CLAIM PROCEDURE

If you or your dependants visit a clinic owned by the Fund, any doctor or service provider contracted to the Fund, they will submit your claims directly to the Fund on your behalf.

Any amount not covered by the Fund will be the member’s responsibility to the service provider.

If a member received treatment as an out-patient at a state hospital, he/she will have to settle the account in full and then submit the account, with the proof of payment, to the Fund. The Fund will refund the member up to his benefit limit.

Claims may be faxed, e-mail or posted to the Fund as per the contact details on the front page of this brochure.