The Pre-authorisation Process

Certain treatments and costs require the submission of a Pre-authorisation Form in advance. Following our approval, cover for these required treatments or costs can then be guaranteed.

This process helps us to control the cost of medical treatment in a worldwide context, and therefore maintain our premium rates at the lowest possible level. It also helps us to provide a better service in the following ways:

  • We can ensure that proposed surgical treatments are carried out on a day-care basis where medically appropriate.
  • In the case of planned treatment, we will have time to communicate with the hospital to facilitate smooth admission and where possible, arrange for direct settlement, offering cashless access to hospitals for in-patient treatment.
  • Treatment can be overseen by our Medical Team.
  • In the case of an evacuation/repatriation, we will be able to organise and co-ordinate the evacuation on behalf of the member.
  • We can ensure members are admitted and discharged at times that do not attract a surcharge.

Submission of a Pre-authorisation Form is required for the following:

  • All in-patient treatments
  • Day-care treatment
  • Out-patient surgery
  • MRI (Magnetic Resonance Imaging) scan. Pre-authorisation may be required for this test if you would like us to settle the bill directly with the medical provider
  • PET (Positron Emission Tomography) and CT-PET scans
  • Nursing at home or in a convalescent home
  • Routine maternity, complications of pregnancy and childbirth (in-patient treatment only)
  • Oncology (in-patient and day-care treatment only)
  • Kidney dialysis
  • Occupational therapy (out-patient treatment only)
  • Rehabilitation treatment
  • Medical evacuation (or repatriation where covered)
  • Travel costs of insured family members in the event of an evacuation/repatriation
  • Repatriation of mortal remains
  • Travel costs of insured family members in the event of the repatriation of mortal remains
  • Expenses for one person accompanying an evacuated/repatriated person
  • Palliative care and long term care

Pre-authorisation Process: how it works

  1. Pre-authorisation is arranged for all in-patient treatment and certain benefits and procedures, as outlined in the Table of Benefits.
  2. The relevant sections of a Pre-authorisation  Form must be fully completed by the member and their physician and sent to us for approval prior to treatment. We will respond within 24 hours of receiving a fully completed form. Members based in the USA should simply direct their medical provider to contact us and we will co-ordinate with them directly.
  3. Our Medical Services Team will then contact the medical facility and, where possible, arrange for the payment to be settled directly.
  4. It is important that members submit a Pre-authorisation Form where required, prior to treatment, as we reserve the right to decline a claim or apply a penalty if this process is not applied.