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About Us

Making a claim

Here you can find all the information you need around making a claim. We are here to help – if you can’t find what you are looking for, please contact us here.

Claims

+852 3702 6162

If you are…

Claiming for out-patient treatment...

Step 1

Download a General Claim Form.

Step 2

Take the Claim Form with you when you visit your doctor. You will need to complete Section A.

If the total amount you are claiming for is going to exceed US$500 or HK$3,875, please ask your doctor to complete Section B.

Step 3

Ask your doctor for a fully itemised invoice along with the receipt, which gives a breakdown of all medical treatment received and any drugs prescribed.

Step 4

Email the completed Claim Form, along with a copy of the invoices, to hkclaims@william-russell.com.

Needing to be admitted to hospital...

Step 1

Contact us as soon as you know you need to be admitted to hospital. You can call us during HK offices hours (0900-1700, Monday to Friday) on +852 3702 6162, or you can email us at hkclaims@william-russell.com.

In the event of an emergency, please call our 24hr Emergency Medical Assistance Helpline on +44 (0) 1243 621155. You can reach them anytime, from anywhere.

Step 2

Upon receipt of your call or notification, we will contact the hospital or medical facility to make all the necessary arrangements for you to be admitted.

Step 3

Depending on your level of cover and the individual hospital, we can sometimes settle costs directly with the hospital. Alternatively, we offer Guarantee of Payment, giving you peace of mind that you will be reimbursed in full for costs incurred. Of course, if you have any queries you are welcome to contact our claim advisers at any time during the process.

Claiming for maternity care

Step 1

To make a claim for routine out-patient maternity care, please download a Maternity Claim Form.

Step 2

Take the Claim Form with you when you visit your doctor. You will need to complete Section A, and your treating doctor will need to complete Section B.

Step 3

Ask your doctor for a fully itemised invoice along with the receipt, which gives a breakdown of all medical treatment received and any drugs prescribed.

Step 4

Email the completed Claim Form, along with a copy of the invoices, to hkclaims@william-russell.com.

Step 5

Once you are within 2 months of your estimated due date, let us know the name and contact details of your treating doctor and the hospital at which you are due to give birth.

We will contact the hospital or medical facility directly and make all the necessary arrangements for you.

Frequently asked questions

Here you can find questions to some of the questions our customers frequently ask us. For anything else, please call our dedicated Hong Kong team.

  • How do I make a claim for out-patient treatment?

    Please download a General Claim Form, and complete Section A.
    If the total amount of your claim is going to exceed US$500 or HK$3,875, please ask your doctor to complete Section B of this form.
    Submit the completed form, along with the fully itemised invoices and receipts for all treatment you have received and medications you have been prescribed, to hkclaims@william-russell.com.
    We will acknowledge your claim, and we will get back to you within 5 working days with either a request for more information or confirmation that we have settled your claim in accordance with the instructions you provide on the Claim Form.

    Important notes

    In some cases we may require your doctor to complete Section B, even if your claim is for less than US$500 or HK$3,875.
    We can only reimburse your claim when we have received copies of the fully itemised invoices and receipts, which give us a complete breakdown of all treatment you have received and any medication you have been prescribed.
    We also reserve the right to request original documentation relating to your medical treatment, so please retain all original invoices and receipts for a period of 12 months.

  • How long will it take to assess my claim?

    We aim to assess your claim within 5 working days.

    This means that, within 5 working days, we aim to have determined if we have enough information to process your claim and to proceed to settlement, or if we need to ask you for further information.

    If we do need to ask you for further information, or if we need to contact your doctor, we will let you know and we will keep you fully informed about our progress.

  • Am I covered for dental treatment?

    If you have an Elite Gold plan

    You are covered for basic dental treatment within the benefit limit specified in your plan agreement after you have been insured for a continuous period of six months.

