EXPAT SERVICES GMBH
Dubai Branch (ESDB)
P.O. Box 112354
Sheikh Zayed Road
Gold & Diamond Park
Building 5, Office 206 & 207
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+971 4 341 55 80 |
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info@expatservices.ae |
CLAIMS PROCEDURES
Below you will find all necessary information for submitting your claim. Kindly follow the steps described below in order to minimize turnaround time. If you have any questions please do not hesitate to contact us.
Download Reimbursement Claims Form
 Reimbursement Claims Form |
PROCEDURES WHILE SEEKING MEDICAL CARE
WITHIN THE UNITED ARAB EMIRATES USING THE EXPAT SERVICES / NEURON NETWORK
- When visiting a network clinic or hospital, please ensure that you present your Expat Services / Neuron ID card. A co-insurance of 25% applies if insurance card is not presented. The medical provider will not provide cashless (direct settlement) treatment without the presentation of your card. Network clinics or hospitals have a supply of Neuron Claims Forms (in triplicate – white, pink and yellow) and will process the necessary paperwork for direct payment through Expat Services / Neuron.
- Once you have seen the doctor and you require prescribed medications, you will be given the pink copy of the Claims Form to take to the pharmacy, along with your prescription. You can use the hospital pharmacy or any of the pharmacies in the network.
- If you require treatment that involves admission to a hospital and need advice or assistance, please inform Neuron. You will be advised of the necessary procedure at that time as to the diagnosis, procedures involved, duration of admission, and eventual cost of treatment. Neuron will be happy to guide and assist you. You can call the NeuronHelpline number 800 44 08 (UAE only) or +971 4 341 47 70) at any time seven days a week. 8:00 am to 10:00 pm – Saturday to Thursday 9:00 am to 9:00 pm – Friday
- Alternatively, you can visit a network medical facility of your choice, in which case the interaction with Neuron will be carried out by the hospital administrative staff.
- A list of the tests / procedures that require pre-authorization from Neuron, before the clinic / hospital can proceed with the treatment, is attached. If you require one of the listed tests / procedures, your clinic / hospital will contact Neuron directly for the pre-authorization. This information has been included to ensure that you are fully informed in the event that such a situation occurs. Again, you are encouraged to call Neuron’s Helpline should you have any queries.
WITHIN THE UNITED ARAB EMIRATES BUT OUTSIDE THE EXPAT SERVICES / NEURON NETWORK (NOT COVERED UNDER THE EXPAT STANDARD GROUP PLAN)
- It is recommended for you to first call the NeuronHelpline on 800 44 08 (UAE only) or +971 4 341 47 70 for advice. Treatments (sum of treatments inclusive of pharmaceuticals) above AED 500 must be pre-authorised; otherwise 25% of bills must be borne by the insured (co-insurance).
- Please pay for your treatment immediately.
- Please take the Expat Services Reimbursement Claims Form, (which may also be downloaded from the Expat Services Website or faxed to the clinic / hospital by Neuron, if Neuron is contacted and requested to do so) to the medical provider and have it completed by the medical practitioner you visit. Please submit the original Claims Form together with all other relevant original documents (prescriptions, reports, invoices, bills) at the ESDB Branch Office or send by post. Photocopies will not be accepted.
- Please ensure that this Claims Form is correctly completed and signed by you and the medical practitioner who must also stamp the form with his / her official stamp.
- You will receive reimbursement for the eligible claim amount by cheque or bank transfer (note that in respect of a bank transfer the transfer fee will be deducted from the claims if a transfer is preferred) within two weeks from the time that all required supporting documents have been received.
WHILE ATTENDING A NON-NETWORK MEDICAL FACILITY OUTSIDE THE UNITED ARAB EMIRATES (KINDLY ENSURE THAT DOCUMENTS ARE SUBMITTED IN ENGLISH)
FOR OUT-PATIENT TREATMENT
- You are required to take an ESDB Claim Form with you when seeking medical treatment.
- The original completed form, together with all other relevant original documents (prescriptions, reports, invoices, bills), should be forwarded by post or courier to ESDB. Please ensure that the Claims Form is correctly completed and signed by you and the medical practitioner who must also stamp the form with his / her official stamp.
Note: Kindly ensure that you retain copies of all documents dispatched to ESDB.
FOR IN-PATIENT TREATMENT
- For emergencies that involve admission to a hospital, please inform Neuron on +9714 341 47 70 or Neuron’s associate company, Cega on the International Medical Emergency Assistance number (+44 124 362 1597) shown on the reverse side of your ESDB / Neuron Membership Card within 24 hours. You will be then advised of the necessary procedure at that time as to the diagnosis, procedures involved, duration of admission, and eventual cost of treatment. Neuron and / or Cega will guide and assist you.
Important Note: All elective In-patient treatments need pre-authorization.
PHARMACEUTICALS
- Note that supply of medicines (only if prescribed by a licensed medical provider) is only permitted for a maximum of one month at any time.
ROUTINE DENTAL TREATMENT
- Routine dental treatment is covered in all policies (not the Expat Standard Group) in simple form.
CHECKLIST FOR DOCUMENTS TO BE SUPPLIED FOR DENTAL CLAIMS ABOVE AED 1,000
- Completed ESDB Claim Form (see Checklist for Reimbursement Claims)
- Doctors report
- X-ray
- Detailed invoice – all treatments carried out must be listed and priced separately
Note: Original documents must be forwarded. Copies will not be accepted. Insurer reserves the right to request insured to go for second opinion if required!
CHECKLIST FOR REIMBURSEMENT CLAIMS
Please ensure that the steps set out below are followed when seeking medical care on a reimbursement basis:/p>
- Claims form must have the doctor's stamp and signature
- Claims form must have the patient signature
- Claims form must have service date and diagnosis / history
- Claims form must have lab reports and test reports if any tests have been carried out
- For inpatient treatment invoice must state cost estimate for costly procedures or in-patient claims an credit note / cancelled bills should be included
- Invoices need to include the amount, description of procedures and amount paid by the client or amounts deducted from the bill
- The amount should be for each procedure so that insurance company knows what was charged for all procedures
- The claims form must be filled completely
PLEASE TAKE THE ESDB REIMBURSEMENT CLAIM FORM TO ANY OUTPATIENT VISIT
| Reimbursement Claims Form |
Important note: The insured is requested to confirm that information provided by medical practitioner on claim form and attached documents is correct. Only first submissions of such reports / documents are accepted.