Solutions for individuals and families

The Care plans are 12 months plans offering comprehensive benefits, a choice of co-payment and deductibles as well as optional plans such as outpatient, dental, maternity and repatriation. They also include telehealth access, second medical opinion, health & wellness programme, mental health support services, and travel security services. 

Complete and return our Application Form available here. We will register you and issue a Broker Agreement with the terms and conditions of our partnership. Once the Broker Agreement is signed, we will provide you with an identification code (Agency ID), which will be used in your dealings with us.

1.       Our Medical Underwriting Team will review the applicant’s details:

• We evaluate the health information provided by an applicant for coverage.
• Based on any declared pre-existing medical history, we will determine the insurance risk and whether to accept the risk, postpone cover or decline it.
• Acceptance of the risk results in an offer of terms either at standard rates or with special conditions.    

If there are medical disclosures, your client may be asked to provide additional information for us to evaluate their case. We will send a Medical Questionnaire for the additional information to be filled in.

 

2.       Once the evaluation is complete, our Medical Underwriting Team will communicate the underwriting decision.  

There could be three outcomes:

Standard Rates	Surcharge/exclusion* or combination of the two	Declined or postponed
Cover is confirmed and offered at standard rates (based on new business quotation). This is the case for more than 70% of applications received by us.	Cover is confirmed and  offered with: A surcharge (additional premium)   OR Policy restrictions/exclusions (e.g. we would exclude a certain medical condition from cover)   OR An additional premium and policy restrictions (this may happen where pre-existing conditions or chronic medical conditions have been disclosed).	Cover is declined. However, this only happens in extremely rare cases as we are able to cover most pre-existing conditions. OR Cover is postponed: We have additional concerns on the applicant’s current medical situation. In such cases we would highlight what is needed, or how long until we can offer terms.

Once the cover offer is accepted by the applicant, we send the invoice and the contract to sign and return. Then we incept the policy and immediately provide the policy documentation – this will be either sent via email or made available on our MyHealth Digital Services.

A Payment letter is issued to your clients at the start of the insurance year.

This letter will indicate the first and subsequent premium due dates (depending on payment frequency selected). Premiums are charged and refunded based on a daily pro-rata rate.

The IPT amount (if applicable) will be listed separately.

We inform clients about the status of their account at each stage of the reminder process:

1. If the premium is not paid in time: A 1^st reminder is issued to the client 7 days after the premium due date.
2. If the premium is still pending: A 2^nd reminder is issued to the client 10 days later. In this letter we will advise that payment of medical claims may be suspended if payment is not received.
3. If premium is still pending: A final reminder is issued 11 days later, confirming that payment of medical claims has been suspended. 

We have a remittance advice system in place, to help allocate payments and minimise the issues where multiple payments are made together. With immediate effect, once a payment has been made by you/your client, please send an email indicating the client’s name, contract number, amount being paid and currency to: [email protected]

Premiums are due to us in advance of the period of cover to which it relates. The premium amount and the chosen payment frequency will be shown on the member’s Insurance Certificate.

For invoicing queries, please contact our Finance Operations Team:

+ 353 (0)1 898 3695

[email protected].

Commission rates are agreed with you at the start of our partnership. Your commission payment will be calculated based on premiums that we have received from your clients, less taxes. A commission statement will be generated and emailed to you every month. Commission payment will be transferred to the account indicated by your agency when you became a registered broker for our products.

For commission queries, please contact our Finance Operations Team: [email protected]

For treatment not subject to pre-approval (Out-patient or dental treatment):

The insured person can simply pay the bill and claim the expenses from us:

• Insured person receives treatment and pay the medical provider.
• Insured person claims costs via our MyHealth app or online portal (or claim form)
  
• We issue the eligible reimbursement and statement of accounts

For all claims queries, please contact our Helpline:

+ 353 1 630 1301

[email protected]

 

Treatment subject to pre-approval

For our international health insurance product, the pre-approval process (through the submission of a Treatment Guarantee Form) applies to most in-patient and high cost treatments indicated in the table of benefits. This process helps us assess each case, organise everything with the hospital before the insured person’s arrival and make direct payment of the hospital bill easier, where possible. 

1. Form is completed and sent to [email protected] (If treatment is scheduled within 72 hours, Helpline will take the details over the phone).
2. Insured person receives a response from us within 24 hours. 
3. We will contact the hospital to organise payment of insured person’s bill directly, where possible.
4. Our Medical Team will issue a Guarantee of Payment to the medical provider, authorising the treatment.

For all claims queries, please contact our Helpline:

+ 353 1 630 1301

[email protected]