Once you have purchased a Gulfhealth plan our claims procedure is simple. All you need to do is follow the steps below:
Medical Emergency claims
1. Where possible you should contact our helpline within 48 hours so they can assist you and arrange payment etc.
2. Call the helpline number located on the back of your membership card.
3. Speak to one of our agents at your selected TPA. A treatment guarantee form will not be required for emergency cases.
Non-emergency claims
All claims should be submitted in line with the claims procedure in your policy wording but as a summary:
In-patient claims
1. For certain treatment, authorisation will need to be obtained by your physician PRIOR to any treatment commencing.
2. Call the helpline number located on the back of your membership card to speak to an advisor.
In most circumstances we can then arrange to pay the hospital directly.
Out-patient and dental claims
1. Visit your physician or dentist in the usual way, remembering to take a claim form with you and request the physician/dentist to complete the form.
2. Pay for the treatment yourself – make sure you get a receipt and all relevant documentation in relation to your claim.
3. Complete page 1 and 2 of the claim form and send it, along with receipts, to your TPA directly or to claims@gulfhealth.ae. Remember to keep a copy for your records.
Please note: We would remind you that all claims should be submitted within 6 months of the date of treatment otherwise they will not be considered for reimbursement.
The full claims procedure can be found in your policy wording. Since the procedure for claiming is different depending upon the policy that you have, please ensure you read the section in your policy wording on claims and making a claim to ensure you are not penalised and to avoid co-insurance being applied to any reimbursement payment. All plans within the UAE are administered by a Third Party Administrator.
Please note: (within the UAE only) should you visit a provider not on the network list of your provided Third Party Administrator this will be classed as ‘out of network’ and a co-pay may apply.
Within the United Arab Emirates, we use a direct billing network, this is a cashless network allowing you to visit a chosen applicable provider for cashless treatment both on an Out Patient and In Patient basis.
All of our Gulfhealth Products will be administered by a Third-Party Administrator (TPA). Your TPA will be on the back of your membership card.
Submit a claim on the Neuron Portal.
Neuron Mobile Application available within the App Store and Google Play Store. To download the most up to date network lists please visit www.neuron.ae. Your relevant network is located on the front of your membership card.
Medical Emergency claims
Once stabilised the hospital provider will contact us within 48 hours so we can arrange payment etc.
Non-emergency claims
All claims should be submitted in line with the claims procedure in your policy wording but as a summary:
In-patient claims
Treatment authorisation will need to be obtained from us prior to any treatment commencing. Your network provider will contact us with the relevant information and request for approval on your behalf.
Please note: Our standard approval times are dependent on us receiving all of the correct information from your chosen provider.
Out-patient claims
1. Visit your physician in the usual way, your chosen provider will contact us directly for any treatment required and/or approval requests.
2. Should you see a delay from your provider on your approval please note the date, time, provider and treatment requested to claims@gulfhealth.ae.
Please note: This is only to be used if the provider has asked you to leave the facility pending approval and has not contacted you within 72 hours.