Claim procedure information

Kindly gather and submit all the documents listed below:

1. Healthcare insurance claim form with fulfill information and signature;
2. Medical report/ medical book/ medical summary;
3. Doctor’s indication note;
4. Test result/ subclinical result;
5. Prescription;
6. Discharge certificate/ discharge summary;
7. Surgery certificate;
8. Oral examination report (for Dental);
9. Treatment plan and progress note complete by physician (for Physical therapy);
10. Invoice/ Receipt and relevant Breakdown of charge;
11. Incident report (for Accident);
12. Policy report (for Accident, if any);
13. Other related documents.

• Image documents: Please take a photo/ scan all original claim documents and submit them to PCV following methods:
  1. eClaim (Click here to view E-claim system guideline ) or
  2. Mobile Application (Click here to view the Mobile App user guide)
  3. Email: claimsubmission@pacificcross.com.vn
• Hard copy documents: Please send directly to PCV’s office (Ha Noi, Ho Chi Minh city).

• Within 3 working days – from the date PCV receives your full claim, you will receive a notification of the claim result; or a request for additional documents if any additional information is needed.

Accept the picture/image/photocopy of claim documents.

Required the original paper documents of the Invoice and Receipt. Other documents can be the copy, scanned or picture.

–  Healthcare insurance claim form with fulfill information and signature;

–  Breakdown of charges of all related costs;

–  Invoice/Receipt:

+ The original paper of the Invoice (or the original Receipt): for the documents are issued outside Vietnam;

+ The E-invoice (VAT): includes the link and code; if it’s a converted e-invoice, require the original invoice with the signature of the coverter.

– Medical summary with relevant diagnosis and indication of treatment (doctor report, medical report, medical examination, medical book, ect.);

– Surgery certificate (if surgery);

– Discharge certificate (for in-day treatment or inpatient stay);

– Discharge summary (for inpatient case) (if any);

– Prescription with diagnosis given by physician;

– Indication to do lab tests (if any);

– All subclinical results (including: lab tests, imaging test, x-ray result, etc.) (if any);

– Other related documents (if any).

PHYSIOTHERAPY/OSTEOPATHY/CHIROPRACTIC/ACUPUNCTURE/CHEMOTHERAPY/RADIOTHERAPY

+ Treatment plan indicated by physician (as sample);

+ Progress note completed by physician (in case the doctor prescribes a new therapy after completing the previous treatment regimen, or after every 5 sessions).

– Oral examination report: completed by doctor/ dentist, applied for the first dental claim. This report will be waived if policy is continuously in-force at least 06 months;

– Dental treatment report: completed by insured person and doctor/ dentist.

– Accident report issued by Police Office/ Conclusion of Police;

– Driver license/Vehicle registration certificate (for traffic accident);

– Minute site inspection (if any);

– Incident report;

– Injury certificate (for Disability cases);

– Death certificate (for Death cases);

– Autopsy report (for Death cases) (if any);

– Legal inheritance papers with relevant support documents (for Death cases).

– Travel certificate;

– Copy of Boarding Pass;

– Copy of all pages of Passport, Visa;

– Copy of air ticket booking;

– Information of reservation/ booking.

MEDICAL EXPENSES

As above – A part

PERSONAL ACCIDENT

As above – C part

BAGGAGE AND PERSONAL EFFECTS

– Incident report (describe date and time, place, cause of loss/ damage) verified by carrier/ hotel/ local police/ department/ authorized organizations;

– List of lost/ damage items (including details of description, specification, quantity, actual cash value and amount of loss or damage);

– Confirmation in writing of carrier or other liable parties on amount recoverable;

– Document to prove the value of lost/ damaged items (such as original invoices);

– Original quotations/ invoices for preparation or replacement of the loss/ damage or re-issuance travel document (Passport, Visa) with relevant date of preparation/ replacement/ re-issuance;

– Document to prove the replacement is essential (depend on each specific situation).

Note: Claimant must immediately report loss/ damage to the proper authorities having jurisdiction at the place of loss or damages (within 24 hours).

BAGGAGE DELAY

– Travel itinerary;

– Baggage Claim form (Property irregularity report from carrier);

– List of emergency purchase of essential clothing and toiletries and original purchasing invoices;

– Receipt of acknowledgement on returned baggage from the carrier.

Note: only considered if the event took place overseas.

TRAVEL DELAY

– Estimated schedule of original trip;

– Breakdown report of the portion of the original trip that was not utilized;

– Official document form carrier clearly stated the cause, date, time and duration of flight delay.

CURTAILMENT OF TRIP/ CANCELLATION CHARGES

– Estimated schedule of original trip;

– Breakdown report of the portion of the original trip that was not utilized;

– Official document form carrier clearly stated the cause, date, time and duration of flight delay;

– Ticket purchase invoice (if any);

– Invoice of any amount paid in advance (pre-paid) (if any);

– Hotel invoice and statement for accommodation (if any);

– Invoice of replaced vehicle for transportation (if any);

– Medical report/ Death certificate/ Court report or Center for Disease Control and Prevention (CDC) and other related documents (if the cancellation comes from Death event/ severe illness or disability/ compulsory witness or isolated in pandemic);

– Support document to prove relationship between the insured and the relatives (if any).

PERSONAL LIABILITY

– Report indicating the nature, time, place and circumstance of the incident or event;

– Estimated claims amount and related document and contact information of any third party;

– Contact details of the third party;

– Written, summon or other notice of legal proceeding from any third party or lawyer (if any).

– In cash or by transfer in Vietnam Dong;

–  Claimant will show ID card or Passport to receive cash at our office;

–  Authorized person must obtain Authorized Letter and copy of passport of Claimant to receive claim payment.

Denial letter will be sent to Claimant stating clearly the reason of rejection.