Step 3: Making a claim

Please read Section 6 for full details of how to claim. Here are some guidelines and useful things to remember.

Direct settlement/pay and claim

Direct settlement, when eligible, is where the provider of your treatment claims directly from us, making things easier for you. The alternative is for you to pay and then claim back the costs from us.

We try to arrange direct settlement wherever possible, in accordance with your level of cover, but it has to be with the agreement of whoever is providing the treatment. In general, direct settlement can only be arranged for in-patient or day-case treatment. However in some instances, we may also be able to pre-authorise out-patient investigations. Direct settlement is easier for us to arrange if you contact us and we prior approve your treatment, or if you use a participating hospital or clinic.

What to send

We must receive a fully completed claim form and the original invoices for your treatment, within three months of the treatment date. If for some reason this is not possible, please write to us with the details and we will see if an exception can be made.

Your claim form

You must ensure that your claim form is fully completed by you and by your medical practitioner. Please remember that your treatment must be on the initial recommendation of your family doctor. The claim form is important because it gives us all the information that we need. Contacting you or your medical practitioner for more information can take time and an incomplete claim form is the most common reason for delayed payments.

You can download a claim form from our website www.bupa.com.mt, or
contact us to send you one.

How we make payments

Wherever possible, we will follow the instructions given to us in the payment section of the claim form:

• we can pay you or the hospital
• we can pay by cheque or by electronic transfer

To carry out electronic transfers, we need to know the full bank name, address, SWIFT code and (in Europe only) the IBAN number of your bank account. You can give us this information on the claim form.

Processing your claim

We will process your claim as quickly as possible as long as we have all the documentation required.

Confirmation of your claim

When your claim has been paid directly to the hospital and/or the consultant, we will send you a letter stating when and how it was paid, and who received the payment. Again, please contact us if you have any questions about this information.