How we deal with your claim
In most cases we pay eligible claims direct to the provider of your treatment - such as your hospital or consultant. Otherwise we will pay the main member. We will write to tell the main member how we have dealt with any claim.
We pay claims under the rules and benefits of the scheme that applied to you on the date you received your treatment.
We only pay costs for treatment that you receive while you are a member of the scheme.
We only pay eligible costs and expenses actually incurred by you for treatment you receive. We do not have to pay a claim if you break any terms and conditions of your membership.
We reserve the right to change the procedure for making a claim. If so, we will write and tell you about any changes.
Ex-gratia payments
If we agree to pay for the costs of treatment to which you are not entitled under the terms of your cover, ie an 'ex-gratia payment', this payment will still count towards the maximum amount we will pay under your cover. Making these payments does not oblige us to make them in the future.
*Lines are open 8am to 8pm, Monday to Friday and 8am to 6pm on Saturdays. Calls may be recorded and may be monitored. BT landline calls to 0845 numbers will cost no more than 3 pence per minute. Charges from other providers may vary and calls made from mobiles usually cost more.