Health insurance claim
Report the loss to Seesam at the first available opportunity, but no later than upon the expiry of the insurance period. A loss adjustment form can be completed directly on the Seesam homepage. 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 the cost of glasses and contact lenses, a prescription for glasses and purchase documents of the glasses or contact lenses, which have been issued during the insurance period;
• 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
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.
