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FEB 2012

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FLOW CHART FOR MA REG 2 CLAIMS


1) FOR A CASHLESS SERVICE (MEDICAL BENEFITS)

First visit your GP. If your GP refers you to a specialist/consultant for further treatment ask the GP the name, specialty and contact details of the specialist/consultant.

Please contact MA REG 2 on TOLL FREE NO: 0800 294 5637 before receiving any private treatment

MA REG 2 will require the following details to assist you: 1) Company name. 2) MAYFAIR ID NO. 3) Employee ID of the primary member (employee). 4) Name of the claimant. 5) If the claimant is not the primary member: relationship to the employee (either spouse or child). 6) Contact details of the claimant: Postal address, Telephone numbers (Mobile preferably) & E-mail ID. 7) Details of the consultation & contact details of the consultant. 8) If hospitalization is required, then the details of the hospital.

MA REG 2 will contact you & provide you with an authorization code

You should then fix an appointment with the specialist/consultant. Please inform the specialist/consultant that you are covered under a PMI Policy (Private Medical Insurance) and the administrator is SIMPLYHEALTH & that you have been given an authorization code XXXXXXXX

In most cases claims are settled directly with the service provider without needing a claim form. In some instances a claim form may be required, if so it will be issued to your UK address and you should take the form with you when you receive Treatment. The Hospital will then be able to send the bills directly to MA Reg 2 without troubling you for payment. Please note, however, if the hospital is not within the MA Reg 2 network you may have to pay & file for reimbursement.

For the latest claims guidance please always refer to your summary of cover which can be found online at: www.mayfairworldwide.com/insureds.htm

FEB 2012

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Points to note

1. When you contact the MA REG 2 Help Desk you will be able to receive advice on your policy and on the eligibility of your claim. This method allows you to know in advance of the claim whether or not it will be covered to give you peace of mind. If you are unable to contact the Help Desk before the treatment proceeds or service is provided, you must advise the MA REG 2 Help Desk within 48 hours of the date of the treatment or service. 2. If MA REG 2 require further information on your condition a claim form maybe needed and this must be fully completed and signed by the patient, the Policyholder, the General Practitioner and Consultant. Please return the completed form as soon as possible. Claims that are not received by MA REG 2 within 30 days of receipt of Treatment services cannot usually be considered for settlement. Please do not delay in sending your claim even though you may still be waiting for some bills for other aspects of your Treatment. 3. In most cases claims are settled directly with the service provider without needing a claim form. If unsure please call or email MA REG 2: (a) Toll Free no. 0800 294 5637 (b) Email: mayfair.claims@simplyhealth.co.uk

For the latest claims guidance please always refer to your summary of cover which can be found online at: www.mayfairworldwide.com/insureds.htm

FEB 2012

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2)

FOR REIMBURSEMENTS (medical BENEFITS)

If possible you should always contact MA Reg 2 first. If however, you receive invoices or pay for treatment yourself, you should call MA Reg 2 on TOLL FREE NO: 0800 294 5637 who will send a claim form to you for completion (you will need to attach all the original invoices, receipts, etc). You will also need to include the following information: 1) Company Name, 2) Mayfair ID, 3) Employee number of the primary member (Employee), 4) Name of claimant, If the claimant is not the primary member then the 5) Relationship to employee (i.e. Spouse or child), 6) Email ID, 7) Full contact details of claimant: Postal Address, 8) Tel nos. (Including your mobile no.). * Please ensure you send all information to MA Reg 2 within 30 days of receipt of treatment.

MA REG 2 will process the claim & issue you a reimbursement cheque to your UK address.

For the latest claims guidance please always refer to your summary of cover which can be found online at: www.mayfairworldwide.com/insureds.htm

FEB 2012

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3)

FOR REIMBURSEMENTS OF Vision Care, Dental, Prescription & GP Charges

Download the Primary Care or Dental claim form from your Insureds login at the Mayfair website. www.mayfairworldwide.com

Complete the claim form, attach all receipts, invoices, etc and submit to MA Reg 2

MA REG 2 will process the claim & issue you a reimbursement cheque to your UK address.

For the latest claims guidance please always refer to your summary of cover which can be found online at: www.mayfairworldwide.com/insureds.htm

FEB 2012

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4)

FOR REIMBURSEMENTS (loss of personal effects)

Download the Loss of personal effects claim form from your Insureds login at the Mayfair website. www.mayfairworldwide.com

Complete the claim form and submit it to MA Reg 2 (you will need to supply a Police report)

MA REG 2 will process the claim & issue the member a reimbursement cheque to their UK address indicated on the claim form.

For the latest claims guidance please always refer to your summary of cover which can be found online at: www.mayfairworldwide.com/insureds.htm

FEB 2012

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5)

FOR REIMBURSEMENTS (Travel related covers)

These claims are administered by MA REG 3 and NOT MA REG 2

Download the travel related covers claim from your Insureds login at the Mayfair website. www.mayfairworldwide.com

Fill in the claim form & submit to MA REG 3 NOT MA REG 2

MA REG 3 will process the claim & issue you a reimbursement cheque to your UK address

For the latest claims guidance please always refer to your summary of cover which can be found online at: www.mayfairworldwide.com/insureds.htm

FEB 2012

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MA REG 2 CONTACT DETAILS


TOLL FREE NO. 0800 294 5637 (MON FRI 8.00 am to 6.00 pm) E-MAIL ID: mayfair.claims@simplyhealth.co.uk ADDRESS: SIMPLYHEALTH , Mayfair Claims, James Tudor House, 90 Victoria Street, Bristol BS1 6GH.

MA REG 3 CONTACT DETAILS (For Travel Related Benefits ONLY)


TOLL FREE TEL NUMBER: + 800 MAYFAIR0 (from UK + 800 6293 2470) THIS IS A GLOBAL TOLL FREE NO. (FROM MOST COUNTRIES JUST DIAL 00800 6293 2470) Or if just needing to discuss a claim and NO assistance is needed please use one of the below options: Use the claims option: CALL COLLECT TEL NUMBER: +91 80 42645000 Use the claims option FAX NUMBER: +91 80 42645050 FOR A CLAIMS UPDATE YOU CAN ALSO CONTACT MA TRAVEL CLAIMS VIA EMAIL ON: Mayfair.claims@mayfairworldwide.com PLEASE SEND THE CLAIMS TO MA REG 3 VIA NORMAL POST OR COURIER: INTERNATIONAL HEALTHCARE MANAGEMENT SERVICES PVT LTD., Mayfair Claims Department # 459, 2nd Floor, Service Road, Off Outer Ring Road, Teachers Colony, Venkatapura, Bangalore- 560 034. INDIA.
**Please note the Claims Dept is only open during normal business hours- 10.00 to 18.30 - IST (GMT + 5.5 )

ENROLMENT TO NHS:In order to ensure that you receive prompt medical treatment when required in the UK please be advised as follows: On arrival in the UK you and your family members (spouse & children) should register with a local GP ASAP. The GP service is provided free by the NHS (National Health Service - NHS). You may call the NHS to locate a GP in your area on the following tel no. 0845 46 47 (This no. is for all inquiries to do with the NHS) For a listing of Emergency NHS Dentists after 6pm & on weekends please call: 0800 923 2324. NHS DIRECT WEBSITE ADDRESS: www.nhsdirect.nhs.uk

For the latest claims guidance please always refer to your summary of cover which can be found online at: www.mayfairworldwide.com/insureds.htm