A Group Health policy will reimburse plan members for covered expenses incurred as a result of an accident or illness, according to the Schedule of Benefits limits noted in the policy. A Group Life policy provides a predetermined sum of money to a named beneficiary in the event of death of a plan member while an employee of the company.
Medical Claims – documents required
- Completed Claim Form (duly stamped and signed by the attending Physician/Dentist)
- Original receipts for incurred expenses, indicating prescription number, Patient’s name, date of purchase, name and quantity of drugs
- Claim Forms should include the following information:
- Policy number
- Employee’s Certificate number
- Company stamp
- Plan Administrator’s signature
- Claims should be submitted no later than ninety (90) days from the date expenses were first incurred.
Death Claim – documents required:
- Completed Claim Form
- Certified Death Certificate
- Certified Birth Certificate
- Life Insurance Certificate
In the event of death by accident, a Coroner’s report is required in addition to the above.
TIP: Documentary proof of attendance must be supplied with respect to a child or children under the age of 19 years and attending an Accredited College of University