Understanding the
claims process.
MAKING A CLAIM
The claims process depends on the type of cover you have.
Health+ guided cover
If you have a Health+ guided policy, your GP makes an open referral and we will carefully select up to three suitable specialists for you based on your diagnostic and treatment needs.
1
Visit your GP.
2
If your GP refers you for treatment, or to see a specialist ask them for an ‘open referral’.
This means that the GP doesn’t name a particular specialist, but the type of specialist you need to see.
3
Then contact us on 0300 123 3253 with details of the open referral.
We will need to see a copy of the open referral letter.
4
We will give you a choice of up to three specialists.
5
After the consultation, we will contact your specialist to request details of any treatment required.
6
We will confirm what is covered and select a convenient hospital so you can proceed with any recommended diagnostic tests and treatment.
7
We will pay the invoice for consultations, diagnostic tests, or treatment, taking into account any options, such as your excess, any benefit limits and specialist fees.
Health+ traditional cover
If you have a Health+ traditional policy you can see any specialist your GP recommends, and you can choose any hospital on your pre-selected list.
1
Visit your GP.
2
If you require treatment, your GP can recommend and name a particular specialist for you to see that can be accessed on your chosen list.
3
Then contact us on 0300 123 3253 with details of the referral.
We will need to see a copy of the referral letter.
4
Accept the recommendation of your GP or conduct your own research to identify a specialist.
5
After the consultation, we will contact your specialist to request details of any treatment required.
6
We will confirm what is covered and you can then select any hospital from your pre-selected list and proceed with any recommended diagnostic tests and treatment.
7
We will pay the invoice for consultations, diagnostic tests, or treatment, taking into account any options, such as your excess, any benefit limits and specialist fees.
