Health Claim Mb


Health Claim Service All about Claim Steps


Health claim in case of advance payment required (direct claim)

When you get sick and receive medical treatment at the hospital with advance payment required, did you know that you can later make a claim with the Company (subject to the policy conditions)?

ยื่นเอกสารได้ที่    Step 1: Prepare documents

Inpatient (IPD) Claims
1. Injury/Illness Claim Form Click
   - Insured’s part - Insured/insured’s guardian fills the information and sign the form.
   - Attending physician’s part – Attending physician fills in the information affix with a signature and hospital’s stamp
2. Original medical expense receipt for H&S case and its copy for HB case
3. Original medical invoice or summary statement of hospital for H&S case and its copy for HB case
4. Official identification of the insured issued by a government agency.
5. Proof of the insured’s consent to disclose medical treatment record of the insuredClick



Outpatient (OPD) Claims
1. Medical certificate or Injury/Illness Claim Form Click
   - Insured’s part - Insured/insured’s guardian fills the information and sign the form.
   - Attending physician’s part – Attending physician fills in the information affix with a signature and hospital’s stamp
2. Original medical expense receipt
3. Official identification of the insured issued by a government agency
4. Proof of the insured’s consent to disclose medical treatment record of the insured Click



Critical Illness (CI) Claims
1. Injury/Illness Claim Form Click
   - Insured’s part - Insured/insured’s guardian fills the information and sign the form.
   - Attending physician’s part – Attending physician fills in the information affix with a signature and hospital’s stamp
2. Original medical expense receipt and medical expense summary (for CI rider with medical expense benefit)
3. Laboratory test report including results of biopsy, MRI, CT scan and other related tests
4. Official identification of the insured issued by a government agency
5. Proof of the insured’s consent to disclose medical treatment record of the insured Click



Claim Reconsideration
1. Record the request of claim result reconsideration
2. Additional attending physician’s opinion or total medical records, as the case may be



Remarks:
1. In case of signing with fingerprints, signatures of 2 witnesses must be completely provided.
2. In case of a minor aged not over 10 year, a father/mother/legal guardian must sign on his/her behalf and specify the relationship.
3. In case of a minor aged over 10 years but less than 20 years old, a father/mother/legal guardian must sign together with the minor and specify the relationship.
4. In case the insured is a minor and less than 20 years old, a father/mother/legal guardian is required to submit a copy of ID card.
5. Before submitting a copy of ID card/passport, please cross out the “religion” or “race” information, as the case may be, until the text cannot be read, and sign to certify the redaction. Otherwise, it will be deemed that the insured allows the Company to cross out the “religion” or “race” information on the insured’s behalf.

ยื่นเอกสารได้ที่    Step 2: Submit documents through 3 channels

1. MTL Click Application
2. MTL Customer Service Center nationwide
3. Mail claim documents to the Company at
Muang Thai Life Assurance Public Company Limited,
250, Rachadaphisek Rd., Huaykwang, Bangkok 10310

Deration:
In case of a claim request
- The Company will complete the claim consideration within a period of 7 days from the date that the Company receives complete documents, or within a period of 90 days in case additional documents are required.
In case of health claim reconsideration request
- The Company will complete the claim reconsideration within a period of 30 days from the date that the Company receives the request or complete additional documents.

Remark: Conditions are as specified by Muang Thai Life Assurance PCL.
For more information, please contact MTL Customer Service Centers nationwide, or call Tel. 1766, available 24/7.



Health and personal accident claim with no advance payment required

Enjoy the convenient 24-hour fax claim service without advance payment by simply presenting the insured card together with ID card in case of hospitalization as an inpatient due to injury or illness at over 300 network hospitals nationwide (in case of being diagnosed by an attending physician to be hospitalized for at least 6 hours) or medical procedure that does not require hospitalization (subject to the conditions of the rider)

Step 1: Present cards
The insured presents the insured card together with ID card or driving license.

Step 2: Check the rights
The hospital checks your rights of medical treatment with the Company.

Step 3: Hospitalization
The insured is hospitalized according to the physician’s treatment plan.

Step 4: Information submitted to the Company
Upon discharge, the hospital will submit the claim information to the Company.

Step 5: Consideration
The Company will complete the consideration within 1 Hours (for normal claim case only). The consideration of cases with additional details may be longer than 1 Hours.

Step 6: Receive the result via SMS
The insured will receive the SMS after the Company receives the documents from the hospital, and completes claim consideration.

Remarks:
1.Please check the effective date of the health or personal accident rider on the insured card as well as coverage and exclusions in the policy.
2.Health rider must not be under the waiting period.
3.Claim consideration is according to the conditions specified in the policy.
4.In case the insurance premium is overdue, but it is still in the grace period, advance payment is required and you can claim for the payment with the Company further.
5.In case the Company deems that the insured card cannot be used to exercise the right, the insured can submit claim documents to the Company after discharge for further consideration.


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Q&A

It is true. According to the conditions of health riders, those who have the medical record of pre-existing conditions before entering into insurance contracts, but do not declare it, will not receive coverage for such diseases. Therefore, the insured cannot claim for medical expenses.