Health & Accidental Claim – UAT PhillipLife

Health & Accidental Claim

When you get sick or have an accident, you can be treated in a contracted hospital using the fax claim service by paying nothing from more than 338 contracted hospitals and clinics. Just show your ID card and inform that you have health insurance with the company. By this, the hospital staff will facilitate you.

Check the contracted hospitals

Please read before filing a fax claim

      • The insured must hold a policy with additional contracts "Health Insurance" which is effective for not less than 60 days from the date of the contract start or the date of approval of the last renewal of the contract to be able to receive the privilege.
      • In case of an accident and having to stay in a hospital, fax claim service can be used from the contract valid date.
      • In the event that the insured is hospitalized and discharged but has been re-treated for the same cause, disease, or complication during 90 days, it is considered to be a treatment for the same systemic and continuation conditions. The medical expense coverage limit must be used continuously from the previous time.
      • The company will approve the privilege to use medical expenses according to the coverage in the policy. When considering the documents sent by the hospital, it must be an injury or illness diagnosed by a doctor and decide that it is necessary to be treated as an inpatient or an operation that is specified in the health insurance supplement contract.
      • In some cases, the hospital will collect medical expenses in excess or in addition to the policy coverage directly from the insured.
      • There are some cases where you may not be able to use the fax claim service, for example:
      1. In case of being sick with a serious or chronic disease, the policy validity is less than 2 years.
      2. In case of being sick with a pre-existing illness or an exception to the coverage as specified in the insurance policy or additional health insurance contract attached to each life insurance policy.
      3. In the case of being admitted to the hospital for a health check-up, rehabilitation, or physical therapy in which the information is unclear, the company cannot communicate with the hospital to request a history or additional treatment details. Besides, in cases where it is necessary to collect additional documents or take time to consult a specialist for accuracy and fairness.

If you are unable to use the fax claim service, you will need to reserve your hospital bills first. Then, you have to make a claim with the company later. The company will consider the additional information and details again.

Reimbursement of medical expenses that you have paid before

With only 3 easy steps: Prepare all documents > Send to the company > Wait for the money to be transferred to your bank account

 

Required documents

  1. Compensation claim form download click
  2. Original receipt (in case of medical expenses reimbursement).
  3. Summary of medical expenses in case of treatment as an inpatient and/or an outpatient, depending on the case.
  4. Medical certificate
  5. If there is a Film X-ray, must attach it.
  6. In case of an accident, a copy of the police officer's daily record must be attached (in the case of physical abuse), including photographs that are useful for consideration, such as injured organs and accidents, etc.
  7. For daily reimbursement, the company will consider evidence of hospitalization as an inpatient.
  8. In the case of reimbursement from other additional contracts, the medical history of both inpatient and outpatient cases must be submitted for further consideration.
  9. Copy of the first page of the Insured's bank passbook (with certified true copy).

Duration  :  Not later than 15 days from the date the company receives complete and correct documents.

You can submit the documents for claiming through a service agent, the company's branch office, or registered mail to Phillip Life Insurance Customer Relations Center.

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