We always aim to settle your claim directly with your treatment provider. If we cannot do this for any reason, please send us a claim by post.
To help us to settle your claim promptly, you should include:
· a fully completed claim form
· all the original invoices for your treatment.
We cannot return original documents such as invoices or letters, but we are happy to send certified copies if you ask for these when you submit your claim.
We may need to ask for extra information to help us process your claim, for example:
· medical reports or other information about your condition
· the results of any independent medical examination that we may ask and pay for
· written confirmation that you cannot claim against another person or insurer.
If this is the case, there will be a delay before we are able to make any claim payment.
We will pay for:
· treatment and conditions included on your plan while you are covered by your membership
· costs as described in ' What is covered? ' as applicable on the date(s) of your treatment
· treatment which is clinically appropriate and suitable for you
· active treatment of a disease, illness or injury that leads to your recovery, conservation of your condition or to restore you to your previous state of health
· costs for treatment which you have received, but not deposits or advance payments for treatment to be received in the future
· reasonable and customary costs. This means that the costs charged by your treatment provider should not be more than they would normally charge and be representative of charges by other treatment providers in the same area *.
* Guidelines for fees and medical practice (including
established treatment plans, which outline the most appropriate course of care for a specific condition, operation or procedure) may be published by a government or official medical body. In such cases, or where published insurance industry standards exist, Bupa International may refer to these when assessing and paying claims. Charges in excess of published guidelines or reasonable and customary costs may not be paid.