Health Claim Procedure 2017-11-07T17:05:17+00:00

Health Claim Procedure

Network Panel Hospital Claims (IPD)

Credit facility at the Health eConnex panel hospitals (TPA)

As per UIL Company agreement with Health eConnex “The Service provider for GHI Claims to UIL”

  1. a)The Health eConnex looks after the IPD Claims as per Health eConnex Standard operating procedures.
  2. b)After scrutiny and assessment of IPD claims received from panel hospital, the Health eConnex forwards the Approved/Processed claims to UIL for Cheque Payments to Network Hospitals.

The UIL pays all eligible expenses directly to the panel hospitals. In respect of non-eligible expenses, the panel hospital may seek deposit money from the insured employee/patient.  The insured employee shall pay all non-eligible expenses directly to the hospital before the patient is discharged.

Health eConnex Network Panel Hospital List (Annexure-A)

Reimbursement of claims for treatment received at non-panel hospitals

If an insured person wishes to be hospitalized in a non-panel hospital, the bills will then be reimbursed according to the rates/charges of the company’s panel hospital as per reasonable and customary deduction in the same city/town and reimbursement claim bills should be assess/verified by Health eConnex.

OPD Reimbursement Claims

It is declared and agreed that cover under this policy is extended to include out-patient medical treatment. Out-patient medical treatment means reasonable and customary charges for all medically necessary treatment and services provided by or on the order of a licensed physician to the insured person, as a result of day to day sicknesses or injuries.

Keep the following information ready before intimating the claim

  • Policy No. (Policy to be issued before registration if not done earlier)
  • Name & contact details of person intimating the claim
  • Date & time of accident / loss
  • Nature of loss, Place of loss and Brief description of loss
  • Name of the hospital if insured is hospitalized
  • Name of person who took insured to hospital
  • Contact no. and address if insured is not at the address given in the policy
  • Designation and grade of the person and since when he is covered under the policy (for group policy)
  • Name of attending physician and family physician
  • e-mail id of insured for future correspondence

Note:

  • Terms and conditions of policy apply.
  • In case the insured is hospitalized, kindly collect all the hospitalization documents at the time of discharge.
  • Submit the claim documents to UIL office for claim processing within 7 days of completion of the treatment.
  • Claim settlement will take approximately 7 days from the date of submit of final document, provided all document are in order.
Contact Us:
Ph.: 021-111-845-111 (For Branches in Karachi)
042-111-845-111 (For Lahore Branch)
061-111-845-111 (For Multan Branch)
051-111-845-111 (For Islamabad Branch)
041-111-845-111 (For Faisalabad Branch)
Email: info@ublinsurers.com