How to File Private Medical Care Claims

In New Zealand, we’re lucky to have a nationwide public health system providing reliable medical care services. The only problem is that they got limited financial resources. The lack of funding makes it practically impossible to diagnose and treat patients with health conditions quickly. As a result, patients have to endure long wait times in medical facilities that are insufficiently staffed and equipped.

Enter private medical care

This is why getting private medical care insurance is crucial. Private medical coverage allows you to receive medical attention quickly. It also gives you the privilege to choose who will be your attending physician.

More important, private medical care coverage is more extensive. Medical insurance offered by private companies includes surgical procedures, treatments by specialists, and diagnostic testing. Some will even cover treatments and non-pharmaceutical medications for as long as your doctor prescribes them.

Filing a claim on your medical care

Now that you know the benefits of getting private medical care insurance, it’s important to know how to enjoy these benefits.

Here are the steps to properly file a claim on your private medical care so that it’s processed quickly.

Get a referral letter

Before you can file a claim, you need to get a referral letter from your doctor. Make sure that you ask this right away, especially if your doctor is a General Practitioner or GP. They’re far busier than specialists, so naturally, they’ll have lots of paperwork to fill.

Some insurance companies may require you to ask your doctor to fill out a questionnaire. It takes a while before your doctor gives you the paperwork you need to file a claim, so check with your private insurance first. This will save you the trouble of having to go back and forth to get the paperwork you need to submit.

Ask for an estimate

Some private insurance companies will need you to give an estimate of how much your medical expenses will be. If they do, ask your doctor to give you one. Doctors are aware that this is a requirement when you file you’re medical, so they’ll be able to help you out.

Keep clear digital copies

Insurance companies now accept digital copies of your documents to help speed things up. If the medical care facility provides you a digital copy of your documents, make sure that you can read them. If you can’t read them, neither will the representatives from your medical care insurance company.

Some medical care facilities can only give you hard copies. When that happens, create a digital copy by either scanning it or taking a photo using your smartphone. Again, make sure that it’s clear. Submitting digital copies that are blurry and unreadable can cause delays in your claim.

Notify your insurance representative immediately

This is vital if you’re filing an urgent medical care claim. Most private medical care insurance companies process claims on a “first come, first serve” basis. Even if your claim is urgent, it can quickly get delayed because of lags in processing.

Giving your medical care representative a heads-up can help speed things up. By notifying your representative immediately, you put the pressure on them. Often, this will help get people moving and your claim processed more quickly.

Filing a medical care claim can be tedious. But, with a bit of know-how about the essentials can make this ordeal more bearable.


Image Source: Flickr/FranchiseOpportunities


This website is written as a general guide and is not personalised advice. It is not intended as personal financial advice,nor is it specific advice to your situation. The author has written this in good faith and disclaims any liability from any action or inaction from how you may use this website or the results it may or may not achieve. Government, bank, company, insurer and lending policies, as well as other policies, procedures, and information in this website are likely to also change from time to time, and rules and decisions and policies may be applied differently and/or on a case-by-case basis. These rules may also change from the approximate time this was written. You are encouraged to recheck if these matters are accurate and up to date. By reading and using this website, you agree to hold the author, associated entities and/or associates, harmless.