    Basic dental treatment means:

    screening (e.g. checks, X-rays, assessments)
    scaling and polishing
    sealing
    fillings (both composite and amalgam)
    simple extractions
    root canal treatment

    If you are an Elite Gold plan holder, and you have paid the additional premium for the Dental Plus benefit, you are entitled to claim for 80% of the following up to the benefit limit specified in your plan agreement:

    denture repair
    full/partial dentures
    dental bridges
    crowns, inlays, and onlays
    dental implants
    If you have an Elite Silver plan

    If you are an Elite Silver plan holder, and you have paid the additional premium for the Dental basic benefit, you are entitled to claim 80% of the cost of the following treatments, up to the benefit limit specified in your plan agreement after you have been insured for a continuous period of six months:

    screening (e.g. checks, X-rays, assessments)
    scaling and polishing
    sealing
    fillings (both composite and amalgam)
    simple extractions
    root canal treatment

    If you are an Elite Silver plan holder, and you have paid the additional premium for the Dental plus benefit, you are entitled to claim for 80% of the following up to the benefit limit specified in your plan agreement:

    denture repair
    full/partial dentures
    dental bridges
    crowns, inlays, and onlays
    dental implants

  • Do you have a list of doctors or clinics I can visit?

    You have the freedom to choose where you have your medical treatment within your area of cover. Contact us for confirmation that your chosen medical provider is within our network. You can see a list of some of the medical providers we work with here.

  • Am I covered for routine medical check-ups and vaccinations?

    If you are on a Silver or Gold plan holder we offer benefits for vaccinations, and preventive health and well-being for adults, after you have been insured by your plan for a continuous period of 6 months.

    These benefits can be used towards routine or preventive health checks or vaccinations, including an annual eye examination.

    There is also a Well Child benefit for children insured as dependents under the Silver and Gold plans, after they have been insured for a continuous period of 12 months.

    If you are claiming for health checks, vaccinations or optical tests, simply scan and email us at hkclaims@william-russell.com your itemised invoices and receipts, and a summary of what you are claiming for, and how you wish to be reimbursed.

  • Am I covered for eyesight tests and glasses?

    If you are a Silver or Gold plan holder, you may claim the cost of an eye examination under the Preventive Health Check benefit.

    We do not cover visual aids such as glasses or contact lenses and we do not pay for corrective treatment.

  • Am I covered to see a physiotherapist and what is the process?

    If you are a Silver or Gold plan holder you are entitled to claim up to 6 sessions of physiotherapy with a registered physiotherapist provided you have a medical doctor’s referral letter. After the 6th session, if you need further sessions, you must contact us for pre-authorisation and we will require a further medical referral letter.

    When you submit your claim, please also include the medical referral letter from your doctor.

    If you are a Bronze plan holder, you are entitled to claim for up to 6 sessions of physiotherapy up to the benefit limit stated in your plan agreement, following a hospital admission, provided you have a medical doctor’s referral letter. Please note that the physiotherapy sessions must be related to the in-patient treatment you have received, and each session must fall within the 90 day period following your discharge from hospital.

    When you submit your claim, please also include the medical referral letter from your doctor.

  • Am I covered for complementary treatment, such as acupuncture?

    Our Global Health Elite plans provide cover for treatment with a chiropractor, osteopath, chiropodist, podiatrist, homeopath or acupuncturist.

    You have to have been referred by a medical doctor for any treatment by a chiropractor, osteopath, chiropodist or podiarist, and we will require the doctor’s referral letter before we can assess your claim.

    There are limits to the number of sessions you may claim for in any one year and these limits are stated in your plan agreement.

    If you are a Bronze plan holder, you can only claim for any of these treatments if you receive them during the 90 day period following discharge from hospital, and the treatment must be related to the in-patient treatment you have received.

  • Am I covered to see a psychiatrist or psychologist?

    Our Global Health Elite plans provide cover for consultations with a psychiatrist.
    All psychiatric treatment must be authorised by us in advance, and there is no cover for any psychiatric treatment you receive within the first 24 months of your cover.

