13
24/7 Claims +44 (0) 1892 504234
If
your
claim has been pre-authorised by
us you
will be given a 5
digit Authorisation Number.
Alternatively,
you
can go to
our
website
/
claims.htm and request pre-authorisation by completing the
online submission form.
Pre-authorising
your out-patient
claim provides the peace of mind
of knowing that
your treatment
costs will be covered.
PLANNED IN-PATIENT & DAY-PATIENT TREATMENT
All in-patient and day-patient treatment must be pre-authorised.
If treatment is not pre-authorised by us, we reserve the right to
decline your claim.
If
your treatment
is subsequently proven to be covered under
the terms and conditions of
your policy
,
we
will pay only 50% of
eligible benefits.
Please note that all
treatment
, including
out-patient treatment,
relating to
psychiatric illness
requires pre-authorisation. If
treatment
is not pre-authorised
we
reserve the right to decline the claim in full.
Please ensure that
you
do this at least FIVE WORKING DAYS prior to
admission or
treatment
appointment.
To pre-authorise your treatment please call us on
+44 (0) 1892 504234 (24/7)
If
your
claim has been pre-authorised by
us you
will be given a 5
digit Authorisation Number.
Alternatively,
you
can go to
our
website
/
claims.htm and request pre-authorisation by completing the
online submission form.
Once
we
have confirmed that
your
claim is eligible under
your
policy
with ALC Health,
you
can then start
your treatment
.
Your
Doctor or
Hospital
will send
your
invoices to
us
for payment.
Once received,
we
will make direct payment to them and will send
you
a statement to confirm that this has been done.
In some circumstances
you
may need to pay for the eligible
treatment
directly. In these cases please forward
your
paid
accounts direct to
us
(by post, fax or online submission) and
we
will send the payment (and statement) to
you
instead.
EMERGENCY ADMISSIONS
If
you
have an emergency situation and require immediate
admission to
hospital
,
our specialist
team are there to support
you
.
You
can contact them on +44 (0) 1892 504234 or
you
can ask
someone to call them on
your
behalf.
If possible, please make sure that when
you
are admitted to
hospital you
give them
your
membership card as this will help
us
to deal with them directly.
In the event of an emergency admission
you
may unfortunately,
not be in a position to notify
us
. Please therefore do ensure that
you
carry
your
membership card at all times.
Hospitals
may
need to have access to this and will, where necessary, check
your
personal belongings to discover it.
It is also a good idea to ensure a relative, close friend or colleague
is aware of
your
medical insurance arrangements.
Complaints
Our
aim is to provide
you
at all times with a first class standard of
service. However, there may be occasions when
you
feel that this
objective has not been achieved and
you
are not satisfied with the
way
we
explained or arranged
your policy
. If
you
have a complaint
about
us
in relation to arranging this insurance
policy
, please contact
us
by phone or alternatively, write to
us
at:
The Managing Director
ALC Health
Chanctonfold Barn
Chanctonfold Horsham Road
Steyning West Sussex United Kingdom BN44 3AA
T
+44 (0) 1903 817970
F
+44 (0) 1903 879719
E
AXA PPP International is the underwriter (i.e. insurance company)
responsible for this
policy
and also look after the handling and
payment of claims.
We
hope
you
never need to raise concerns about AXA PPP
International’s service or any aspect of
your policy
. However,
we
realise situations happen that may cause
you
concern.
If having contacted the Personal Advisory team
you
still feel things
have not been put right, please contact:
The Customer Relations Executive
AXA PPP International
Phillips House
Crescent Road
Tunbridge Wells TN1 2PL
T
+44 (0) 1892 772163
The Customer Relations Executive, on behalf of the Senior
Appointed Representative for complaints for AXA PPP International,
will arrange for
your
complaint to be acknowledged on receipt.
They will investigate it and respond to
you
as soon as possible. To
allow
us
to investigate
your
complaint fully, the Financial Services
Authority (FSA) gives
us
up to eight weeks to get back to
you.
However,
we
will respond sooner than this if
we
are able.
The Financial Ombudsman Service will review
your
complaint if
you
remain dissatisfied after the AXA PPP International Customer
Relations Executive has issued their final response. The address
you
need to write to is:
The Financial Ombudsman Service
South Quay Plaza, 183 Marsh Wall, London E14 9SR
T
+44 (0) 845 080 1800
E
Website:
The Ombudsman will review complaints about:
n
the way in which
your policy
was sold to
you
n
the administration of
your policy
n
the handling of any claims.
Please note that the Ombudsman will not normally investigate
complaints concerning an insurer’s exerciseof commercial judgement.
The Ombudsman will also not generally review a complaint where:
n
You
have not received a final decision from the Customer
Relations Executive
n
The final decision issued by a company was received more than
six months ago
n
Your
complaint already involves (or has involved) legal action.
Complaints about the handling of
your policy
.
1,2,3,4,5,6,7,8,9 11,12