HOW TO CLAIM

Making a claim

Firstly if you are a client of Adelphi Insurance Brokers Ltd we want to honour our pledge to you that we are here for you from quote to claim. It is always your prerogative to deal directly with the insurer but we do recommend that you call us on 0800 656 670 so we help you through any claims you may have.

Health Insurance Claims Process

Pre-approval before treatment

Before having any surgery, treatment or investigations you need to seek pre-approval, so you know that the procedure you require will be covered. To request a pre-approval, simply follow the steps below or call us on 0800 656 670

Steps to apply for pre-approval

To make a claim, please follow the steps below. If you need any help, call us on 0800 656 670

Once the insurer has received all the information they need, they aim to assess and process your claim within five working days. Please note there will be a delay if they need to request additional information.

1. Click on the link to your insurer and download their pre-approval claim form, or call us on 0800 656 670 to request a copy.
   • nib-Claims-Form.pdf
   • Partners-Life-Claim-Form.pdf
2. Fill out all sections of the form that apply to your claim, download the claim form guide, if available, for help on the sections you need to complete.
3. Sign the back page.
4. Attach or include any additional information requested in each section of the form that applies. This information will include:
   • Completed Doctors Questionnaire (this should be completed by your referring medical provider)
   • Referral letter from your GP to your Specialist
   • Specialist report
   • An estimate for the procedure
5. Send the insurer your claim form with any additional information needed.

   Email:	claims@nib.co.nz
   Fax:	0800 345 134
   Post:	nib nz limited PO Box 91 630 Victoria Street West Auckland 1142

   Email:	claims@partnerslife.co.nz
   Fax:	0800 14 54 33
   Post:	Partners Life Private Bag 300995 Albany Auckland 0752

6. After you have received your pre-approval you can confidentially proceed with your procedure. Your approved pre-approval form will also serve as your claim form.
7. After you have had your procedure you will receive invoices from the relevant medical professionals e.g. Specialist, Anaesthetist, Hospital etc. Photocopy these and send the originals directly to the insurer. Your insurer will pay directly to the relevant medical professionals.
   • If you have already paid for specialist consultations or diagnostic test, that are covered under your policy then make sure you supply your insurer with you bank account details and they will reimburse you directly.
8. Please note you need to send original invoices and receipts showing the invoice has been paid before a claim can be paid to you. Pre-approval requests and claims for payment to providers can be emailed, faxed or posted to the insurer and you should retain the original documents in case your insurer requires them later.