Before You Claim

We want your claim to go as smoothly as possible, so before you make a claim for a hospital stay or day-to-day expense, there are some important things you need to know:

  • What are you covered for?

    The first step is to check your table of cover. The table of cover sets out the benefits that are available to you under your plan. For example, it will tell you whether you are covered for a semi-private room in a private hospital. You can find your table of cover online or in the welcome/renewal pack that you were sent.

    Your table of cover will also highlight what hospital list you’re covered for. You will be covered on Health Plans Hospital Lists 1,2,3 or 4 or Tailored Health Plans Hospital Lists A, B, C or D.

  • Do you have an excess on your plan?

    An excess is the first part of any claim that you have to pay yourself. For outpatient or day to day claims this is the amount we deduct from your claim before we send you the payment. You can see what excesses apply to you on your table of cover. Find out more about excesses here.

  • Do waiting periods apply to you?

    A waiting period is the amount of time that must pass from the start date of a health insurance policy before full cover is available. If you are new to health insurance, have a pre-existing condition or recently upgraded your plan, waiting periods may apply to you. Check here if waiting periods apply to you.

What Are You Claiming For?

Choose from one of the options below and we’ll guide you through the process.

  1. Gather Your Receipts

    If you are claiming for an outpatient or day to day expense, keep all your receipts throughout the year. Your receipts should include the following:

    • The amount you paid
    • The full name of the member receiving treatment;
    • The date the treatment was received;
    • The type of practitioner that you attended;
    • The name, address and qualifications of the practitioner providing the care on the practitioner’s headed paper.

    Click here to see an example of a receipt that includes all of the above.

    Click here for information on how to submit your Personalised Package claims.

How would you like to submit your claim?

  1. Include a Cover Letter

    Please include a hand-written or typed cover letter with your receipts. Make sure to include your name, address and policy or membership number on the cover letter. If it’s easier for you, you can download our template cover letter here.

  2. Post the Envelope to Us

    At the end of your policy year, send your receipts and cover letter to:

    Claims Team,
    Irish Life Health Insurance Ltd.,
    FREEPOST,
    PO Box 764,
    Cork

    Please note: If you request for your receipts to be returned, these will be returned to you after we have processed your claim.

You can avail of this service if you renew or join after 1st August 2015. If you have receipts from your previous policy year, please submit them by post.

  1. Log in to your Member Area

    • Click here to login to your member area.
    • Enter your membership number (found on your membership card) and password.
    • Click on the claims tab to access online claiming.
  2. Upload your receipts

    Upload a photo of your receipt and fill in your receipt details including date of treatment, cost of treatment and the member who received the treatment.

    One receipt may have a number of treatments; these should be added as individual items.

  3. Submit your claim

    In order to pay your claim, we'll need your bank details. We may already have your bank details but if not you can provide them when requested. You will also have the ability to change your bank details if required.

    Once you confirm your bank details you will be able to submit your claim. Once you submit your claim you will receive a claim reference ID.

  1. Before you go into hospital

    When you know what treatment you require, call our customer care team on 1890 714 444 to confirm your cover. Remember to have the following details to hand:

    • hospital name
    • consultant name
    • procedure code – you can get this from your consultant’s secretary

    Don’t Worry! In some cases we may ask you for your previous health insurance details. We do this so we can confirm your waiting periods and pay your claim as quickly as possible.

  2. During your stay in hospital

    Make sure you advise the hospital staff that you have health insurance and have your plan name to hand - you can find this in your welcome pack.
    The hospital will then supply you with your claim form which you need to complete.

  3. After your stay

    We have direct payment agreements with our listed hospitals and can settle the bill directly for all eligible costs under your plan. You don’t need to do anything else!

Some other tips on getting your claim paid quickly:

  • If there are two people on the policy with the same name, for example a father and son, the practitioner should specify the date of birth so we can quickly identify who received the treatment.
  • Where you received more than one treatment, for example, reflexology and massage, please ensure there is a breakdown of each treatment and associated cost.
  • Please send us receipts only. Unfortunately, we can’t accept invoices for claims.
  • To get your claim paid quicker, sign up for payment via EFT in your member secure area. This means your payment will go directly into your bank account, making life easier for you.
  • For further information on how to claim, please see your membership handbook or call us in Cork on 1890 714 444.