Domestic Travel Claim Service

 

Claim Channel

 

24-hour hotline:
indicated on the insurance card

 

Call 02-239-2840
During business hours
08.30 - 16.30

 

Email:
[email protected]

How to use the service

The representation of proofs for the rights to receive medical treatment
  1. The insured have to present an insurance card, a photo of insurance card, the insurance photo from application or employee card and ID card or other cards issued by the government before receiving medical treatment at a hospital in the policy coverage. 
  2. In the event that the insured is a child under 7 years of age, the parent will be asked to provide a government-issued card.
In the case that the insured does not have, forget or lose an insurance card.

The company can confirm the rights of the insured to claim for the coverage from the insured’s name, surname and ID card number. However, the hospital can contact Hotline 02-660-1221 any time when any information cannot be found.

Outpatient Medical Treatment (OPD)

If there is not any exception, the hospital will provide the right to the insured immediately. In the case of inpatient (IPD), the hospital staff will contact the company to provide medical care and treatment every day.

In the event that medical expenses are in excess of the coverage

After the treatment, patients are not subject to any expenses if the medical expenses do not exceed the coverage limit provided by the company. Yet, if there is an excess beyond the Protection Eligibility or any outside the coverage, the hospital will notify the insured to pay the excess immediately.

Examples of insurance cards:

Dhipaya Care Card
PA Dhipaya Care Card
KTB Shop Smart Peal
KTB Shop Smart Palladium
GSB Debit Smart Care
GSB Debit Smart Life
Mobile Application TIPInsure

Procedures and documents for claims

In the case that the insured use a health insurance card with a medical facility in the contract
  • The insured have to present a health insurance card and an ID card or a driver’s license or any card issued by the government to the hospital staff every time before receiving medical treatment.
  • The medical facility will give the right to the outpatients right away if Outpatient Medical Treatment (OPD) is not an exception of the insurance.
  • In the case of Inpatient (IPD), the hospital staff will coordinate to the company to offer services to the insured all the time.

For further information, please contact the hotline number shown on the card 24 hours a day.

In case of reserve payment for medical expenses

For the Individual Insurance

  • The insured can show the insurance card to receive treatment in a hospital in the contract, and if there is any excessive expending, the hospital will inform the insured of the additional charge right away.
  • In the case that the insured has already reserved the medical expenses, but it is the service provided from the hospital outside the contract, the insured need to bring the evidence to claim for a compensation from the company following 2 types of procedure.
    • Bring the documents to submit at the company in person.
    • Mail the documents via post to the company, Personal Health and Accident Claims Department.
  • When the company has considered the compensation, the check will be delivered to the insured, or the company will transfer money to the insured’s account in the case that the

insured have made the insurance through an agency (Group Insurance.)

  • The insured are able to receive treatment in a hospital in the contract all the time by showing the insurance card to the hospital staff, but, if there is excessive medical expenses, the hospital will notify the insured to pay for the additional charge immediately.
  • In the case that the insured have already paid for the medical cost, he can bring the evidence to submit to the agency to notify the company for compensation claims.
  • When the company has considered the compensation, the check will be delivered through the agency, or money will be transferred to the insured’s account.
Documents related to the claiming for compensation

Documents required to provide to the Personal Health and Accident Claims Department

  • Documents for consideration of death from illness                                       [Download]       
  • Documents for determining compensation in the event of accidental death             [Download
  • Documents for consideration of claims in the event of disability or loss of organs       [Download]
  • Additional supporting documents for medical expenses claim                            [Download]
  • Documents for consideration of income compensation claim while hospitalized          [Download]     
  • Documents for consideration of Motor Add on compensation                            [Download]
  • Documents for consideration of travel accident policy (TA)                               [Download]
  • Documents for claiming Motor Add on Lady                                              [Download]
  • Documents for consideration of compensation in the event of critical illness            [Download]
  • Documents to consider for indemnity in the case of cancer                             [Download]
International insurance standards

with ISO 9001 and ISO 27001 systems


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