Frequently Asked Questions for members

Contact Us

  • Sales
  • Support
  • Social Media

We provide below our answers to your most frequently asked questions.

Should you have any further questions, please contact us. Note that we will need your name and policy number to identify you in our system and be able to respond to queries on your cover, your claims, etc. – so please don’t forget to have your policy number with you when you call us or to state it in your email (together with your full name) if you prefer to write.

Choose a topic

Claims queries

How do I claim for medical expenses that I have already paid for to my medical provider?

The procedure applicable to your policy will depend on the product available to you and will be described in detail in your Benefit Guide (which you will have received upon inception).

 

However, if you are under one of our standard International Healthcare Plans, we summarise below the general claiming procedure applicable to you:

 

Claiming your out-patient, dental and other expenses

If your Table of Benefits indicates that your treatment does not require pre-authorisation, then simply follow these steps:

 

  1. Receive your treatment and pay the medical provider.
  1. Get an invoice from your medical provider. This should state your name, treatment date(s), the diagnosis/medical condition that you received treatment for, the date of onset of symptoms, the nature of the treatment and the fees charged.
  2. Claim back your eligible costs via our MyHealth app. Simply provide a few key details, take a photo of your invoice(s) and press ‘submit’.

 

As an alternative to MyHealth app, you can also claim your treatment costs by completing and submitting a Claim Form, downloadable here. You will need to complete section 5 and 6 of the Claim Form only if the information requested in those sections is not already provided on your medical invoice. Please send the Claim Form and all supporting documentation, invoices and receipts to us by email, fax or post (details on the form).

 

Quick claim processing

We can process a claim and issue payment instructions to your bank within 48 hours, when all required information has been submitted. However, without the diagnosis, we cannot process your claim promptly, as we will need to request these details from you or your doctor. Please make sure you include the diagnosis on your claim!

 

We will email or write to you to let you know when the claim has been processed.

 

Watch our videos to find more information about getting treatment and claiming procedure!

What do I need to consider when claiming for maternity expenses?

The claiming procedure applicable to your policy will be described in your Benefit Guide. However, if you are under one of our standard International Healthcare Plans, the above procedure for out-patient, dental and other expenses will apply to pre-natal care claims too, where pre-natal care is included in your cover.

For the delivery, however, submission of a Treatment Guarantee Form (available here) is required. Please complete and submit it 4-6 weeks before the estimated delivery date in order for our Medical Team to confirm cover and arrange for direct billing (where possible) with the medical provider of your choice. In case of an emergency, don’t worry: just obtain your medical assistance and call us within 48 hours of the emergency, to inform us of the hospitalisation. Treatment Guarantee Form details can be taken over the phone when you (or your medical provider, or a family member – if you are unavailable to talk on the phone) call us. Please note that we may decline your claim if Treatment Guarantee is not obtained: full details of our Treatment Guarantee process can be found in your Benefit Guide.

What do I need to consider when claiming for orthodontic treatments?

The claiming procedure applicable to your policy will be described in your Benefit Guide. However, if you are under one of our standard International Healthcare Plans, the above procedure for out-patient, dental and other expenses will apply to orthodontic claims too, where orthodontic treatment is included in your cover.

Please note that the costs incurred will only be reimbursed after treatment has taken place. This means that, if you are paying for your orthodontic treatment in instalments, you can submit your claims monthly or quarterly (depending on the payment frequency you have agreed with your medical provider). You will need to ensure that the invoice includes a description of the treatment received and the treatment dates for the period invoiced.

Orthodontic treatment is covered only in cases of medical necessity, and for this reason, at the point of claiming, we will ask you to submit supporting information to determine that your treatment is medically necessary and therefore eligible for cover. The supporting information required (depending on your case) may include, but is not limited to, the following documents:

  • Medical report issued by the specialist, stating the diagnosis (type of malocclusion) and a description of the patient’s symptoms caused by the orthodontic problem.
  • Treatment plan indicating the estimated treatment duration, estimated cost and type/material of the appliance used.
  • The payment arrangement agreed with the medical provider.
  • Proof that payment has been made in respect of the orthodontic treatment.
  • Photographs of both jaws clearly showing dentition prior to treatment.
  • Clinical photographs of the jaws in central occlusion from frontal and lateral views.
  • Orthopantomogram (panoramic x-ray).
  • Profile x-ray (cephalometric x-ray).

You will find the “Orthodontic treatment” definitions and any applicable exclusions in your Benefit Guide, if you wish to check the level of cover provided under your policy.

What do I need to consider when claiming for “In-patient cash benefit”?

If this benefit is included in your policy, a specified amount (indicated in your Table of Benefits) will be paid to you per each night you spend in hospital, up to a specified maximum number of nights per Insurance Year, where the hospital treatment you are receiving is free of charge and covered within the terms of your plan.

To claim for the “In-patient cash benefit”, please follow the procedure described in the question above regarding “How do I claim for medical expenses that I have already paid for to my medical provider?"  Note that you also need to attach your admission/discharge notice from the hospital when you send your claim to us (via MyHealth or Claim Form, as your prefer). The admission/discharge notice will need to show the number of nights spent in the hospital, the treatment received and a confirmation that the treatment received was free of charge.

What terms and conditions are applicable to the claiming process?

Please note that important terms and conditions are applicable to the medical claiming process. These terms and conditions may vary depending on the product available to you and on the type of insurance contract. We therefore advise to check your Benefit Guide to confirm the claiming terms and conditions applicable to your policy with us.

 

For convenience, we summarise below the terms and conditions that normally apply to standard policies in terms of medical claims:

 

    1. All claims should be submitted (via our MyHealth app or Claim Form) no later than six months after the end of the Insurance Year. If cover is cancelled during the Insurance Year, claims should be submitted no later than six months after the date that your cover ended. Beyond this time we are not obliged to settle the claim.
    2. Submission of a separate claim (via our MyHealth app or Claim Form) is required for each person claiming and for each medical condition being claimed for. Please note that as well as our hard and soft copy claim forms, members can now avail of our MyHealth app for fast and easy claims submission.
    3. It is your responsibility to retain any original supporting documentation (e.g. medical receipts) where copies are submitted to us, as we reserve the right to request original supporting documentation/receipts up to 12 months after claims settlement, for auditing We also reserve the right to request a proof of payment by you (e.g. bank or credit card statement) in respect of your medical receipts. We advise that you keep copies of all correspondence with us as we cannot be held responsible for correspondence that does not reach us for any reason that is outside of our reasonable control.
    4. If the amount to be claimed is less than the deductible figure under your plan, keep collecting all out-patient receipts and Claim forms until you reach an amount in excess of your plan deductible, then forward to us all completed Claim Forms together with supporting receipts/invoices.
    5. Please specify on the Claim Form the currency in which you wish to be paid. Unfortunately, on rare occasions, we may not be able to make a payment in the currency you requested on the Claim Form, due to international banking regulations. In this instance we will review each case individually to identify a suitable alternative currency option. If we have to make a conversion from one currency to another, we will use the exchange rate that applies on the date on which the invoices were issued, or we will use the exchange rate that applies on the date that claims payment is made.


