Health insurance claim


Report the loss to Seesam immediately after the occurrence of the insured event. A loss adjustment form can be completed directly on the Seesam homepage, by calling the contact telephone or by writing an e-mail. From the menu selection below you will also find information about how to act following the occurrence of an insured event.

To apply for health insurance indemnity, please do not forget to submit:

•    documents evidencing the costs of medical service (e.g. receipts, invoices, payment orders);
•    if the invoice does not display content of the treatment, an extract from the medical history of the person who received treatment;
•    a copy of the family doctor’s or specialist’s referral in the event of tests and analyses;
•    in the event of rehabilitation, a referral from a doctor or another medical document that reveals the prescription of the rehabilitation by a doctor;
•    in the event of indemnification of costs of glasses and contact lenses, a certificate concerning a change in visual acuity, purchase documents of glasses or contact lenses;
•    a copy of the prescription in the case of indemnification of prescription medicines.

Most of the necessary documents are available at www.digilugu.ee and www.eesti.ee

How does the indemnification of health insurance claims take place?

Choose a suitable medical institution.

•    In the case of an illness or another need for treatment, the insured person may choose a suitable medical institution.
•    A visit to a specialist doctor can be made without a family doctor’s referral. A doctor’s referral is necessary for tests unless otherwise agreed in the insurance contract.

Pay for the treatment at first yourself.

•    Upon using medical service, the insured person must at first pay for the treatment themselves.

Submit a loss adjustment form and necessary documents to Seesam.

•    The expenses are indemnified according to the chosen insurance covers and to the extent of the sum insured, and excess is deducted from the indemnity.
•    In the case of an insured event of health insurance, all the information is managed only by the insurance company. You do not have to submit your expense receipts and medical records to the employer, but send them directly to Seesam.
 



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Insurance is provided by Compensa Vienna Insurance Group, ADB Estonian Branch, which operates under the Seesam trademark in Estonia. Before concluding policies, please read the terms and conditions at www.seesam.ee and consult an expert if needed.
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