Please advise the practice and your insurance company from the outset should you wish to raise a claim. Please be aware that some insurance companies have tight deadlines for submission of claim forms and we would always recommend you read the small print. Also please look carefully at what has been excluded on the policy before requesting work is carried out.
There are two types of claim.
Indirect Claims
When payment is made by you in full to the practice and then the claim is raised, and you are reimbursed directly by the insurance company.
What your vets need from you:
- Full payment of your invoice(s) before your claim can be processed
- The claim form policy holder section completed and signed
- A completed claim form per condition you wish to claim for.
- For any claim that you submit to your insurer through our systems or services, we require you to initiate the claim by notifying your insurer in advance of your intent to make a claim and to complete and sign an Insurance Claim Details Form prior to submission of the claim.
Your insurer may ask you to complete your claim online. If this is the case what your vets need from you will be greatly simplified. Please note processes differ between insurers
What your vets will do:
- Complete the claim form and have it signed by the vet in charge of the case
- Send the claim promptly to the insurer by post or electronically. (assuming your account has been settled in full and the claim form has been completed appropriately by you)
- Attach the clinical history, and in certain cases a clinical report on request from your Insurer
- Provide any other information requested by your insurer during the processing of the claim e.g. blood results, x-rays, etc
Please be aware of the difference between an Indirect and Direct claim.
A direct claim can only be processed with prior agreement with the Practice Manager at the time of treatment. If you wish to make a direct claim please make our team aware at the time of treatment.
Direct Claims
When you pay your excess and insurance processing fee and the practice is reimbursed directly by your insurance company.
What your vets need from you:
- Certificate of your insurance policy, which shows the policy limit, excess amount, start date and any exclusion(s) that may exist on the policy
- An administration fee for the processing of the Direct claim (per condition)
- Payment of your Insurance excess before the claim can be submitted. If you have a % excess a payment of £200 will be requested and the balance on settlement of the account.
- The claim form policy holder section completed and signed by the policy holder stating that the insurance payment comes direct to us. This should be completed at the start of treatment and received by our practice within 3 working days.
- All sections of the claim form which the policy holder is required to complete must be filled out correctly
- A completed claim form for each condition you wish to claim for
- Payment for any non-insured work at the time of treatment
- For any claim that you submit to your insurer through our systems or services, we require you to initiate the claim by notifying your insurer in advance of your intent to make a claim and to complete and sign an Insurance Claim Details Form prior to submission of the claim.
What your vets will do:
- Complete the claim form and have it signed by the vet in charge of the case.
- Send it to the insurer by post or electronically within 5 working days of receiving from you the client
- Attach the clinical history, and in certain cases a clinical report on request from your Insurer
- Provide any information requested by the insurer during the processing of the claim e.g. blood results, x-rays, etc
- Contact you if we have not received payment from the insurer 4 weeks after sending the claim form (most insurers request 4 weeks to process a claim) in order that you may query this with your insurance provider.
Please note:
If the insurer declines to settle the insurance claim it is your responsibility to settle the account in full
If your Insurer fails to settle the account within 14 days from the start of the claim It Is your responsibility to settle the account In full
We will write to you requesting full payment
Continuation Insurance claims
We commit to sending on a continuation claim for follow on treatment as soon as the treatment is completed. If continuations forms are not required, then any invoices relevant to your claim will be submitted to your insurance company. If a continuation for is required then please ensure they are submitted to the practice in a timely manner. If the treatment occurs several months after the initial or last continuation claim, please let us know, at the time of booking the appointment, that it is part of any ongoing claim.
Further Information
We will inform you of any further information your insurance provider has advised they require through the course of the claim. Eg. Passport, clinical history.
After a claim has been made your insurance company may exclude a condition. Please contact us if you need to discuss any exclusions. When appropriate we can perform an assessment of a horse and report our recommendations regarding an exclusion. We cannot guarantee the insurance company will remove the exclusion.
If you have any queries regarding insurance please do not hesitate to contact the practice.