      Please note that we reserve the right to choose which currency exchange rate to apply

    6. Only costs incurred as a result of eligible treatment will be reimbursed within the limits of your policy, after taking into consideration any Treatment Guarantee requirements. Any deductibles or co-payments outlined in the Table of Benefits will be taken into account when calculating the amount to be reimbursed.
    7. If you are required to pay a deposit in advance of any medical treatment, the cost incurred will only be reimbursed after treatment has taken place.
    8. You and your dependants agree to assist us in obtaining all necessary information to process a claim. We have the right to access all medical records and to have direct discussions with the medical provider or the treating physician. We may, at our own expense, request a medical examination by our medical representative when we deem this to be necessary. All information will be treated in strict confidence. We reserve the right to withhold benefits if you or your dependants have not honoured these obligations.

How quickly will I be reimbursed for eligible out-patient treatment?

Please note that the claiming process (including our Service Level Agreement) may vary depending on the product available to you and on the type of insurance contract. We therefore advise you to check your Benefit Guide to confirm the claiming process applicable to your policy.

 

For example, if you are covered under one of our standard International Healthcare Plans, (and as long as your claim is submitted with all relevant details, documentation, invoices and receipts within six months after the end of the Insurance Year) we will aim to process your claim within 48 hours. Please note that without the diagnosis, we cannot process your claim promptly, as we will need to request these details from you or your doctor. To help us processing your claim in the quickest time possible, please ensure to include the diagnosis, an eligible copy of each invoice and any supporting documentation on your claim!

 

If you have access to our MyHealth app, you can submit your claims via our mobile app and then follow the status of your claim there (this will be applicable only to claims that you have submitted via the app). Alternatively, if Online Services are available under your policy, you can follow the status of your submitted claims (regardless of how you submitted them, e.g. mobile app, post, email, etc.) by login into your account.

 

Please note that, if you submit your claim via any channel besides our MyHealth app, we will email or write you to advise when your claim has been processed; we will also include a settlement letter and a statement of accounts. Payment instructions are sent to our bank at the same time of claim processing, but please note that it can take up to 10 working days for the payment to reach your bank account (as this depends on the bank’s international transaction timelines).

I was overpaid on a claim I submitted. What should I do now?

If you notice that you were overpaid for any claim submitted to us please contact our Helpline and provide the relevant claim number, amount overpaid and any important information. A member of our team will instruct you on how to proceed and, in most cases, will provide you with bank account details to where the overpaid amount can be transferred.

My claim was declined or partially paid – why?

Before you submit a claim it is important to understand your level of cover and the terms and conditions applicable to your policy: for this, please check your Table of Benefits and your Benefit Guide. Our Claims Team follow rigorous quality control measures to ensure your claim is processed correctly and efficiently. Nonetheless, there are a few reasons why a claim might be fully declined or partially reimbursed.

 

Some of the possible reasons why this may happen are detailed below. Please refer to the specific question/ answer below for more detail. If you can not identify your claim with any of the reasons mentioned you might contact our Helpline for clarifications.

What does the “6 month period” refer to in relation to claim submission?

Unless otherwise stated in your Benefit Guide or in your Table of Benefits, all claims should be submitted no later than six months after the end of the Insurance Year. If cover is cancelled during the Insurance Year, claims should be submitted no later than six months after the date that your cover ended. Beyond this time we are not obliged to settle the claim.

My claim was declined or partially paid due to “Duplicate claim”. What does it mean?

If you submit an invoice that has already been processed and reimbursed under another claim submission, we will decline it as a duplicate.

My claim was declined or partially paid due to “Benefit limit exceeded”. What does it mean?

If the maximum benefit limit for the benefit you claimed for has been reached, the invoice(s) can not be reimbursed in full. Please refer to your Table of Benefits in conjunction with your Benefit Guide for full details of the benefit limits that apply to your policy.

My claim was declined or partially paid due to “Co-payment applied”. What does it mean?

If a co-payment your plan, it means that a percentage of the eligible costs incurred are to be paid by you. Normally co-payments apply per person, per Insurance Year, unless indicated otherwise in your Table of Benefits. Some plans may include a maximum co-payment per insured person, per Insurance Year, and if so, the amount will be capped at the amount stated in your Table of Benefits. Co-payments may apply individually to the Core, Out-patient, Maternity, Dental or Repatriation Plans, or to a combination of these plans. The details of your co-payment are stated in your Table of Benefits.

In the following example, Mary requires several dental treatments throughout the year. Her dental treatment benefit has a 20% co-payment, which means that we will refund 80%. The total amount payable by us may be subject to a maximum plan benefit limit.

Allianz Partners - co-payment

My claim was declined or partially paid due to “Deductible applied”. What does it mean?

If a deductible applies to your plan or to the benefit you are claiming for, it means that we will start paying your medical expenses once the fixed deductible amount has been reached. Where applied, deductibles are payable per person per Insurance Year, unless indicated otherwise in the Table of Benefits. Deductibles may apply individually to the Core, Out-patient, Maternity, Dental or Repatriation Plans, or to a combination of these plans. When applied, the deductible will be listed in your Table of Benefits. You will find further information about deductibles in the “Cover overview” and “Claims” sections of your Benefit Guide.

In the following example, John needs to receive medical treatment throughout the year. His plan includes a €450 deductible.

Allianz Partners - deductible

My claim was declined or partially paid due to “Excluded under Terms and Conditions”. What does it mean?

Although we cover most illnesses, expenses incurred for certain treatments, medical conditions and procedures are not covered under the policy unless confirmed otherwise in the Table of Benefits or in any written policy endorsement. Please refer to the “Exclusions” section of your Benefit Guide.

My claim was declined or partially paid due to “No further information received”. What does it mean?

In some cases, upon receipt and initial review of your claim, our Claims Team may request further information necessary to process the claim. For example, if you are claiming for an orthodontic treatment, we will require submission of a treatment plan. If this information is missing from your claim, we will request it from you. If the information is not received within two months of our initial request, we will be unable to evaluate and process your claim and therefore your file will be closed. We can of course re-open your claim, provided that this is done within the expire of the claim submission period.

When you submit the missing information requested in relation to your claim, our Claims Team will be happy to complete the processing of your claim according to the terms and conditions of your policy. The missing information can be emailed to: claims@allianzworldwidecare.com (please indicate the claim number on the subject line of your email, for easy identification of your claim).

My claim was declined or partially paid due to “Missing Pre-authorization (MPA)”. What does it mean?

Your Table of Benefits will indicate what (if any) treatments are subject to pre-authorisation through submission of a Treatment Guarantee/Pre-authorization Form. Usually these are in-patient and high cost treatments. Use of the Treatment Guarantee/Pre-authorization Form helps us to assess your case and facilitate direct settlement of your bill with the hospital.

