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How do I make a claim?

Firstly if you are a client of Adelphi Insurance Brokers Ltd we want to honour our pledge to you that we are here for you from quote to claim. It is always your prerogative to deal directly with the insurer, but we do recommend that you call us on 0800 656 670 so we help you through any claims you may have.

Health Insurance Claims Process – Pre-approval before treatment

Before having any surgery, treatment or investigations, it’s recommended that you seek pre-approval, so you know that the procedure you require will be covered. To request a pre-approval, simply follow the steps below or call us on 0800 656 670

1

1. Click on the link to your insurer and download their pre-approval claim form, or call us on 0800 656 670 to request a copy.

nib Partners Life

2

Fill out all sections of the form that apply to your claim, download the claim form guide (if available) for help on the sections you need to complete.

Sign the back page.

3

Attach or include any additional information requested in each section of the form that applies. This information will include:

– Completed Doctors Questionnaire (this should be completed by your referring medical provider)
– Referral letter from your GP to your Specialist
– Specialist report
– An estimate for the procedure

4

Send the insurer your claim form with any additional information needed.

nib
Email: claims@nib.co.nz
Fax: 0800 345 134
Post: nib nz limited
PO Box 91 630
Victoria Street, West Auckland 1142

Partners Life
Email: claims@partnerslife.co.nz
Fax: 0800 14 54 33
Post: Partners Life
Private Bag 300995
Albany, Auckland 0752

5

After you have received your pre-approval, you can confidentially proceed with your procedure. Your approved pre-approval form will also serve as your claim form.

6

After you have had your procedure, you will receive invoices from the relevant medical professionals, e.g. Specialist, Anaesthetist, Hospital etc. Photocopy these and send the originals directly to the insurer. Your insurer will pay directly to the relevant medical professionals.

If you have already paid for specialist consultations or diagnostic test, that is covered under your policy, then make sure you supply your insurer with your bank account details, and they will reimburse you directly.

Please note you need to send original invoices and receipts showing the invoice has been paid before a claim can be paid to you.
Pre-approval requests and claims for payment to providers can be emailed, faxed or posted to the insurer
and you should retain the original documents in case your insurer requires them later.

“Why do I need an advisor, can’t I just do it online?”

A: Yes, you can go online, but unfortunately, not all insurance companies or insurance policies are created equal, especially with health, life, serious illness and disability insurances. Some companies may call their policies by the same names but may have significantly reduced features and benefits or have a much higher threshold to trigger a claim (often referred to as “the small print”). An advisor will ensure you have the correct insurance policies for your individual circumstances and needs. This is important because you never know the true value of an insurance policy until it’s time to claim.

Q: “What is the difference between Personal Insurance and Business Insurance?”

A: In very simply terms: Personal Insurance is asking the question “If a key member of the family (generally mum or dad) were to die, become seriously ill or unable to work for a period of time what financial risk does that expose the family to. You then pay a monthly amount to an insurance company to remove that risk. Business Insurance is asking the question “If a key member of the business (key stakeholder or key person) were to die, became seriously ill or unable to work for a period of time what financial risk does that expose the business to. You then pay a monthly amount to an insurance company to remove that risk.

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With the Internet spreading linke wildfire and reaching every part of our daily life, more and more traffic is directed to websites in search for information.