    After 24 months, you may claim for consultations with a psychiatrist, provided you have been referred to the psychiatrist by your medical doctor.
    If your claim is eligible and the psychiatrist feels it would be beneficial for you to see a psychologist, we will pay for the consultations with the psychologist up to the number of sessions specified in the Table of Benefits applicable to your plan.

    When you submit your claim we will require your medical doctor’s referral letter and your psychiatrist’s referral letter.
    Please note that the Bronze, Silver and Gold plans each provide cover for up to a maximum of ten out-patient psychiatric consultations per period of cover. Each consultation with a psychologist would be included in this maximum.

    If you are a Bronze plan holder, you are only eligible to claim for post hospital psychiatric consultations that occur within 90 days of your discharge from a psychiatric unit.

    There is also a lifetime limit to the amount you can claim for psychiatric treatment. Please refer to your plan agreement to view the limits for your plan.

  • Do I need to pre-authorise advanced diagnostic tests such as MRI, CT and PET scans?

    You do not have to pre-authorise your Advanced Diagnostic tests with us in advance, but we will require a referral letter from your doctor, (or from your specialist if it is a PET scan), before we can assess your claim.

    If you would like us to confirm cover prior to undergoing the scan or you would like us to try to place a guarantee of payment directly with the medical facility, we will need at least 48 hours notice prior to the scan to enable us to obtain the information we need to assess whether the scan is covered.

    Please contact us as soon as you know you need to have a scan. You can find our contact details here.

  • Is there a time limit for submitting claims?

    We recommend that you submit your claims into us within six months of the date of treatment, however if your claim is older than this please still do submit into us for us to review.

  • Do you cover fees charged by a doctor to complete a claim form?

    Unfortunately we do not cover fees for the completion of claim forms, or any other administration or registration fees charged by doctors or hospitals.

  • How do I check if a condition or treatment is covered under my plan?

    The first place to check if a condition or treatment would be covered by your plan is by turning to the Table of Benefits for your plan type, in your plan agreement.

    Please also refer to the Costs We Don’t Cover section in your plan agreement.

    Alternatively please contact our claims department on +852 3702 6162 or email hkclaims@william-russell.com.

  • Where can I get a copy of your claim form?

    You can download a copy of our claim form from the document library section on our website. Alternatively please contact us at hkclaims@william-russell.com and we will be happy to email you a copy.

  • How do I find out if I have an excess on my plan and how does it work?

    The excess shown on your certificate of insurance is the amount you will have to pay towards the cost of your treatment.

    If your plan has an excess and the benefit you are claiming for has co-insurance and/or limits, we will apply the co-insurance first, then the excess, then the limit.

    If you have chosen a plan which has an excess per claim, this is the amount you will have to pay each time you make a new claim for treatment covered by your plan. New claims are those that are for a condition which is not related to an existing claim.

    If your claim is for the treatment of a chronic condition, AIDS/HIV, or for out-patient follow-up consultations and/or tests for
    cancer and the treatment continues into a new period of cover, we will treat it as a new claim. In these circumstances we will reapply the excess at your plan renewal date and each subsequent plan renewal until the claim is finished.

    If your claim is in respect of the well-being benefits, your excess will be applied once per period of cover.

    If your excess is per annum it will be applied once per period of cover. For example, if your excess is US$250 per annum, we will not pay for the first US$250 of eligible expenses you incur during your period of cover. We will apply one excess per period of cover irrespective of the number of claims you make. You must submit all eligible claims to us – even claims within your annual excess, as we will only be able to reimburse you when the value of the eligible expenses you incur exceeds the amount of your annual excess. When you renew the plan, the annual excess will apply again in respect of your new period of cover.

  • How do I claim for dental or wellbeing benefit?

    Please send us the fully itemised invoices and receipts for which you are claiming reimbursement to hkclaims@william-russell.com, together with your bank account details. A claim form is not ordinarily required.