The terms related to the Treatment Guarantee/Pre-authorization process may vary slightly depending on the product available to you. For example, if you have one of our standard International Healthcare Insurance plans, the following applies to cases where the Treatment Guarantee/Pre-authorization is required but not obtained:

  • If the treatment received is subsequently proven to be medically unnecessary, we reserve the right to decline your claim.
  • For the benefits listed with a 1, we reserve the right to decline your claim. If the respective treatment is subsequently proven to be medically necessary, we will pay only 80% of the eligible benefit.
  • For the benefits listed with a 2, we reserve the right to decline your claim. If the respective treatment is subsequently proven to be medically necessary, we will pay only 50% of the eligible benefit.

My claim was declined or partially paid due to “No benefit under your plan”. What does it mean?

Unfortunately, if the benefit you are claiming for is not included under your plan, we are not liable to reimburse your claim. Please refer to your Table of Benefits and to your Benefit Guide to understand what is included in your cover.

My claim was declined or partially paid due to “Over-the-counter drugs”. What does it mean?

If the “Prescribed drugs” benefit is included in your Table of Benefit, cover is provided as stated there for over-the-counter medication that have been prescribed by your doctor. However, if the “Prescribed drugs” benefit is not listed in your Table of Benefits, over-the-counter medication will not be covered even if you have a prescription from your doctor. Please check the definitions and exclusions included in your Benefit Guide to confirm this.

My claim was declined or partially paid due to “Waiting period applied”. What does it mean?

Your Table of Benefits indicates if any of your eligible benefits are subject to waiting periods. When a waiting period applies, you will be eligible for cover under that specific benefit when the waiting period has expired; e.g. if your benefit is subject to a six month waiting period, you will start being covered for it after six months have passed from your policy start date (or effective date if you are a dependant). Please refer to your Table of Benefits and Benefit Guide for full details of the terms and conditions of your policy.

I have received reimbursement for my claim but bank charges have been applied to the payment. What should I do?

When we issue a claim payment, we instruct your bank to charge any applicable transaction fees to us: therefore, your bank should credit the full reimbursement amount to your account. Nevertheless, there may be multiple banks involved in the international transaction of your funds and each of them may charge a fee. These fees vary by bank, country and currency.

We have been advised by our bank, Citibank, that even though we instruct your bank that we pay the charges associated with the claim payment, this does not mean that your bank won’t charge you for crediting your account (as banks handle payments based on their own banking and country rules/policies). To investigate any charges applied to your claim payment, we advise you to first contact your bank. Afterwards, should you require more clarification, we will be happy to help by setting up a case file to confirm if your payment was processed correctly: in this case, please email us your request and include a document from your bank that states the incurred charges. Also, please provide the claim number related to the payment.

Email:   client.services@allianzworldwidecare.com

I received a claim update letter saying that my claim was processed but I have not received the payment. What should I do?

Claim payments are issued by us the day after your claim is processed: however, please note that, depending on the bank transaction timelines, the payment can take up to 10 working days to appear in your bank account.

If you have not received your payment within 10 working days, we would appreciate if you could re-confirm your bank account details to us. You can check what account details we have used to pay your claim in your Statement of Accounts: this is made available to you on our MyHealth App (if your claim was submitted via the app) or was sent to you by email (if your claim was submitted via any other channel, e.g. email or post, etc.) If the account details in your Statement of Account are incorrect, please contact our Helpline to provide your correct bank details and related claim number so we can investigate your payment for you.

If you opted to receive your claim payment by cheque, please note that cheques might take up to 6 weeks to arrive at your address, depending on the geographic area of destination. If passed this time you still have not received your cheque please contact us, indicate the claim number that payment is related to and confirm your postal address – so we can check the status of your check in the post. Alternatively, you can ask us to reissue the payment by bank transfer instead. In that case, you will also need to provide your full bank details as stated below:

  • Payment currency
  • Name of account owner
  • Account number
  • Sort/branch code and BIC/Swift code
  • IBAN code (also required if your bank is within the EU)
  • Bank name and address
  • Details of intermediary bank (should payment need to be made via an intermediary) including the bank name, Swift code and account number
  • Any additional information required in order to process international transactions within your country (e.g. Agency Code, Tax ID)

Emergencies and pre-authorization process

What do I do in an emergency?

Get the emergency treatment you need and call us if you need any advice or support.

Where possible you, your physician or one of your dependants should contact our Helpline within 48 hours of the emergency event, to inform us of the hospitalization. Treatment Guarantee/Pre-authorization Form details can be taken over the phone when you call us.

How do I arrange direct settlement for planned in-patient treatment?

First, check that your plan covers the treatment you are seeking. Your Table of Benefits will confirm which benefits are available to you, however, you can always call our Helpline if you have any queries.

Normally planned in-patient treatments are subject to our Treatment Guarantee/Pre-authorization process for direct settlement of your medical bills. This process may be different depending on the insurance product available to you – for this reason, please check your Benefit Guide to confirm what process applies to your policy. For example, if you are covered under one of our standard International Healthcare Plans, the process requires that you submit a Treatment Guarantee Form in advance of treatment by following the process below:

  1. Download a Treatment Guarantee Form (available here).
  2. Send the completed form to us at least five working days before treatment. Scan and email, fax or post (details on the form).
  3. We contact your medical provider directly to arrange settlement of your bills (where possible and where your costs are eligible for cover).

To find out more about the Treatment Guarantee Process, watch our short video here.

Accessing medical providers

What doctors or hospitals can I go to within my area of cover?

Under our plans, normally our insured members are free to choose the medical provider they prefer, as far as this is within their selected area of cover. However, different arrangements may apply depending on the type of plan available to you: for example, your policy may be linked to the use of a specific medical provider network. Please check your Table of Benefits and your Membership Card to confirm if any medical network applies to your policy.

If your plan is linked to a specific medical network, for your convenience you will have received a list of medical providers included in your network within your Membership Pack.

If your policy is not linked to the use of a medical network, then you can choose the medical provider that you prefer. In this case, if you need help locating a provider in your area, you can use our MyHealth mobile app (if you have a policy with access to our app) to search for hospitals around your location and get GPS directions to them. Alternatively, you can always access our International Healthcare Provider Finder on our website, which allows you to search for hospitals, clinics, doctors and specialists on a country by country basis, with the ability to narrow down the search to specific regions and cities. You can also search under Medical Practitioner categories e.g. Internal Medicine, as well as on Specialism e.g. General Surgery, Neurosurgery or Traumatology etc. You are not restricted to using the providers listed in this directory: the medical providers are available in our directory for your convenience only and we do not recommend, endorse or sponsor them, nor their inclusion in our directory implies that we have any agreements in place with them.

If you are covered in the USA and are seeking a medical provider there, we recommend that you contact our third party administrator that we have appointed to administers your policy in the USA. Our third party administrator can assist you with locating a medical provider close to you and scheduling an appointment. The contact details of our third party administrator can be found on the back of your Membership Card.

Medical evacuation/repatriation

What is covered under the “Medical evacuation” benefit?

If included under your plan, this benefit applies where the necessary treatment for which you are covered is not available locally or if adequately screened blood is unavailable in the event of an emergency. In this case, we will evacuate you to the nearest appropriate medical centre (which may or may not be located in your home country) by ambulance, helicopter or aeroplane. The medical evacuation, which should be requested by your physician, will be carried out in the most economical way having regard to your medical condition. Following completion of treatment, we will also cover the cost of the return trip, at economy rates, for you to return to your principal country of residence.

