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Medical Claims questions

Please click on one of the frequently asked questions below to reveal the answer.

Q. I am abroad and need urgent medical assistance. Who do I need to contact?
A. We do not deal with medical emergencies. If anyone insured on your policy needs urgent medical assistance, you must contact the emergency assistance provider. Their details will be contained in your policy wording. If you do not have this document, or cannot find their details, you should contact the company which sold you this insurance as they will know their contact details. If not, call us and we will try and obtain the correct details for you.

Q. What is an Emergency Assistance service?
A. In the context of travel insurance, an Emergency Assistance service is a service provided to you under the cover of your travel insurance policy. They are appointed by the insurers to ensure you are adequately cared for in the event of a medical emergency service and to monitor costs in real time. In some instances it is a condition of the policy that you contact the Assistance service and their contact details should be prominently displayed within the policy wording or policy schedule.

Q. What documents do I need to send you in support of my Medical claim?
A. Different claims will demand different documents and once you have notified us of your claim we will confirm exactly which documents to provide.

As an indicator it is likely that we will require the following documents:

ALL MEDICAL CLAIMS
Proof of insurance
Booking invoice/proof of travel dates
Receipts
Discharge report
Photocopy of EHIC card

ALTERED TRAVEL ARRANGEMENTS
Medical confirmation of need to alter travel arrangements
We may also require a medical certificate to be completed but will confirm in writing if this necessary
Refund confirmation on any unused bookings

HOSPITAL BENEFIT
Hospital reports confirming admission and discharge dates

SKI PACK
Evidence of original ski costs, itemised per person and showing the dates covered.

If you do not have any of the above documents, please discuss this with your claims handler as they will be able to advise you of any alternative documents that are acceptable.

Q. Where can I get the medical certificate from?

A. If a medical certificate is necessary your claims handler should have explained this to you and provided you with a medical certificate to be completed. If you have been asked to get a medical certificate completed but were not given the form, you may download this form:

Click here for Cancellation claims

Click here for Curtailment claims

Click here for Medical claims

Q. Are my incidental expenses, such as food, covered?
A. Most policies do not cover incidental expenses such as food and drink. The industry consensus has been that by their nature, sustenance costs would have been incurred in any event and so are not deemed insurable. However, if you were hospitalised you may be able to claim for a set benefit aimed to cover miscellaneous expenses associated to being hospitalised.

That said, as not all policies are the same we are unable to provide a specific answer to this question without first referring to your own policy. We would therefore ask you to discuss this with your specific claims handler or if you are submitting your claim online, list the expense and let the claims handler detail any necessary adjustments.

Q. What is Hospital Benefit?
A. Some policies provide cover for Hospital Benefit which is a set benefit calculated on the length of your admission. The limits are usually shown on your Policy Schedule and the basis of cover within your Policy Wording.

Q. I have received outstanding medical bills, what should I do with them?
A. You must notify us of your claim as soon as possible. We should then be sent the bill straight away ensuring you quote your claim reference number. 

Q. I am still receiving chasers on medical bills I have already sent in. What should I do?
A. Sometimes we will settle bills directly with the providers but in other instances we may settle them through a cost containment service that is able to audit the bills and negotiate preferential rates. During this process it is not unusual for the facility’s billing department to continue sending out reminder invoices/statement of accounts. These should be sent onto us, quoting your claim reference.

If you contacted the medical assistance team whilst you were overseas, send the bills to us and we will forward them to this assistance team, as they will have agreed to pay these directly.

Q. What is a cancellation invoice and where do I get it from?
A. A cancellation invoice confirms that you did not travel and tells us how much money we need to pay if your claim is covered. Without it, we cannot finalise your claim. The Tour Operator, Travel Agent or transport/ accommodation provider produces these invoices and will send them to you. You will probably have to contact them to request it.

Q. Why do you need a medical certificate completed?
A. Insurance policies can only cover certain, specific circumstances and they all contain terms and conditions, as well as exclusions. To enable us to decide whether the situation giving rise to your claim is covered, we need to understand the history of the medical problem which caused you to claim.

