Making A Private Medical Insurance Claim

The Claims Process


A health insurance claim should be a straightforward process. We’ve written this simple step-by-step guide to help take you through the process:


1) Read Your Policy Document


To start with you should read your policy document – not all health insurance providers will adopt the same claims process and these may vary. It’s also worth checking the insurance firm’s website to check for specific guidance.


2) Visit Your GP


Talk to your GP about your health condition – just as you normally would. Your GP will be able to refer you for private treatment via an open referral (where the GP does not address a specific specialist or consultant) or a named referral (a specific specialist or consultant). It’s important to read the terms and conditions of your policy so that you understand what the insurer will be looking for with regards to referrals.


3) Phone Your Health Insurance Provider’s Claims Team


Call your health insurance provider’s claims team – making sure you have the following information to hand:

  • Your insurance policy number (located in your policy documents).
  • Details of the symptoms and when they started.
  • Details of what your GP has told you about the condition.
  • Information related to your referral – i.e. name of the specialist on the letter and where they practice, or if an open referral; the required specialism/sub specialism.

4) Get Diagnosis, Treatment Or Surgery


Should your specialist arrange treatment or surgery for a diagnosed condition you should call your health insurance provider and notify them of the following:

  • Where you’re being treated or undergoing surgery
  • When you plan to have the treatment or surgery
  • The procedure (CCSD) code from your specialist

5) The Insurer Pays The Bill


Most specialists should send the bills directly to the insurer, however, if you receive one at home, then either ask them to send a copy to your insurer or you can send it on to the relevant Insurer bill payment team.


We have included the details of our insurers below showing claims contact details and billing information:


Aviva Health Insurance

Claims number: 0800 068 5821

AXA PPP Healthcare

Claims number: 0800 132 203

VitalityHealth

Claims number: 0345 601 0072

Bupa Healthcare

Claims numbers:
By You Members 0345 609 0777
Health Insurance Members 0345 609 0111
Business Scheme Members 0345 609 0444

WPA Health Insurance

Claims number: 01823 625230

The Exeter

Claims number: 0300 123 3200

Health-on-line

Claims numbers:
Priority Health 0345 600 7696
Health For You 0345 600 1292
Health Select 0800 206 1794
Personal Health 0800 027 1384
Personal Choice/Co Choice 0800 206 1794

Freedom Health Insurance

Claims number: 0800 999 2013