If medical necessity prevents you from undertaking the evacuation or transportation following discharge from an in-patient episode of care, we will cover the reasonable cost of hotel accommodation up to a maximum of seven days, comprising of a private room with en-suite facilities. We do not cover costs for hotel suites, four or five star hotel accommodation or hotel accommodation for an accompanying person.

Where you have been evacuated to the nearest appropriate medical centre for ongoing treatment, we will agree to cover the reasonable cost of hotel accommodation comprising of a private room with en-suite facilities. The cost of such accommodation must be more economical than successive transportation costs to/from the nearest appropriate medical centre and the principal country of residence. Hotel accommodation for an accompanying person is not covered.

Where adequately screened blood is not available locally, we will, where appropriate, endeavour to locate and transport screened blood and sterile transfusion equipment, where this is advised by the treating physician. We will also endeavour to do this when our medical experts so advise. Allianz Partners and its agents accept no liability in the event that such endeavours are unsuccessful or in the event that contaminated blood or equipment is used by the treating authority.

You must contact Allianz Partners at the first indication that an evacuation is required. From this point onwards Allianz Partners will organise and coordinate all stages of the evacuation until you are safely received into care at your destination. In the event that evacuation services are not organised by Allianz Partners, we reserve the right to decline all costs incurred.

Please note that the “Medical evacuation” benefit may vary slightly from what we have described above, depending on the plan available to you. To confirm if the benefit is available under your plan, please refer to your Table of Benefits; to confirm the terms applicable to your “Medical evacuation” benefit, please check the definitions and the exclusions included in your Benefit Guide.

What is covered under the “Medical repatriation” benefit?

This benefit covers you if the necessary eligible treatment that you require is not available locally: in that case, you can choose to be medically evacuated to your home country for treatment, instead of to the nearest appropriate medical centre. This only applies when your home country is located within your geographical area of cover. Following completion of treatment, we will also cover the cost of the return trip, at economy rates, to your principal country of residence. The return journey must be made within one month after treatment has been completed.

You must contact Allianz Partners at the first indication that repatriation is required. From this point onwards, Allianz Partners will organise and coordinate all stages of the repatriation until you are safely received into care at your destination. In the event that repatriation services are not organised by Allianz Partners, we reserve the right to decline all costs incurred.

The “Medical repatriation” benefit may or may not be included in your cover (this depend on the plans available to you). Please check your Table of Benefits to confirm if this is listed as one of your benefits. Also the “Medical repatriation” benefit may vary slightly from what we have described above, depending on the plan available to you. To confirm the terms applicable to your “Medical repatriation” benefit, please check the definitions and the exclusions included in your Benefit Guide.

How is an evacuation/repatriation organised?

At the first indication that a medical evacuation/repatriation is required, please call our 24 hour Helpline and we will take care of everything. Given the urgency of an evacuation/repatriation, we would advise that you call us; however, you can also contact us by email. When emailing, please include “Urgent – Evacuation/Repatriation” in the subject line. Please contact us before talking to any alternative providers, even if approached by them, to avoid potentially inflated charges or unnecessary delays in the evacuation process. In the event that evacuation/repatriation services are not organised by us, we reserve the right to decline all costs incurred.

Our emergency assistance service is available 24 hours a day, 365 days a year by calling our Helpline.
Email: medical.services@allianzworldwidecare.com

Cover queries

In which countries can I receive treatment?

Please note that our terms and conditions regarding this may vary depending on the plans that are available to you – so please check your Benefit Guide to confirm where you can receive treatment.

However, if you are under one of our standard International Healthcare Plans, note that you can avail of treatment in any country within your area of cover, if the necessary medical treatment for which you are covered is not available locally. In order to seek reimbursement for eligible medical treatment and travel expenses incurred (where covered), you will need to submit a Treatment Guarantee Form for approval prior to travel.

If the necessary medical treatment for which you are covered is available locally, but you choose to travel to another country within your area of cover for treatment, we will reimburse all eligible medical costs incurred within the terms of your plan, however, we will not pay for travel expenses incurred.

Please note that as an expatriate living abroad, you are covered for eligible costs incurred in your home country, provided that your home country is within your area of cover.

What’s the scope of my cover?

You can confirm the scope of you cover by checking your Insurance Certificate – in this document, you will find confirmation of:

  • The name of the plan(s) available to you.
  • The geographical area of cover selected for your policy.
  • The start date and renewal date of your cover.
  • Any special terms that apply (if your policy is underwritten).


The list of benefits covered under your plans is available in your Table of Benefits.

The definitions, exclusions and all other terms and conditions of your policy are detailed in your Benefit Guide.

What is a geographical area of cover?

This is the geographical territory where your cover is valid. We offer multiple geographical area of cover options – please check your Insurance Certificate to confirm which one applies to you.

For example, if your area of cover is “Worldwide”, this means that your cover will be valid everywhere in the world. If your area of cover is “Africa”, then your cover will be valid everywhere in Africa.

What do I do if I need treatment outside of my geographical area of cover?

If you require treatment outside the area of cover indicated in your Insurance Certificate, you may still be covered if the “Emergency treatment outside area of cover” is listed in your Table of Benefits.

This benefit provides cover for medical emergencies which occur during business or holiday trips outside your area of cover. In most cases, cover is provided up to a maximum period per trip within the maximum benefit amount (indicated in your Table of Benefits) and includes treatment required in the event of an accident, or the sudden beginning or worsening of a severe illness which presents an immediate threat to your health. Treatment by a physician, medical practitioner or specialist must commence within 24 hours of the emergency event. Cover is not provided for any curative or follow-up non-emergency treatment, even if you are deemed unable to travel to a country within your geographical area of cover, nor does it cover charges relating to maternity, pregnancy, childbirth or any complications of pregnancy or childbirth.

If you are covered under a group scheme, you should advise your company’s Group Scheme Manager if you are moving outside your area of cover for more than six weeks. If you are covered with an individual policy please contact our Individual Business Unit by email to: underwriting@allianzworldwidecare.com.

Can you explain to me how the most common benefits work?

To be certain of your level of cover, you should always consult your Table of Benefits in conjunction with your Benefit Guide, where you can find full details of the cover applicable to you, including definitions and/or exclusions applicable to your plan.

However, for your convenience, we list below some of the most common benefits available under our standard International Healthcare Plans. Please check your Table of Benefits to confirm if any of the below benefits are included in your cover and refer to your Benefit Guide to verify if the terms, definitions and exclusions related to your covered benefits are the same as described below, as cover differs depending on the plans available to you. Please refer to the specific question/ answer below for more detail on the relevant benefit.

What does “In-patient treatment” mean?

In-patient treatment refers to treatment received in a hospital where an overnight stay is medically necessary.

What does “Day-care treatment” mean?

Day-care treatment is planned treatment received in a hospital or day-care facility during the day, including a hospital room and nursing, that does not medically require the patient to stay overnight and where a discharge note is issued.