Q. What documents do I need to support my Cancellation claim?
A. Different claims will demand different documents and once you have notified us of your claim we will confirm exactly which documents to provide.

As an indicator it is likely that we will require the following documents:

Proof of insurance
Booking invoice/proof of travel dates including original date of booking and amounts paid
Cancellation invoices
Evidence of the cause of cancellation
If you are claiming based on medical grounds you will be required to have a Medical Certificate completed by your usual GP. This will be provided by your claims handler, but this can also be obtained by clicking here. If you do not have any of the above documents, please discuss this with your claims handler as they will be able to advise you of any alternative documents that are acceptable.

Q. What is Air Passenger Duty and how do I reclaim it?
A. Air Passenger Duty (APD) is a tax levied by the government based on certain flights. Airlines will normally charge you this amount as part of the booking. However, if you do not travel no tax is applicable and so travel insurers generally expect these costs to be refunded by the airline. Therefore, in the event of cancellation, please contact the airline directly with a view to reclaiming this part of your claim.

Some policies exclude these costs whether the airline have refunded them or not.

Q. What happens if I delay the cancellation of the trip?
A. Most (but not all) bookings are subject to a scale of cancellation charges that tend to charge more for cancelling, the closer this is left to the travel date. This is because they have less time to try and resell the booking. Therefore, as soon as cancellation can be anticipated, the insurers would expect the trip to be cancelled in order to stop the charges from escalating. If there is a delay in cancelling, and this increases the costs of the cancellation charges, insurers will only look to cover the costs up to the date cancellation could have been anticipated.

In some instances, there might be a delay but it does not affect the charges, for example, you may still be in the loss of deposit phase of charges. For cases such as these, we would ask you to provide a copy of the booking terms and conditions or a link to the provider's site that details the scale of charges.

Q. Do you cover the cost of obtaining medical certificates needed to support the claim?
A. Most policies will not cover the costs you incur in supporting your claim. This includes the costs of getting a medical certificate completed.

Q. Can I send a death certificate instead of getting the Medical Certificate completed?
A. This depends on a number of factors, including the cause of the death, the amount of information contained within the Death Certificate and whether the claim relates to an insured person or third party.

We would suggest that if a death certificate is readily available, a copy of this be sent in. If it does not provide the necessary level of information the claims handler will request the Medical Certificate from you.

Alternatively, if you do not want the claim to be delayed by the need for subsequent contact you may want to get a Medical Certificate completed instead.

Q. I paid for the trip for a non-insured can I claim their cancellation costs?
A. No. The insurers took a premium to cover the claims costs they associated purely to the people insured under the policy and no-one else. They will need to claim back their costs under their own travel policy and (if appropriate) reimburse you.

Q. Who are Rightpath Claims?
A. Rightpath are an independent company that specialise in claims management. We are not the insurer but are appointed by insurers to handle claims on their behalf.

Q. How do I submit my claim?
A. The claims process differs dependent on the nature and complexity of your case. For some instances claims can be submitted online, whereas for others we will look to assess your claim over the phone. In some circumstances we will send you a claims form.

Click here to go to the Claim section of the website, select the section you wish to claim under and you will see your options for how to submit a claim to us.

Q. I have an option to submit my claim online – how does this work?
A. Once you click on the link within the Claim section you will be directed to an online form. This will provide us with the information required to set up your claim and to assess your claim.

Once you submit the form you will be sent an email confirming your claim reference and detailing the documents you need to send into us to complete your submission.

Upon receipt of the papers your claim should be assessed within 5 working days and we will send you an email confirming the claims decision.

Q. I have an option to call you to submit a claim – what is the process from there?
A. When you call, one of our customer service agents will collect details about your claim and set you up a claim. This will also allow them to make a provisional decision on your claim and on the basis of there being cover in place you will be told what documents you need to submit to us.

We would suggest you have all relevant documentation to hand when calling us. We may need to collect information contained in these documents when you notify us of your claim.

We would ask you to appreciate that in all instances our decisions are provisional until your claim has been fully finalised.

