CHOICES

Visit your GP
If your GP is able to provide all the treatment that is necessary, no further action will be required as the services provided by a GP are not covered under the policy.

If further treatment is required
If your GP refers you for further treatment (including consultations) you must telephone the Universal Provident helpline on 0844 8730 900 as under the terms of your policy all treatment must be pre-authorised by us.

When you phone us, please have the following information available:

• your policy number,
• the condition to be treated,
• the date when you first became aware of the condition,
• what treatment is planned at this stage,
• the name of the specialist, physiotherapist or complementary medicine practitioner you are arranging to visit, and
• the hospital to be used (if known or if applicable)

We will then be able to discuss your claim with you, let you know what we will do and advise you how you should proceed.

Please note that any authorisation given at this stage is subject to confirmation upon receipt of a full completed claim form. If subsequent information contradicts the information on which our pre-authorisation has been based, your claim may be invalidated.

Payment
Wherever possible we will pay all bills direct to the provided of the treatment or services. You must advise the provider of your insurance details before you have the treatment so that they can send their bills to us. You must also check whether direct settlement is available for out-patient treatment. If you have paid for any treatment yourself, we will reimburse you. If your policy is subject to an excess we will deduct the excess from the appropriate bills and advise you to whom the excess should be paid.

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DENTALCARE

Visit your dentist
If your dental practitioner advises that you require treatment, telephone our helpline to request a claim form. You should also inform your dental practitioner of your insurance details.

Please note that certain treatment (implants, treatment for tooth wear and any treatment where the estimated cost is more than £500) covered by this policy must be pre-authorised by us before you have the treatment. If you need to have such treatment please have the following information available when you telephone us:

• your policy number,
• the condition being treated,
• the date you first became aware of the condition,
• the treatment planned and the estimated cost, and
• the name of the dental practitioner who will undertake the treatment

Based on the information you provide we will confirm:

• that the condition and treatment are covered by the policy,
• that the dental practitioner is approved by us, and
• the eligibility of the proposed treatment.

We will then send you a claim form, part of which will be completed from the information you have provided.

When you receive the claim form
Ensure that the information already on the form is correct and complete any remaining information within the “Member’s Section”.

Ask the dental practitioner who undertakes the treatment to complete the “Dentist’s Section” of the claim form.

Once the form is complete
Return the claim form to us together with any accounts you may have received for the treatment provided, so that we can reimburse you for the eligible costs you have incurred. Please let us know if you would like us to pay the accounts directly to the dental practitioner. Any additional accounts should be sent to us as soon as you receive them.

Additional claim forms
If further treatment is required

1. once the last treatment is regarded as complete, or
2. after a period of six months has elapsed since the last treatment, we will regard this as a new claim and will require a new claim form to be completed and the treatment to be pre-authorised, if appropriate.

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LIVINGCARE

Phone the Universal Provident helpline.
If you need to claim under this policy you must first of all call our helpline on 0844 8730 900. When you phone us, please have the following information available:

• your policy number
• details relating to your disablement
• the disability commencement date.

We will then be able to discuss the claim with you and issue a claim form.

When you receive the claim form
Please complete the claim form in full and return it to us with any additional documentation requested. We will then request a medical report from your medical attendant to enable us properly to assess your claim.

Once we have received the medical attendant’s report and any additional information we may require, we will inform you of the validity of your claim and, if appropriate, arrange for benefit payments to commence at the end of the deferred period.

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INCOMECARE

To notify your claim you should contact us within 30 days of the date of your accident or the start of your illness. We will explain the procedure and send you the appropriate forms to complete.

You can contact us at the following address:-

Universal Provident Limited
John Ormond House
899 Silbury Boulevard
Central Milton Keynes
MK9 3XL

Telephone: 0844 8730 900
Fax: 0845 120 1027

Throughout your claim, to substantiate your entitlement to benefits, you must provide us with

• medical certificates issued by a United Kingdom registered medical practitioner, and
• any other documentation we may reasonably require.

Medical certificates must be sent to us within 15 days of issue. Other documents must be sent to us within 30 days of being requested to do so.

If we request medical examinations we will meet the cost.

In the course of validating your claim we, or persons working on our behalf, may arrange to visit you. You must make yourself available for such visits.

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MORTGAGECARE

If you become disabled or unemployed, you should contact the claims administrators within 30 days of the start of your disability or unemployment. When you contact them please ensure that you have your certificate number to hand.

They will explain in full the claims procedure, send you the appropriate claim form for completion and let you know what further documentation or information may be required in support of your claim. They will then handle all matters relating to your claim directly with you.

The claims administrators are:

Cassidy Davis Insurance Services Ltd
21 Perrymount Road
Haywards Heath
West Sussex
RH16 3TP

Phone: 01444 450550
Fax: 01444 458234

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TRAVELLERSCARE

Please note that the procedure varies according to the policy section under which you are claiming.

WHAT TO DO IF YOU WISH TO MAKE A CLAIM
If you need to make a claim please obtain a claim form by telephoning or writing to the appropriate claims service below, the number shown on your Certificate of Insurance and which section of the policy you are claiming under.

FOR SECTIONS 1 to 10 and 12 to 13
ETI Travel Claims, Albany House, 14 Bishopric, Horsham, RH12 1 QN. Telephone: +44 (0) 1403 788 515 (calls may be monitored or recorded for quality purposes) Fax: +44 (0) 870 241 5774. Email travelclaims@travel-insurance.com
Please quote scheme number 535.

FOR SECTION 11 – LEGAL EXPENSES
Legal Expenses claims are managed by DAS Legal Expenses Insurance Co. Ltd., DAS House, Quay Side, Temple Back, Bristol BS1 6NH. You must notify DAS immediately in the event of a claim Tel: +44 (0) 117 934 2000, Fax: +44 (0) 117 934 2109. Please refer to the Policy Section 11 (policy conditions/exclusions) for the Legal Costs and Expenses.

ETI EMERGENCY MEDICAL ASSISTANCE
ETI Emergency Assistance provides immediate help in the event of your illness or injury arising outside the United Kingdom. Should a serious medical problem arise you must contact ETI Emergency Assistance immediately, who provide 24 hour multi-lingual emergency service 365 days a year and can be contacted by telephone, or fax.

Emergency telephone number: 01444 443222
IMPORTANT – please quote your policy number shown on your Certificate of Insurance

You are responsible in advising your attending doctor to seek prior approval for any treatment except in extreme circumstances where a request for prior approval would delay surgery in a life threatening situation or medical crisis. Failure to contact ETI Emergency Assistance may limit the benefits payable, or in certain circumstances, cover will not be provided. When you call upon the services of ETI Emergency Assistance it is a condition of the service that ETI Emergency Assistance shall solely be responsible for all decisions on the most suitable and reasonable solution to any medical problem. The service includes, where necessary:

1. Multi-lingual assistance with hospitals and doctors.
2. Repatriation arrangements and necessary escorts by a medical attendant.
3. Travel arrangements for other members of your party or next-of-kin.
4. On arrival in the United Kingdom, an ambulance service to hospital or home.

Please note: we are not responsible for the availability, quality or results of any medical treatment received by you. Also, this emergency service should not be used for casual enquiries.

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