Please note that any endoscopic procedures such as gastroscopy or colonoscopy are covered under the “Day-care treatment” benefit, except if they are done for routine health check purposes – in that case, they will be covered under the relevant benefit included in your Out-patient Plan, if this is included in your policy.

What does “Out-patient treatment” mean?

Out-patient treatment refers to treatment provided in the practice or surgery of a medical practitioner, therapist or specialist that does not require the patient to be admitted to hospital.

Any regular doctor visits and laboratory tests that do not require overnight stay in the hospital are considered out-patient treatment.

Which maternity-related expenses are covered under my plan?

Under the multiple plans we offer, we include a number of different maternity-related benefits. These could be “Routine maternity”, “Complications of pregnancy”, “Complications of childbirth”, “Home delivery” etc. Depending on the plans available to you, you may be covered for some or all of these benefits. It is therefore important that you refer to your Table of Benefits to confirm which maternity-related benefits are available to you and whether any benefit limits and/or waiting periods apply.

Below we provide you with a generic explanation of the most common maternity-related benefits which you may be covered for, depending on your plan. Please note that the terms (e.g. definitions and exclusions) related to the below benefits may be slightly different depending on the plan you have, so please check your Benefit Guide to confirm your cover.

  1. Routine maternity refers to any medically necessary costs incurred during pregnancy and childbirth, including hospital charges, specialist fees, the mother's pre- and post-natal care, midwife fees (during labour only) as well as newborn care. Costs related to complications of pregnancy or complications of childbirth are not payable under routine maternity. In addition, any non-medically necessary caesarean sections will be covered up to the cost of a routine delivery in the same hospital, subject to any benefit limit in place. If the home delivery benefit is included in your plan, a lump sum up to the amount specified in the Table of Benefits will be paid in the event of a home delivery.
  2. Pre-natal care includes common screening and follow-up tests as required during a pregnancy. For women aged 35 and over, this includes Triple/Bart’s, Quadruple or Spina Bifida tests, amniocentesis and DNA-analysis, if directly linked to an eligible amniocentesis.
  3. Post-natal care refers to the routine post-partum medical care received by the mother, up to six weeks after delivery.
  4. Newborn care includes customary examinations required to assess the integrity and basic function of the child's organs and skeletal structures. These essential examinations are carried out immediately following birth. Further preventive diagnostic procedures, such as routine swabs, blood typing and hearing tests, are not covered. Any medically necessary follow-up investigations and treatment are covered under the newborn's own policy. Please note that for multiple birth babies born as a result of medically assisted reproduction, in-patient treatment may be limited to a specified amount per child for the first three months following birth (please consult your Benefit Guide for full details). Out-patient treatment is paid within the terms of the Out-patient Plan.
  5. Complications of pregnancy relate to the health of the mother. Only the following complications that arise during the pre-natal stages of pregnancy are covered: ectopic pregnancy, gestational diabetes, pre-eclampsia, miscarriage, threatened miscarriage, stillbirth and hydatid form mole.
  6. Complications of childbirth refer only to the following conditions that arise during childbirth and that require a recognised obstetric procedure: post-partum haemorrhage and retained placental membrane. Where the insured’s plan also includes a routine maternity benefit, complications of childbirth shall also refer to medically necessary caesarean sections.
  7. Maternity-related benefit limits
    Benefit limits for “Routine maternity” and “Complications of childbirth” are payable on either a “per pregnancy” or “per Insurance Year” basis (this will be confirmed in your Table of Benefits). If your benefit is payable on a “per pregnancy” basis and a pregnancy spans two Insurance Years, please note that if a change is applied to the benefit limit at policy renewal, the following will apply:
    -    All eligible expenses incurred in the first year will be subject to the benefit limit that applies in year one.
    -    All eligible expenses incurred in the second year will be subject to the updated benefit limit that applies in year two, less the total benefit amount reimbursed in year one.
    -    In the event that the benefit limit decreases in year two and this updated amount has been reached or exceeded by eligible costs incurred in year one, no additional benefit amount will be payable.
  8. Maternity-related exclusions:
    -    Termination of pregnancy, except in the event of danger to the life of the pregnant woman.
    -    Treatment directly related to surrogacy, whether you are acting as a surrogate, or are the intended parent.
    -    Genetic testing, except: a) where specific genetic tests are included within your plan; b) where DNA tests are directly linked to an eligible amniocentesis i.e. in the case of women aged 35 or over; c) testing for genetic receptor of tumours is covered.
    -    Pre- and post-natal classes.
    -    Triple/Bart’s, Quadruple or Spina Bifida tests, except for women aged 35 or over.

Which dermatology- related expenses are covered under my plan?

Dermatologist consultations and treatments are covered if medically necessary under the “Specialist fees” benefit (if this is listed in your Table of Benefit and therefore included under your plan). If the skin condition is seen by a general medical practitioner rather than a specialist, then you will be covered under the “Medical Practitioner fees” benefit (if included under your plan).

Dermatology-related exclusions
Please note that normally, depending on the plan available to you, exclusions may be related to dermatology treatments. Please check you Benefit Guide to confirm what exclusions relate to your policy. For your convenience, we indicate below the exclusions related to dermatology that are normally included in our standard International Healthcare Plans:

-    Plastic surgery. Any treatment carried out by a plastic surgeon, whether or not for medical/psychological purposes and any cosmetic or aesthetic treatment to enhance your appearance, even when medically prescribed. The only exception is reconstructive surgery necessary to restore function or appearance after a disfiguring accident, or as a result of surgery for cancer, if the accident or surgery occurs during your membership of the scheme.
-    Loss of hair and hair replacement. Investigations into, and treatment of, loss of hair and any hair replacement unless the loss of hair is due to cancer treatment.

What cover is available in relation to psychiatry and psychotherapy expenses?

This cover is available to you if the “Psychiatry and psychotherapy” benefit is listed in your Table of Benefits, either under the Core Plan or under the Out-patient Plan (or in both), depending on the plans available to you. Where covered, your Table of Benefits will also state any benefit limits and/or waiting periods which apply to the cover for psychiatry and psychotherapy. Our standard definition of the “Psychiatry and psychotherapy” benefit and related exclusions are as follows, although they may vary slightly depending on the plans available to you – please refer to your Benefit Guide for the definition and any exclusions applicable to your plan.

