Claim procedure information

Click here to view instruction for claims process

Click here to view Claim Procedure Information

• Please visit website at “Customer Center”– “Medical Providers” or the link here to get the list of Direct Billing Facilities which provide Cashless Services to customers of Pacific Cross Vietnam;
• Please show Coverage Card issued by Pacific Cross Vietnam and ID card (or Passport) when visiting Clinic/Hospital which is in the list of Medical Providers for Direct Billing Services;
• Please complete page one of Notification of Claim form; check Invoice to ensure all information is accurate and sign on Invoice after receiving all services.
• The application of direct billing services cannot be guaranteed by Pacific Cross Vietnam in every claim situation. Policy holders and policy members are advised when seeking medical treatment to have an alternative means of payment prepared in case direct billing services are unavailable. For more information on how direct billing services are administered, please contact us at inquiry@pacificcross.com.vn

To submit a claim, please follow the steps below:

Step 1: Prepare your claim documents
Please gather all required documents.

Step 2: Submit your claim to Pacific Cross Vietnam (PCV)
You can choose one of the following methods:

2.1. Submit by email:

– Take clear photos or scan all claim documents in high quality.

– Send your claim pictures or scanned copy to: claimsubmission@pacificcross.com.vn

– You will receive an automatic confirmation email shortly after submission.

2.2. Submit hard copies in person:

Deliver your physical documents to the PCV office in Hanoi or Ho Chi Minh City.
(*Addresses are provided at the bottom of this page.)

Step 3: Receive your claim result
– PCV will process your claim within 5 working days, after receiving all required documents and information.

– In the case your claim document does not have enough information/ documents, PCV will send an email to instruct you provide the additional information/ documents for completing the claims process.

Notice: Pacific Cross Vietnam (PCV) has the right to re-adjudicate if information on hardcopy and the photo or image PCV received are not coincided.

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.

1. MEDICAL EXPENSES

As above – A part

2. PERSONAL ACCIDENT

As above – C part

3. 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).

4. 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.

5. 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.

6. 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).

7. 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.