How do I make a claim?
How do I make a health insurance claim, how is this different to a cash benefit claim and what claiming methods are available to me?
Everyone hopes they will never need to use their health insurance. But should you need to access your benefits and make a claim, you expect your insurance provider to be there for you. The following is designed to help you understand the treatment process, the difference between a medical insurance claim and a cash plan claim, as well as taking you through the different ways you can make a claim, depending on your circumstances and preferences.
The treatment process
Contact a GP
The first step if you're feeling unwell is to get in contact with a GP, as they are best placed to advise what investigations and treatment may be necessary. This can be your own GP, or you can use the Remote GP Services benefit to get access to a private GP helpline 24 hours a day, 7 days a week. In a medical emergency you should seek urgent advice/treatment via the NHS - you should not delay.
If the GP feels that you need investigations and/or treatment, they will refer you and tell you the type of medical professional you need to see. The GP may be able to refer to a specific person or hospital or, alternatively, we can tell you which private healthcare providers (e.g. specialists, therapists and hospitals) are available in your area. Tell your GP that you have health insurance cover to ensure that you are referred to the correct provider.
Start a claim
Before any tests or treatment are started it is important that you set up your claim with us. This gives us the opportunity to advise you on the benefits available to you and will ensure you do not receive any unexpected expenses. You can start a claim via our app, by logging into My WPA or by contacting our helpdesk.
When you set up your claim, you will need to provide dates and details of your symptoms, along with the name of the healthcare provider you wish to see. In most cases, an immediate decision will be given which will confirm your claim details and the benefits available on your health insurance policy.
Once your claim has been authorised you can book your specialist consultation, tests or treatment at a time and place that is convenient to you. Our website allows you to search for healthcare providers in your area that are recognised by WPA, so you can rest assured that they meet the professional standards of their governing body, and your care will be of the highest quality.
Treatment provider bills
We will settle the bills for your treatment or tests directly with the treatment provider. If you have an excess, Shared Responsibility or benefit limit that is affected we will contact you to let you know what your contribution will be. You can track the progress of your claims and view any remaining benefit limits you might have via the WPA health app or via the My WPA area of the website.
The Private Healthcare Information Network looks at the quality and cost of private care. You can find independent information about doctors and hospitals at www.phin.org.uk.
Multiple ways to start a claim
1
WPA Health app
The WPA Health app provides easy access to make a claim 24/7, track claim and benefit limits, access 24/7 Remote GP Services, send and receive secure messages and more!
2
My WPA
Access 24/7 Remote GP Services, contact us using Live Chat, make and track a claim or send and receive secure messages all via the My WPA Login.
3
Helpdesk
Our trained, experienced UK based team are on hand to help you at every stage of your treatment journey.
Claiming a cash benefit?
A cash benefit is a monetary amount towards everyday healthcare costs including time spent in an NHS hospital. If you choose to receive in-patient treatment, day-patient treatment, out-patient complex diagnostic scans or out-patient procedures as an NHS patient instead of as a private patient, you may be able to claim a cash benefit. Additionally, your WPA health insurance may offer other cash benefits such as NHS car parking charges, optical and dental treatment.
You can still claim for a cash benefit using the WPA Health app, My WPA login or by contacting our helpdesk, but unlike a health insurance claim we will reimburse you directly into your bank account (subject to benefit limits and level of cover) once you have paid the provider and submitted an eligible claim. All claims must be submitted within 6 months of the treatment taking place.
Making a claim with the WPA Health app
The following videos have been created to show you the simple steps needed to make a new medical or cash benefit claim via the WPA Health app. It can take less than two minutes to make a claim and we'll tell you immediately if your claim is authorised.
WPA Health app: Making a new medical claim
WPA Health app: Making a new cash benefit claim
We are here for you
Existing members
Members have access to a range of support services, including 24/7 Remote GP Services, as well as exclusive member offers and ways to manage your membership on the go.
Find healthcare providers
Search for healthcare professionals, hospitals, clinics and scanning centres recognised by WPA in your area.