  1. Related definition
    Psychiatry and psychotherapy is the treatment of mental disorders carried out by a psychiatrist or clinical psychologist. The condition must be clinically significant and not related to bereavement, relationship or academic problems, acculturation difficulties or work pressure. If included under your plan all day-care or in-patient admissions must include prescription medication related to the condition. Psychotherapy treatment (on an in-patient or out-patient basis) is only covered where you or your dependants are initially diagnosed by a psychiatrist and referred to a clinical psychologist for further treatment. In addition, outpatient psychotherapy treatment (where covered) is initially restricted to 10 sessions per condition, after which treatment must be reviewed by the referring psychiatrist. Should further sessions be required, a progress report must be submitted to us, which indicates the medical necessity for any further treatment.
  2. Related exclusions
    -    Family therapy and counselling. Costs in respect of a family therapist or counsellor for out-patient psychotherapy treatment (regardless if your plan includes a benefit for psychiatry and psychotherapy).
    -    Behavioural and personality disorders. Treatment for conditions such as conduct disorder, attention deficit hyperactivity disorder, autism spectrum disorder, oppositional defiant disorder, antisocial behaviour, obsessive compulsive disorder, phobic disorders, attachment disorders, adjustment disorders, eating disorders, personality disorders or treatments that encourage positive social-emotional relationships, such as family therapy, are not covered unless indicated otherwise in the Table of Benefits.
  3. If you want to confirm cover for your planned treatment
    If you would like us to confirm cover for a psychiatry or psychotherapy benefit before commencing treatment, please forward us (using the email address below) a detailed medical report from the referring psychiatrist that includes the DSM-IV or ICD-10 code and that indicates the causes or reason of your condition. Our medical team will promptly review the report and will be able to advise you about your cover.
    Please note that any psychiatry or psychotherapy treatment due to take place on an in-patient or day-care basis requires submission of a completed Treatment Guarantee Form and approval in advance of treatment. Find out more about the Treatment Guarantee Process here.


Email: medical.services@allianzworldwidecare.com

Which treatments are covered under the dental and orthodontic benefits?

If dental benefits form part of your cover, under most of our plans you can simply pay for your treatment and then claim back any eligible expenses via our MyHealth app (if this is available under your plan) or by submitting a completed Claim Form along with all supporting documentation by e-mail, fax or post.

Any dental benefits available to you are shown on your Table of Benefits along with any deductibles, co-payments, benefit limits, waiting periods or age restrictions which apply. Your Table of Benefits should be read in conjunction with your Benefit Guide for full details of your dental benefits, including definitions and/or exclusions. For your convenience, below we list the definitions and the exclusions related to dental benefits that apply to our standard international healthcare plans – these may vary slightly depending on the plans you have, so please consult your Benefit Guide and Table of Benefits to confirm the definitions and exclusions available to you:

  1. Dental-related definitions
    1. Dental treatment includes an annual check up, simple fillings related to cavities or decay, root canal treatment and dental prescription drugs.
    2. Dental prescription drugs are those prescribed by a dentist for the treatment of a dental inflammation or infection. The prescription drugs must be proven to be effective for the condition and recognised by the pharmaceutical regulator in a given country. This does not include mouthwashes, fluoride products, antiseptic gels and toothpastes.
    3. Dental surgery includes the surgical extraction of teeth, as well as other tooth related surgical procedures such as apicoectomy and dental prescription drugs. All investigative procedures necessary to establish the need for dental surgery such as laboratory tests, X-rays, CT scans and MRI(s) are included under this benefit. Dental surgery does not cover any surgical treatment that is related to dental implants.
    4. Periodontics refers to dental treatment related to gum disease.
    5. Orthodontics is the use of devices to correct malocclusion and restore the teeth to proper alignment and function. Orthodontic treatment is covered only in cases of medical necessity, and for this reason, at the point of claiming, we will ask you to submit supporting information to determine that your treatment is medically necessary and therefore eligible for cover. The supporting information required (depending on your case) may include, but is not limited to, the following documents:
      •    Medical report issued by the specialist, stating the diagnosis (type of malocclusion) and a description of the patient’s symptoms caused by the orthodontic problem.
      •    Treatment plan indicating the estimated treatment duration, estimated cost and type/material of the appliance used.
      •    The payment arrangement agreed with the medical provider.
      •    Proof that payment has been made in respect of the orthodontic treatment.
      •    Photographs of both jaws clearly showing dentition prior to treatment.
      •    Clinical photographs of the jaws in central occlusion from frontal and lateral views.
      •    Orthopantomogram (panoramic x-ray).
      •    Profile x-ray (cephalometric x-ray).
      Please note that we will only cover orthodontic treatment where the standard metallic braces and/or standard removable appliances are used. Cosmetic appliances such as lingual braces and invisible aligners are covered up to the cost of metallic braces, subject to the “Orthodontic treatment and dental prostheses” benefit limit.

      In summary, the “Orthodontics” benefit covers:
      •    Braces
      •    Brackets
      •    Orthodontist's fees
      •    Other related treatment such as x-rays or photographs of jaws
      Orthodontic treatments take place on an Out-Patient basis. They are usually carried out over the course of several years: however, you do not need to wait until the end of your treatment to be reimbursed. You might submit invoices throughout the duration of your treatment (e.g. quarterly), but only once the part of the treatment relating to the invoice you submit has all taken place. For example, you could submit an invoice at the end of every quarter for the treatment that has taken place in that quarter.
    6. Dental prostheses include crowns, inlays, onlays, adhesive reconstructions/restorations, bridges, dentures and implants as well as all necessary and ancillary treatment required.
    7. Emergency Out-Patient Dental treatment refers to treatment received in a dental surgery/hospital emergency room for the immediate relief of dental pain caused by an accident or an injury to a sound natural tooth, including pulpotomy or pulpectomy and the subsequent temporary fillings, limited to three fillings per Insurance Year. The treatment must be received within 24 hours of the emergency event. This does not include any form of dental prostheses, permanent restorations or the continuation of root canal treatment. If a Dental Plan was selected, you will be covered under the terms of this plan for dental treatment in excess of the (Core Plan) emergency out-patient dental treatment benefit limit.
  2. Dental-related exclusions
    1. Dental veneers. Dental veneers and related procedures are not covered, unless medically necessary.

What does the benefit for “Complementary treatment” cover?

Below you will find the definition related to “Complementary treatment” that apply to our standard international healthcare plans – these may vary slightly depending on the plans you have, so please consult your Benefit Guide and Table of Benefits to confirm the definitions and exclusions available to you:

  • Complementary treatment refers to therapeutic and diagnostic treatment that exists outside the institutions where conventional Western medicine is taught. Please refer to your Table of Benefits to confirm whether any of the following complementary treatment methods are covered: chiropractic treatment, osteopathy, Chinese herbal medicine, homeopathy, acupuncture and podiatry as practiced by approved therapists.
    Where covered, this benefit does not require pre-authorization, therefore in order to claim for your expenses you can simply follow the procedure detailed in the section “Claiming your out-patient, dental and other expenses” under Claims queries.

Which optical benefits are available to me?

Below you will find the definition related to “Prescribed glasses and contact lenses including eye examination” that apply to our standard international healthcare plans – these may vary slightly depending on the plans you have, so please consult your Benefit Guide and Table of Benefits to confirm the definitions and exclusions available to you:

Prescribed glasses and contact lenses including eye examination provides cover for a routine eye examination carried out by an optometrist or ophthalmologist (one per Insurance Year) and for lenses and glasses to correct vision.

  • Pre-approval is not required to access this benefit but you will need to submit your prescription (stating your dioptre) together with your invoice when claiming your expenses.

What does the benefit “Diagnostic tests” cover? Do I need pre-authorisation before I undergo diagnostic tests?