Q. What rate of exchange do you use?
A. We want to be able to put you back in the same financial position you were in before you suffered your loss and so our preference is to go by the rate of exchange you obtained when you travelled. Therefore, please forward any confirmation of exchange rates you might have to allow us to try and base calculations on that rate.

In the absence of such documentation, we will look to establish the published rate of exchange for that date and use that instead.

Q. Why do you need proof of travel?
A fundamental requirement for a travel insurance claim is that the loss occurred on a trip (or in relation to a trip). Confirmation of your travel arrangements is therefore a standard requirement for claims assessments.

For cancellation claims, a booking invoice is also required to confirm how much was paid for the trip and the date the trip was booked.

Also, if you have an annual multi-trip policy there are most likely to be restrictions based on what is considered a ‘trip’ and this will include the trip length. Confirmation is therefore required to confirm the date you travelled from and to your home.

Q. What is a policy excess? And how much is it?
The policy excess is the first amount of every claim for which you are responsible and helps to keep insurance premiums affordable. You act as a self-insurer for this part of your claim and the benefit is that it releases the insurers from the burden of having to price the premium to cover the large number of small value claims.

The amount varies between policies and you will need to check your wording or call our claims handlers to get confirmation.

Q. Why has more than one excess been applied to my claim?
However, you should be confident that any decision we make is correct and so if you feel we have not explained this decision properly please contact us to let us know and we can provide some further explanation.

In the meantime, here are some of the reasons why multiple excesses may have been applied:

Per Person
The cover listed in most policies (e.g. sums insured, policy limits and excesses) are applicable per person. Therefore, just as we would not look to limit two people’s claim to the value of one limit or sum insured, we cannot apply only one excess.

Per Section
Your policy is a composite of various types of cover all rolled up and packaged as one product: your travel insurance policy. However, these sections tend to all cover distinctly different risks and so often insurers set excesses to apply individually to any claim under each section.

Per Claim
Each claim represents a separate insured event and all limits and excesses apply separately.

Q. What is an insurance Schedule and where do I get it from?
A. Different companies confirm that you have bought insurance in different ways. You may have received an e-mail which shows your policy number, how much you paid and who is insured. If not, this information may be included in your holiday booking invoice, or you may have received a separate document which shows who you are insured with. Without this information, we will not know which insurance policy you bought and will not be able to deal with your claim. If you are unsure, please contact the company you bought insurance from. If you don’t know who you bought your insurance from, please feel free to e-mail or call us for advice.

Q. Why are you asking for my insurance details? Don't you have this information already?
A. Rightpath are an independent claims handling company that specialise in claims management. As a third party we may not have details of your insurance and so to expedite the claim assessment process we may ask you to provide us with a copy of your policy schedule.

Q. Is there a time limit to when I need to send in my documents?
A. Yes. You must notify us as soon as possible about your claim and your policy should stipulate the time period (usually 30 days). If it takes longer than this to notify us of your claim, you will need to explain why this has happened. If the delay does not prejudice the handling of your claim, we may still be able to assist you. Once you have notified us of your claim you can submit the papers as and when you are able (but within 6 years).

Q. What address do I send my documents to?
Papers should be sent to:

Rightpath Claims,
Airport House,
Purley Way,
Croydon,
Surrey,
CR0 0XZ,
UK

Please make sure that you clearly mark your claim reference number on the first page of your papers.

You should also ensure that you pay adequate postage costs on the envelope, particularly if you are sending a large envelope.

You should always take copies for safekeeping and ideally send them recorded/registered delivery.

Q. How long does it take for the claim to be handled?
A. Your claim should be looked at within 5 working days of receipt.

For emails, we count the day of receipt as anything received up to 9 a.m. that day.

Q. Why haven't I received an acknowledgement to my email/letter?
A. As we aim to look at your correspondence within 5 working days, we do not acknowledge post/emails separately.

Q. How will you settle my claim?
A. We will make a bank transfer to your account. Once we confirm settlement, this should appear in your bank account within 5-7 working days.

Q. I am an overseas customer can you pay into my overseas account?
A. This will depend on the instructions provided to us by the insurers, and if the policy was taken out in the UK, for a UK resident, this is unlikely to be agreed as there are considerably higher costs in making overseas payments.

