Making a claim: Your questions answered

We understand that, for many people, periods of illness and injury and medical treatment can be stressful times and the last thing you want is a complicated and confusing claims process.

Our claims team is here to assist you and if you ever have any questions about your claim, please do contact us and we will be pleased to help.

In the meantime, here are some common questions we often receive in relation to our policies and the claims process. If you have a question that isn't answered here, please contact us.

Do I need to check with you before receiving treatment?

Yes, this is to ensure that all treatment recommended will be covered by you policy.

When can I contact you to make a claim?

Yes - before you make a claim or receive any medical treatment, you must contact our claims helpline. This is so we can ensure that any treatment you receive will be covered by your policy and we can advise you on any limits that may apply.

When can I contact you to make a claim?

Our claims helpline is available Monday to Friday from 8am to 6pm (excluding Bank Holidays) and can be contacted by:

Telephone: 0870 444 8291 (your calls may be recorded and may be monitored)
Fax: 0870 444 8296
Email: healthclaims@groupama.co.uk

Can I fax/email my claim form to you?

Yes you can, using the contact details above. We are able to issue claim forms via fax / email if required.

Can you recommend a Specialist or Hospital?

Unfortunately we are unable to make specific recommendations regarding your treatment. Your doctor or Specialist is best placed to make those decisions according to your clinical need and personal circumstances.

How will you settle my claim?

In the majority of cases, payment will be made directly to the provider of your treatment. If you pay for any treatment yourself, please forward the original receipted invoice to us and we will be happy to reimburse you directly.

Are there any benefit limits applicable to my policy?

Most of our policies will provide a full refund of eligible treatment costs, however some benefits will have either a monetary limit or a time period limit. For a full explanation of your cover, please refer to your benefits table, policy booklet and membership certificate as these documents provide all the information you need about your policy cover.

In addition, when you contact our claims helpline to make a claim, we will tell you about any limits that apply to that claim.

Do I have a policy excess?

Depending on the type of policy you have, you may have a policy excess. Your membership certificate will show whether or not an excess applies to your policy and the amount of the excess.

Again, when you contact our claims helpline to make a claim, we will tell you about any excess that applies to that claim.

Will my claim details remain confidential?

Any personal information we collect during your claim will be kept strictly confidential and only used for the purposes of assessing and settling your claim in accordance with current data protection legislation. If we require further medical information from your doctor or Specialist to help us assess your claim, we will ask for your permission to obtain this information and advise you of your rights under the current Access to Medical Reports Act (1988).