Medical Insurance Claims
Medical Claim
Claims Services
We will guide you step by step.
Learn what to expect when submitting a claim; details and documents that you will need to have it ready, any succeeding steps and where to submit it.
Direct billing within network
To avail this benefit, you need to use one of our network providers, which are hospital, medical center, clinic, and pharmacy empaneled with us. All you need to do is present your insurance card and we will cover the cost of your treatment based on your policy terms and condition.
Reimbursement outside network
If you avail any medical treatment and services outside our network providers, then you will need to submit a claim for reimbursement.
For claim settlement, we will do this by transferring the payable amount directly to your bank account or thru cheque as preferred. You will receive a notification when the transfer is complete.
What Documents You'll need?
Prepare all the right details and documents ready, so you can submit your claim as smoothly as possible.
To submit your medical claim, you will need:
- Copy of insurance card and QID
- Detailed bill
- Medical report
- Investigation Reports (Laboratory, Radiology, Pathology)
- Doctor's prescription for medicines
- Discharge summary from the hospital (In-patient)
- Insured personal banking details
- Reimbursement Claim form (GlobeMed or NextCare)
Where to submit your claim
You can report the incident by Clicking the File a Claim button or by sending us an email to SharqMedicalClaims@sharqinsurance.com.qa.
For more details and clarification, please contact us at 40154032 or 40154027.
Visit our Branch in Doha Bank C-Ring Branch - 2nd Floor.
FAQ
What is covered under Medical Insurance?
The benefits of our health insurance are completely dependent on the kind of policy being taken. However, our basic health plan covers hospitalization costs, pre and post hospitalization expenses, emergency ambulance expenses, day care procedures, outpatient department (OPD) expenses and more.
What is Network Provider or Cashless Facility?
Our Third-Party Administrators have tie-up arrangements with several hospitals all over the country as part of our Network Providers. Under our medical insurance policy offering cashless facility, our member can take treatment in any of the network providers without having to pay the hospital bills as the payment is made to the hospital directly by our Third-Party Administrator, on our behalf. However, expenses beyond the limits or sub-limits allowed by your insurance policy or the uncovered expenses under the policy must be settled by you directly to the Network Provider. Cashless facility, however, is not available if you take treatment outside the Network provider List.
What is the maximum number of claims allowed over year?
Any number of claims is allowed during the policy period unless there is a specific cap prescribed in your policy. However, the sum insured is the maximum limit under the policy.
If I Have to Seek Treatment at a Non-Network Hospital, How Do I Make a Claim?
It is often possible that you may end up getting hospitalized at a Non-Network Providers. In this case, you can file for a reimbursement claim after their treatment is over. In this case, you can get treated, pay for the treatment, and then file for a reimbursement claim. Such a claim will cover all expenses which are covered under the policy coverage, except the ones which falls under the exclusion or non-coverage.
How long does it take to process a medical reimbursement claim?
Claims are processed within 21 working days from the date of submission or as per our agreement.
Who do I contact If I need to follow up on my medical claim, or if there are any discrepancies in the settlement?
To get in touch with us about your claim, you may either call us at 401504052 or 40154057, or you can send your queries to sharqmedicalclaims@sharqinsurance.com.qa.
Am I intimated of any additional requirements?
Yes. We will let you know if we require any other documents needed for your reimbursement claim.
What do I do if I face some issues with Network Provider?
You may call directly your chosen Third-Party Administrator wherein their Customer Support Center Hotline can be found at the back of your medical insurance card.