Below you will find the definition related to “Diagnostic tests” that apply to our standard international healthcare plans – these may vary slightly depending on the plans you have, so please consult your Benefit Guide and Table of Benefits to confirm the definitions and exclusions available to you:

  • Diagnostic tests are investigations such as x-rays or blood tests, undertaken in order to determine the cause of the presented symptoms.
    Usually these tests do not require pre-authorization, however please be aware that some more invasive tests will need to be pre-authorised via submission of a Treatment Guarantee/Pre-authorization Form. Please refer to your Table of Benefits to confirm this. You can find more information on pre-approval in the “Emergency and pre-authorization process” above.

What does the benefit for “Health and wellbeing checks” cover?

Below you will find the definition related to “Health and wellbeing checks” that apply to our standard international healthcare plans – these may vary slightly depending on the plans you have, so please consult your Benefit Guide and Table of Benefits to confirm the definitions and exclusions available to you:

Health and wellbeing checks including screening for the early detection of illness or disease are health checks, tests and examinations, performed at an appropriate age interval, that are undertaken without any clinical symptoms being present. Checks are limited to:

  • Physical examination
  • Blood tests (full blood count, biochemistry, lipid profile, thyroid function test, liver function test, kidney function test)
  • Cardiovascular examination (physical examination, electrocardiogram, blood pressure)
  • Neurological examination (physical examination)
  • Cancer screening:
    • Annual pap smear
    • Mammogram (every two years for women aged 45+, or earlier where a family history exists)
    • Prostate screening (yearly for men aged 50+, or earlier where a family history exists)
    • Colonoscopy (every five years for members aged 50+, or 40+ where a family history exists)
    • Annual faecal occult blood test
  • Bone densitometry (every five years for women aged 50+)
  • Well child test (for children up to the age of six years, up to a maximum of 15 visits per lifetime)
  • BRCA1 and BRCA2 genetic test (where a direct family history exists and where included in your Table of Benefits)

What does the benefit “Medical practitioner fees” cover?

Below you will find the definitions related to “Medical practitioner fees” that apply to our standard international healthcare plans – these may vary slightly depending on the plans you have, so please consult your Benefit Guide and Table of Benefits to confirm the definitions and exclusions available to you:

Medical practitioner is a physician who is licensed to practice medicine under the law of the country in which treatment is given and where he/she is practising within the limits of his/her licence.

Medical practitioner fees refer to non-surgical treatment performed or administered by a medical practitioner.

What does the benefit  “Specialist fees” refer to?

Below you will find the definitions related to “Specialist fees” that apply to our standard international healthcare plans – these may vary slightly depending on the plans you have, so please consult your Benefit Guide and Table of Benefits to confirm the definitions and exclusions available to you:

Specialist is a qualified and licensed medical physician possessing the necessary additional qualifications and expertise to practice as a recognised specialist of diagnostic techniques, treatment and prevention in a particular field of medicine. This benefit does not include cover for psychiatrist or psychologist fees. Where covered, a separate benefit for psychiatry and psychotherapy will appear in the Table of Benefits.

Specialist fees refer to non-surgical treatment performed or administered by a specialist.

Any fee applied for an eligible consultation or treatment provided by a qualified specialist, i.e. ENT, endocrinologist, gynaecologist, cardiologist, etc. will be covered under the “Specialist fees” benefit.

If the “Specialist fees” benefit is listed in your Table of Benefits, cover will be provided in line with the terms and conditions of your policy without the need for pre-authorization, i.e. on a pay and claim basis. However, if the specialist fees you need to pay are related to an in-patient treatment (or to any treatment which require pre-authorization as stated in your Table of Benefits) and you will need to include them on the Treatment Guarantee/Pre-authorization Form that you will send us, to enable us to organise the settlement of your bill directly with the hospital (where possible).

Please be aware that in some countries you might need to visit your general doctor in order to get a referral for a specialist consultation.

Is out-patient physiotherapy covered under my plan?

Below you will find the definitions related to physiotherapy that apply to our standard international healthcare plans – these may vary slightly depending on the plans you have, so please consult your Benefit Guide and Table of Benefits to confirm the definitions and exclusions available to you:

  1. Non-prescribed physiotherapy refers to treatment by a registered physiotherapist where referral by a medical practitioner has not been obtained prior to undergoing treatment. Where this benefit applies, cover is limited to the number of sessions indicated in your Table of Benefits. Additional sessions required over and above this limit must be prescribed in order for cover to continue; these sessions will be subject to the prescribed physiotherapy benefit limit. Physiotherapy (either prescribed, or a combination of non-prescribed and prescribed treatment) is initially restricted to 12 sessions per condition, after which the treatment must be reviewed by the referring medical practitioner. Should further sessions be required, a progress report must be submitted to us, which indicates the medical necessity for any further treatment. Physiotherapy does not include therapies such as Rolfing, Massage, Pilates, Fango and Milta therapy.
  2. Prescribed physiotherapy refers to treatment by a registered physiotherapist following referral by a medical practitioner. Physiotherapy is initially restricted to 12 sessions per condition, after which the treatment must be reviewed by the referring medical practitioner. Should further sessions be required, a new progress report must be submitted to us after every set of 12 sessions, which indicates the medical necessity for any further treatment. Physiotherapy does not include therapies such as Rolfing, Massage, Pilates, Fango and Milta therapy.

If the “Prescribed physiotherapy” benefit is included in your cover, it does not require pre-authorization; therefore you should pay for the sessions received and submit the bills for reimbursement to us, together with the referral or prescription from your treating doctor. Please note that if you are claiming for multiple sessions, you will need to provide the breakdown of costs and dates of each individual session.

Am I covered if treatment and medical assistance is needed following skiing and trekking accidents?

We cover treatment for medical expenses arising from injuries sustained while both on- and off-piste skiing or while trekking as part of a leisure activity, if medically necessary. The treatment is covered within the limits of your plan and your geographical area of cover. However, please note that treatment or diagnostic procedures for injuries arising from an engagement in professional sports are not covered at any circumstances.

If you need to be transported to a hospital and you can be reached by a ground ambulance, the costs for the ambulance is covered under the benefit "Local ambulance" listed in your Table of Benefits under your Core Plan. However, if you can not be reached by ground ambulance due to being in a remote location, you may need to be transported off the mountain by the Army, Emergency Services, a specialist rescue company or similar and these costs are not covered under your plan.

Should you need to be evacuated/repatriated following admission to hospital because the required medical treatment is not available locally, costs for this will be covered under the “Medical evacuation” or “Medical repatriation” benefits, if included under your plan and if all conditions for eligibility under these benefits are met. Please refer to your Table of Benefits and Benefit Guide for more information regarding your level of cover and specific benefit information.

Am I covered if treatment and medical assistance is needed following water sports accidents?

We cover treatment for medical expenses arising from injuries sustained while practicing any water sports if medically necessary. The treatment is covered within the limits of your plan and your geographical area of cover. However, please note that treatment or diagnostic procedures for injuries arising from an engagement in professional sports are not covered at any circumstances.

If you need to be transported to a hospital and you can be reached by a ground ambulance, i.e. in-shore, the costs for the ambulance is covered under the benefit "Local ambulance" listed on your Table of Benefits under your Core Plan. However, if you can not be reached by ground ambulance due to being off-shore or in a remote location, you may need to be transported by the Army, Emergency Services, a specialist rescue company or similar as these costs are not covered under your plan.

