Hong Kong Health Insurance Claims

When you receive treatment under a Hong Kong Health Insurance plan you will need to submit a claim to the insurance company in order to be reimbursed for the cost of treatment.

Claims are one of the most important aspects of a Medical Insurance plan, and you need to be secure in the knowledge that your insurance provider is able to handle their claims process in a smooth and efficient manner. As such, Hong Kong Health Insurance chooses only to work with Insurance Companies which have displayed above average capability in their claims process.

In addition to carefully evaluating the providers we work with, we have taken extensive measures to ensure that you can submit your claims as easily as possible. With our own in-house claims team we are able to monitor the status of your claim and interact directly with the insurer on your behalf to ensure speedy reimbursement of your medical expenses.

Types of Health Insurance Claims

There are a number of different types of claims which can be made under a Hong Kong Health Insurance plan. It is important to understand how a claims process works to ensure that you are reimbursed as quickly as possible. Common types of claims made on Hong Kong Medical Insurance policies are:

In-Patient Health Insurance Claim Treatment Guarantee

If you require scheduled In-patient medical treatment it is extremely common that you will be asked to submit a Treatment Guarantee Form to your insurance company prior to being admitted to the in-patient facility in question.

Submitting the Treatment Guarantee to the insurer prior to receiving treatment allows your insurance company to liaise directly with the medical facility where you will be receiving treatment in order to confirm full payment of your healthcare.

In-Patient Emergency Treatment Claim

In the event that you experience and accident and require emergency assistance it may not be possible to contact your insurance company prior to being admitted to hospital.

The majority of insurers will settle emergency medical bills directly with the treating hospital. However, in some cases you may need to cover the costs of your treatment up-front, and then submit a claim to the insurer for reimbursement of your expenses.

When dealing with an emergency situation where you require medical treatment it is advisable that you, or someone close to you, contact the insurance company providing your Hong Kong Health Insurance plan as soon as possible upon being admitted to the hospital in order to ensure speedy settlement of the treatment costs.

Out-Patient Direct Settlement

Many of the Insurance Companies which we work with at Hong Kong Health Insurance have access to extensive direct settlement networks for out-patient treatment.

A direct settlement network usually consists of a number of medical providers, clinics and/or hospitals which the insurer has an agreement with to directly cover the costs of treatments for policyholders. If your plan offers direct settlement options, then you simply have to present your policy details, receive your treatment, and the insurance company will settle the bill directly with the medical provider.

General Out-Patient Claims

Generally when receiving out-patient medical treatment it is common for the policyholder to pay the bill at the time of treatment, and then submit a claim to the insurer for reimbursement. The way in which you are reimbursed for out-patient claims is generally left to your choice under most Hong Kong Health Insurance plans.

Common Issues with Health Insurance Claims

While we take the utmost care to ensure that your Hong Kong Health Insurance claims are handled as efficiently as possible, we do recognize that there are some common problem areas which individuals may come across when first dealing with a Medical Insurance Claims process.

With our many years of industry experience, and a dedicated on-site claims team we aim to help you receive reimbursement for you medical expenses as quickly as possible, and avoid the two potential problem areas of Incomplete Paperwork, and Pre-existing medical conditions.

Incomplete Paperwork

One of the biggest obstacles in receiving speedy reimbursement of your medical insurance claim is with the paper work you submit to the insurance company. Ensuring that all the documents you provide to the insurance company for your claim are completed, with appropriate doctor’s signatures, receipts, and other supporting paperwork will help to enable quick reimbursement of your Hong Kong Health Insurance claim.

Our in-house claims team will review all your claims paperwork before submitting it to the insurance company, ensuring that all the relevant documents have been completed accurately.

We also recommend that you make copies of any claims paperwork you may submit. This helps you to keep track of your claims and means that you will always have the necessary documents on hand.

Pre-existing medical conditions

Pre-existing medical conditions are normally excluded from coverage under Hong Kong Health Insurance plans. Please click Pre-existing medical condition insurance for additional information.

If you make a claim for a pre-existing condition this is normally not covered under your plan and will typically be denied. Please ensure you are aware of the coverage your Hong Kong Health Insurance plan provides prior to submitting a claim under the policy.

Hong Kong Health Insurance Quote

If you would like to receive additional information about the claims process of a Hong Kong Medical Insurance plan, please contact one of our dedicated advisors today. Alternatively, you can request a Free Hong Kong Health Insurance quote by completing the short form at the top of this page.