How your employees can make a claim

How to claim for medical treatment

Whether your employees are making a claim for a doctor visit or need treatment in a hospital, they’ll find information on this page about what to do.

If you or your team are unsure about anything and would like to speak to someone, give us a call on +44 (0) 1276 486 460. Our team works 0600-1800 (GMT), Monday to Friday. You can also email your question to claims@william-russell.com.

How to claim for outpatient treatment

Outpatient treatment is medical treatment that doesn’t require admission to hospital. Doctor visits, consultations with a specialist, scans and imaging tests, and physiotherapy sessions are all examples of outpatient treatment.

We ask your employees to pay the bill for your outpatient treatment, then claim back their expenses from us later. This practice is sometimes called ‘pay and claim’, or ‘reimbursement claiming’.

Follow these steps when outpatient treatment is required:

1. Before you receive your treatment—Feel free to ask us whether your plan covers your proposed outpatient treatment. Your employees can check themselves by reading their certificate of insurance and checking the table of benefits in their plan agreement. We need to pre-authorise certain types of outpatient treatment.
2. Pay the bill—Once they have received treatment, they must as their doctor for a fully itemised invoice. The invoice must be paid, and they should keep a copy of the invoice and receipt. If the claim exceeds US$500 (or equivalent in another currency), they must ask their doctor to complete Section B of this PDF form.
3. Complete our online form—Complete our online claim form for outpatient treatment. The form will ask for an uploaded photograph or scan of the invoices, receipts, and any other relevant document.
4. We reimburse you—We review your claim and reimburse eligible expenses.

How to claim for inpatient or daypatient treatment

Inpatient treatment is medical treatment received that requires overnight admission to hospital. Surgical cancer treatment, transplants, or treatment following a stroke or cardiac problem are examples of treatment that will likely require one night or more to be spent in hospital. Sometimes, treatment might require formal admission to hospital but without the need to stay overnight. This is called daypatient treatment, and we treat it in the same way as inpatient treatment.

When your employees need eligible inpatient treatment, we settle the bill directly with the hospital or clinic where treatment has been received.

Follow these steps when inpatient treatment is required:

1. Contact us—As soon as your employee is aware they need medical treatment that requires admission to hospital, they must complete our online pre-authorisation form for inpatient treatment. The form will ask for a photograph or scan of the doctor’s medical notes to be uploaded.
2. We pre-authorise your treatment—We’ll contact the hospital or clinic where treatment will be received and ask them for the necessary medical information. If the health plan covers the proposed treatment, we’ll attempt to send the hospital our guarantee of payment for the treatment. There are some situations where we may not be able to settle medical bills directly with the hospital. For instance, remote clinics in parts of Africa cannot handle international payments. In these cases, we’ll work with your employee and the hospital to find a way to settle the bills.
3. We settle your bills—Once treatment has been received and the hospital has sent us the final invoice, in most cases we’ll pay the bill directly to the hospital.

We ask that contact is made with us at least 5 days before the date of admission to hospital. This gives us enough time to contact the hospital. If it’s not reasonably possible to contact us in advance (e.g., admitted straight to hospital following an accident), please contact us within 24 hours of admission.

How to claim for private maternity care

If you’re employee is pregnant and their plan gives them cover for routine maternity care, they will need to follow these steps:

1. Complete our claim form—We have a PDF claim form for maternity care. This needs to be printed off and taken to their next appointment with their maternity doctor. Employees must complete Section A, and their maternity doctor will need to complete Section B.
2. Keep any invoices and receipts for your ante-natal treatment—Once ante-natal treatment has been received, ask the doctor for a fully itemised invoice. This invoice should be paid, then a copy of the invoice and receipt should be retained.
3. Email everything back to us—A completed claim form should be sent to claims@william-russell.com, along with copies of invoices and receipts.
4. Tell us where you’ll be giving birth—Once your employee is within 2 months of their estimated due date, they should let us know where they are planning to give birth and the contact details of their treating doctor.
5. We settle your bills—We’ll contact the hospital and attempt to send them our guarantee of payment for childbirth and related maternity treatment up to the remaining benefit on your plan. If that’s not possible, we’ll work out a solution with your employee and the hospital. Once they have given birth, we’ll pay the bill directly to the hospital.

If your employee is in need of an emergency medical evacuation

If a member of your team suffers a life-threatening or limb-threatening injury or illness, which needs immediate inpatient treatment that isn’t available locally, we’ll arrange their medical evacuation to the nearest suitable location.

1. Call us—Call +44 (0) 1243 621 155 for our 24hr emergency medical assistance helpline.
2. We quickly assess the situation—While our medical team establishes the particulars of your situation, our operations team will assess the situation on the ground.
3. We organise the logistics of your evacuation—We decide on the evacuation destination and the means of transport that is best suited to the situation. We take into account several criteria, including the severity of your employees condition and air ambulance availability.
4. Identify your destination hospital—We’ll secure admission at the destination hospital, sending that hospital our guarantee of payment for treatment.
5. Your transport arrives—We’ll ensure your employee is collected from their local medical team and get them into an air ambulance.
6. Returning home—Once they are ready for discharge from hospital, we’ll pay for their economy return airfare to their country of residence.

By ‘we’, we mean the claims team at William Russell and our assistance service partner, Charles Taylor (formerly called CEGA). We work closely together to organise evacuations and arrange treatment/s at the evacuation destination.

Claiming for life insurance

We understand that if a your employee or a member of their family is making a life insurance claim, they will be going through an incredibly difficult time. We want to reassure you that we’ll do everything we can to make the claims process as simple and straightforward as possible.

1. Inform us that a William Russell policyholder has passed away by calling us on +44 1276 486 460 or email claims@william-russell.com.
2. It’s good to have any documentation on hand, including: a copy of the policyholder’s death certificate, confirmation of the policyholder’s date of birth (e.g. a passport), and proof of the policy holder’s income at the time they took out a policy.
3. It’s imperative these documents are certified by a solicitor or public notary.
4. We’ll also need documentation relating to each of the name beneficiaries on the deceased’s life insurance policy, including: identification showing the beneficiary’s name and date of birth (e.g. a passport), proof of address, full bank details on the bank’s letter headed paper, and proof that the beneficiary is alive.