Should you need to be evacuated/repatriated following admission to hospital because the required medical treatment is not available locally, costs for this will be covered under the “Medical evacuation” or “Medical repatriation” benefits, if included under your plan and if all conditions for eligibility under this benefit are met. Please refer to your Table of Benefits and Benefit Guide for more information regarding your level of cover and specific benefit information.

Forms to use

Where can I find the Treatment Guarantee Form?

Most of our Treatment Guarantee Forms are available here. However, if you are under a special plan, your specific Treatment Guarantee Form may be available in a special webpage as indicated in your Benefit Guide.

Where can I find the Claim Form?

Most of our Claim Forms are available here. However, if you are under a special plan, your specific Claim Form may be available in a special webpage as indicated in your Benefit Guide.

Administration of your policy

How can I change my post address, email address or any other personal information that you hold on record from me?

You should communicate any change in your home or business address as well your email address to our Helpline as soon as possible. This information will help us to keep in contact with you accordingly.

I am covered under an individual plan (i.e. underwritten policy). How can I add dependants/a newborn child under my policy?

You may apply to include any of your family members on your policy by completing the relevant application form and submitting it to: underwriting@allianzworldwidecare.com. However, newborn infants (with the exception of multiple birth babies, adopted and fostered babies) will be accepted for cover from birth without medical underwriting, provided that we are notified within four weeks of the date of birth and the birth parent or intended parent (in the case of surrogacy), has been insured with us for a minimum of six continuous months. To notify us of your intention to have your newborn child included on your policy, please email your request with a copy of the birth certificate to our Underwriting Team at: underwriting@allianzworldwidecare.com. Notification of the birth after four weeks will result in newborn children being underwritten and cover will only commence from the date of acceptance. Please note that all multiple birth babies, adopted and fostered children will be subject to full medical underwriting and cover will only commence from the date of acceptance.

I am covered under group scheme that is not underwritten. How can I add dependants/a newborn child under my policy?

You may apply to include any of your family members as a dependant provided that you are allowed to do so under the agreement between your company and us. Notification to add a dependant should be made through your company unless otherwise stated. If the dependant is a newborn infant, he/she will be accepted for cover from birth, provided that we are notified within four weeks of the date of birth. To have a newborn added to the policy, you must ask your company to submit a request in writing, including a copy of the birth certificate, to its usual Allianz Partners contact person for membership changes. If we are notified four weeks or more after the date of birth, newborn children will be underwritten and cover will only start from the date of acceptance.

I am covered under group scheme that is underwritten. How can I add dependants/a newborn child under my policy?

You may apply to include any of your family members as a dependant provided that you are allowed to do so under the agreement between your company and us. Notification to add a dependant should be made through your company unless otherwise stated. If the dependant is a newborn infant, he/she (except multiple birth babies, adopted and fostered children) will be accepted for cover from birth without medical underwriting, provided that we are notified within four weeks of the date of birth and the birth parent or intended parent (in the case of surrogacy) has been insured with us for a minimum of six continuous months. To have a newborn added to the policy, you must ask your company to submit a request in writing, including a copy of the birth certificate and send it by email to our Underwriting Team at: underwriting@allianzworldwidecare.com. If we are notified four weeks or more after the date of birth, newborn children will be underwritten and cover will only start from the date of acceptance. Please note that all multiple birth babies, adopted and fostered children will be subject to full medical underwriting and cover will only commence from the date of acceptance.

I am responsible for paying the premium for my cover. How do I do that using my credit card?

In order to maintain the highest levels of data protection, we encourage our members to update their own credit card details online via our secure Online Services, if they have access to these under the plan they have.

If Online Services are available for you, you can access them at any time by clicking on “Login” at the top right corner of this page. You will need your personal login details, which have been provided to you as part of your Membership Pack, in order to access our Online Services. If you have forgotten or misplaced your login details please click on the ‘Reset Password' link in the ‘Login’ section of our website and follow the instructions provided. You will then receive your login details via email.

Once logged into Online Services, please complete the following steps:

  • Select the ‘Payments’ tab at the top of the Online Services homepage.
  • Click on the ‘Change payment details’ option from the list of subheadings.
  • Enter your credit card details into the relevant fields.
  • Click on ‘Save changes’.

When you have updated your credit card payment details please send an email to creditcontrol.individual@allianzworldwidecare.com notifying us that changes have been made. Once we are made aware of these changes, we will process your next payment and notify you by email, when the transaction has been successfully completed.

What happens to my cover if I return to my home country?

It is important that you advise us when you change your country of residence as it may impact the cover or premium, even if you are moving to a country within your geographical area of cover. If you move to a country outside of your geographical area of cover, your existing cover will not be valid there. Please note that cover in some countries is subject to local health insurance restrictions, particularly for residents of that country. It is your responsibility to ensure that your healthcare cover is legally appropriate. If you are in any doubt, please seek independent legal advice, as we may no longer be able to provide you with cover. The cover provided by Allianz Partners is not a substitute for local compulsory health insurance. Notification of change of residence should be made through your company unless otherwise stated.

Can I ask a third person to administer my policy or release personal information on my behalf?

We process your personal information according to the our Privacy Notice. The processing of your personal information will only be conducted in accordance with the provisions outlined in this Privacy Notice.

In accordance with our Privacy Notice, sensitive information may only be discussed with or disclosed to the natural person to whom the information relates, unless:

  • That individual has provided their explicit consent to the disclosure of their sensitive information with another person (natural or legal); or,
  • The disclosure of that individual’s sensitive information to another person (natural or legal) is in the vital interests of the individual and they are not physically or mentally able to provide their explicit consent to the disclosure.

    Where any natural person is under 18 years of age:

  • Such information can be discussed with or disclosed to the parent’s or legal guardian’s of the individual.
  • It is the responsibility of the parent/s or legal guardian’s of that individual to provide consent on behalf of the individual for disclosure of their sensitive information in accordance with the above requirements.
  • If you would like to consent that we disclose details of your claims or any other sensitive information (as defined in our Privacy Notice) to a family member or a third person (natural or legal), we would ask you to complete the Third Party Data Access Form available here . Please submit the completed and signed form to us by email to: client.services@allianzworldwidecare.com.
  • We would like to make you aware that you can specify in the Third Party Data Access Form the type of information your explicit consent is limited to (e.g. only personal data but not sensitive data).

Mobile App

You can find our Mobile App FAQ here.

Complaints

What steps should I take to submit a formal complaint?

Our Helpline is always the first number to call if you have any comments or complaints. If we have not been able to resolve the problem on the telephone, please email or write to us at:

Telephone: +353 1 630 1301
Email: client.services@allianzworldwidecare.com
Postal address:Customer Advocacy Team,
Allianz Partners,
15 Joyce Way,
Park West Business Campus,
Nangor Road,
Dublin 12,
Ireland.

We will handle your complaint according to our internal complaint management procedure detailed here.  

You can also contact our Helpline to obtain a copy of this procedure.