You are here: Home | Healthcare | Planholders | Individual planholders | How to make a claim
Products provided by Standard Life Healthcare Limited.

How to make a claim

We understand how stressful it can be when you need medical treatment. If you think you may need to make a claim, please call us before starting any treatment. We'll guide you through the claims process and offer you any advice and reassurance you may need.


General claims

Your claims process is linked to the hospital list you've chosen. You can find the name of your hospital list on your certificate of insurance. Click on the appropriate hospital list below:


Countrywide hospital list
Countrywide London upgrade hospital list
Extended London upgrade hospital list
Guided Option hospital list

Claims process for the Countrywide, Countrywide London upgrade and Extended London upgrade hospital lists

To help us handle your claim quickly and efficiently please follow these simple steps:

1. Your GP refers you to a consultant or specialist

If your GP decides that you need a specialist appointment, advise them that you have cover with Standard Life and ask for the following details:

  • What is the name of the condition you are suffering from?
  • What is the name of the consultant and hospital where the consultation will take place?
  • When is your consultation/treatment due to take place?

2. Getting your claim approved

Before you attend your specialist appointment, please call us to register your claim. Have your plan number ready when you call (you'll find the correct telephone number and plan number on your certificate of insurance). We'll ask you the following questions about the condition you require treatment for:

  • What is the name of the condition you are suffering from?
  • When did you first become aware of the symptoms?
  • When did you first see your GP about this condition?
  • Has your GP suggested any treatment?
  • What is the name of the consultant and hospital where the consultation will take place?
  • When is your consultation/treatment due to take place?

We'll talk you through the claims procedure and ensure that your claim is handled as quickly and smoothly as possible. We are usually able to agree your claim when you call, however, there may be occasions when we need your GP to provide us with further information. This may require the completion of a claim form, but we'll let you know when you call. We'll also tell you if there are any exclusions on your plan that may apply to your claim. Once accepted, we'll send you an acceptance letter to confirm your claim to you in writing.


3. Your consultation appointment

Take your acceptance letter with you to your first consultant and hospital appointments to confirm you are covered by Standard Life.

If your consultant recommends further out-patient tests or scans to help diagnose or treat your condition, you can go ahead and arrange these at a time that suits you, so long as they are covered by your plan and take place at a hospital on your hospital list.

If your consultant says you need to be admitted to hospital for in-patient or day-patient treatment, please contact us again so we can confirm that both the hospital and the treatment are covered by your plan.


4. Your stay in hospital

We'll write to the hospital to confirm your stay is covered and send you a copy of the letter to take with you when you go into hospital. The letter will contain all the information the hospital will need to ensure your claim is dealt with quickly.

When you leave hospital please settle any personal expenses yourself and ask the hospital to forward any invoices for your approved treatment direct to us.


5. After your hospital stay

If you need more treatment after your stay in hospital, please call us and we'll be happy to help.

Please remember that we can only pay for eligible treatment, once you've been referred to an appropriate specialist or consultant by your GP, that:

  • aims to cure or substantially improve an acute medical condition, or the acute periods of a long-term medical condition
  • is given by a specialist or consultant who is recognised by us
  • takes place at a hospital or other facility on your hospital list
  • is appropriate for your condition and is established medical practice at the time of the treatment, and
  • is covered by the benefits of your plan, subject to any terms and conditions.

If you have an excess on your plan

  • Send any invoices you receive to us, unpaid
  • We'll deduct the excess from any invoices we pay and then write to you to confirm what you need to pay yourself
  • Please don't send a cheque for the excess amount to us as this may delay payment
Back to top back to top


Claims process for the Guided Option hospital list

To help us handle your claim quickly and efficiently please follow these simple steps:

1. Visit your GP

If you become ill and need to visit your GP, remember to take your 'open referral' form with you. You can download a copy of the form here.

If your GP decides that you need a specialist appointment, ask them to fill in the form. It's very important that your GP does not name a particular consultant on your 'open referral' form. The form explains to them why we don't want them to refer you to a named consultant. If your GP would prefer to write a referral letter they can do so, but it must not be addressed to a named consultant.


2. Getting your claim approved

Once your GP has completed your 'open referral' form, you should call us to register the claim. Have your plan number ready when you call (you'll find the correct telephone number and the plan number on your certificate of insurance). We'll ask you the following questions about the condition you require treatment for:

  • What is the name of the condition you are suffering from?
  • When did you first become aware of the symptoms?
  • When did you first see your GP about this condition?
  • Has your GP suggested any treatment?
We'll talk you through the claims procedure and ensure that your claim is handled as quickly and smoothly as possible. We are usually able to agree your claim when you call, however, there may be occasions when we need your GP to provide us with further information. This may require the completion of a claim form, but we'll let you know when you call. We'll also tell you if there are any exclusions on your plan that may apply to your claim. Once accepted, we'll send you an acceptance letter to confirm your claim to you in writing.


3. We'll contact the hospital for you

Once your claim is accepted, we'll contact the most appropriate hospital with your details. Usually this will be the nearest hospital to you from the Guided Option hospital list.

Please note that it's essential that you do not send your 'open referral' form direct to a hospital or arrange your own appointment. Treatment, investigations and consultations are only covered if they are arranged by us contacting the hospital.


4. The hospital will contact you to make an appointment

The hospital will usually contact you within three working days and let you know which consultant will be looking after you, and to arrange your appointment.


5. Send or take your 'open referral' form with you

Once your appointment is confirmed, you'll be asked to send your 'open referral' form to the hospital, or alternatively, to take it with you to your first appointment.

When you leave hospital please settle any personal expenses yourself, and ask the hospital to forward any invoices for your approved treatment direct to us.


6. Arranging further treatment

If, once you've seen your consultant, they recommend further treatment, you can arrange this directly with the same hospital, so long as the treatment is covered by your plan.

Please remember that we can only pay for eligible treatment, once you've been referred to an appropriate specialist or consultant by your Guided Option hospital, that:

  • aims to cure or substantially improve an acute medical condition, or the acute periods of a long-term medical condition
  • is appropriate for your condition and is established medical practice at the time of the treatment, and
  • is covered by the benefits of your plan, subject to any terms and conditions.

If you have an excess on your plan

  • Send any invoices you receive to us, unpaid
  • We'll deduct the excess from any invoices we pay and then write to you to confirm what you need to pay yourself
  • Please don't send a cheque for the excess amount to us as this may delay payment
Back to top back to top



Useful tools
 





Home page


What's this?


This website is intended for the information of residents of the United Kingdom. Standard Life Healthcare Limited (02123483) and Standard Life Healthcare Services Limited (06430487) are both registered in England at Marshall Point, 4 Richmond Gardens, Bournemouth BH1 1JD. Standard Life Healthcare Limited is authorised and regulated by the Financial Services Authority.

© 2010 Standard Life Healthcare (Images used under licence)