Q. Will my claim affect my future premiums?
A. Currently, no policy we deal with adjusts future premiums based on claims history.

Q. What happens to my documents once I send them in?
A. Your documents will be kept for a period of 6 months and will then be destroyed. If you requested your documents to be returned to you these should be received within 14 days. If you have not received your documents back after this period we ask you to get back in contact with us.

Q. Are calls recorded?
A. All calls are recorded for training and quality control.

Q. How are my bank details protected?
A. Your account number and sort code are stored within two fields that are encrypted with 128-bit master keys and use the AES (Advanced Encryption Standard) algorithm. Once saved these two fields are masked and can only be viewed by select members of the Accounts Team responsible for making claim payments.

Q. The claimant has died who do you pay?
A. We are not positioned to be able to establish legal entitlement and so we will only be able to raise a cheque made payable to the ‘Executors of Estate for [DECEASED’S NAME].

Q. Can I email you scanned documents?
A. Yes. However, there are a couple of important notes:

Size
We do not advise sending any emails greater than 2MB in size as these may not be received.
If the size of your attachments is larger than this, try breaking them down into smaller sized attachments sent across by several emails.
The size of the attachments is often determined by the resolution settings of the scanner. Black and white at 200dpi should be sufficient.

Format
For security reasons, we are only able to accept the following file extensions:

.pdf
.jpg

Also, we cannot accept compressed/zipped files.

Q. How long do I have to submit my claim?
A. All claims should be submitted as soon as possible. Most policies state that you must notify us that you need to claim within 30 days of the incident. If you are trying to obtain all the information/ proof you need to submit your claim. Still let us know that you need to claim so we can set a claim up for you and give you any advice and help you might need. If you wait too long to tell us you need to claim, we may not be able to get all the information we need to make a decision. If this is the case, we won’t be able to help you with your claim.

Q. What is a Recoveries Form?
As well as calculate how much the insurers need to pay you in settlement of your claim, we also have to identify if there is anyone else that may cover the loss. The Recovery Form is designed to collect all the information needed to make this part of the assessment. Therefore, it is essential we have this information before we can proceed toward settlement.

This information may be either collected from you over the phone, via an online form or by sending you a form to complete.

Q. Where can I get a Recoveries Form?
If we have requested a Recoveries Form the claims handler should have provided you with a form to complete, however, these can also be downloaded:

Click here if your claim is for cancellation
Click here if your claim is for personal possessions
Click here if your claim is for medical expenses
Click here if your claim is not any of the above

Q. Why does it matter what other insurance I have in place?
It is a well established principle of insurance that when two insurers cover the same loss the insurer who settles the claim is entitled to approach the other for a contribution toward their outlay. In most cases this will not affect your no-claims discount or premiums.

Q. Why do you need my credit card details?
It is a well established principle of insurance that when two insurers cover the same loss the insurer who settles the claim is entitled to approach the other for a contribution toward their outlay. Some credit cards now provide a number of benefits which can include travel insurance. For this reason, as part of our assessment, we need to know who you have credit cards through and the level of cards held.

Q. Why do you need to know who I bank with?
It is a well established principle of insurance that when two insurers cover the same loss the insurer who settles the claim is entitled to approach the other for a contribution toward their outlay. An increasing number of bank accounts provide a number of benefits which can include travel insurance. For this reason, as part of our assessment, we need to know what bank your main current account is with and the level of account held.

Q. I just have a standard bank account can I just put that down?
A. We have to make an independent assessment of your claim and we will need to know the exact level of account held in order to identify if travel insurance is also held under this account. If you do not know this information, and are unable to find it on your bank statements or online, please contact your bank and ask for their clarification.

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Telephone: 0844 887 0305 / + 44 (0) 20 8667 1600 Email: enquiries@rpclaims.com Address: Rightpath Claims, PO Box 6053, ROCHFORD, SS1 9TT
Rightpath Claims is a trading style of Rightpath Insurance Solutions Ltd. © 2012 Rightpath Insurance Solutions Ltd.
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