Calling all future claimants

We know that every claim we pay makes a big difference to someone’s life. That’s why we pride ourselves in the number of claims we’ve paid out over the years. Last year we paid 90% of health claims totalling at £38.1m. 

We also know that ease of claiming is really important, and we want to help you understand what you need to do, and when, so it goes as smoothly as possible. 

Here are a few key steps:

1. Get your claim started

To get started, give us a call or send us an email. We’ll ask for a referral letter from your GP so we can start authorisation. Pending review, we’ll give you the green light to make an appointment with a specialist and get your initial diagnostic tests done. 
If you have a Guided Specialist policy, we’ll find you 3 specialists to choose from when you call us, so you can make an appointment that best suits you.

2. Keep us in the loop after your consultation

Once you’ve had your consultation, please let us know the outcome. If you need more treatment, we’ll confirm what’s covered by your policy. Your specialist will give you the information we need, so it’s important to share this with us as soon as possible to avoid any delays. It’s important you don’t go ahead with treatment without making us aware first as if you do, we’ll have to reject the claim. This also makes sure you’re completely covered and don’t encounter any unexpected costs. 

If your policy includes a hospital list, make sure to familiarise yourself with the hospitals available under your chosen level of cover and where your specialist works. 

3. Stay in touch!

After your treatment, we’ll pay the invoices from the hospital and specialist, considering any excess or benefit limits you’ve chosen. Please keep in touch with us during and after treatment, so we can ensure everything is going smoothly and address any changes. If your treatment continues, each session or appointment needs to be approved by our claims assessors, so its best we know as soon as possible, to avoid delays or gaps in cover. 

You can find out more detail on the claims process in your policy document, but these 3 points are useful to bear in mind. 

Mrs S’s experience 

Mrs S registered a claim by calling our team and emailing over her GP referral letter whilst chatting with us. We were able to help her right away by checking the eligibility of her claim and giving the go ahead for her initial consultation and diagnostic tests, all in the same call. 

Once Mrs S had seen her specialist and completed a series of tests, she got back in touch with us with the news that she urgently needed complex cancer surgery. We immediately referred her to one of our Nurse Case Managers who made contact to assure that they would be supporting her throughout her cancer journey.  The case was also urgently sent to our Clinical team due to the surgery’s complexity. In less than an hour, our Chief Medical Officer had approved the treatment, giving Mrs S the reassurance that her claim was fully covered. 

We were pleased to be able to have a small positive impact during a difficult time for our member and we wish Mrs S a speedy recovery. 

Remember to check your policy document for more information on the claims process. 

If you ever need to start a claim
Contact us on 0300 123 3253 or by email at pmi-claims@the-exeter.com