.

Please complete Sections A, B, C and D and ask your Doctor or Consultant (as appropriate) to fully complete and sign Section E the Medical Certificate. If the Medical Certificate and/or Declaration is not completed or signed, the claim cannot be processed

Please attach all original invoices. Photocopies, receipts and credit card slips cannot be accepted

A separate Claim Form is required for each patient and each medical condition

If claiming for Cash Benefit, a certificate from the hospital confirming the number of nights in-patient stay is required

We recommend that you keep copies of all documents submitted, should you require them at a later date

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 the current or previous Medical Practitioner as appropriate

The settlement of your claim may be delayed if you fail to complete your claim form properly

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.

CONTACT DETAILS

Treatment Requests for In-patient and Day-patient treatment

à la carte healthcare claims

Medical Services Department

Allianz Worldwide Care

18B Beckett Way

Park West Business Campus

Nangor Road

Dublin 12

Ireland

T+ 353 1 629 7140

F+ 353 1653 1780