Claims FAQs

Here are some answers to questions that we regularly hear. If you can't find what you're looking for our claims team will be happy to go through your questions and make sure your claim runs smoothly.

  • Your claims team number: 0800 068 5821
Monday to Friday
8.00am – 8.00pm
Saturday
8.00am – 1.00pm

Calls to and from Aviva may be monitored and/or recorded

Am I covered?

Your policy schedule along with the terms and conditions of your Healthier Solutions policy will tell you which treatments are included in your cover. If you're unsure about whether or not you can make a claim, please call us. We're happy to help.

Who can discuss my policy / claim on my behalf?

We know that in some circumstances you may need to ask someone else to manage your policy or update your claim on your behalf. In order to ensure we protect your data we require your consent to be able to do this.

If you would like us to be able to discuss your claim, take instruction about your policy or answer queries regarding your cover, for example with a family member or someone else, please complete our customer consent form (PDF 499KB).

Full details about the nature and duration of consent are included on the attached form. Please read this carefully to ensure you’re happy to provide this.

Once complete you can send this form to us by emailing us at hcct@aviva.com or by posting the attached form to:

Aviva Health UK Ltd Dept 31
PO Box 443
Chandlers Ford
Eastleigh
SO53 3WZ

Do I call you first, or get treated first?

Please call us before you organise treatment, appointments or care to check you're covered for your treatment. If you're not sure about how to claim, we're happy to help you every step of the way.

What is the MyHealthClaim App?

If your GP refers you for further assessment or treatment you can use the app to search for a specialist.

Whilst with your GP use the MyHealthClaim app to search for a specialist. With your GP choose a specialist from this list within the app and ask your GP to write you a named referral letter to choose a specialist from the list displayed in the search results and ask your GP to provide you with a referral letter naming that specialist. The referral letter should include the name of the hospital displayed in the search results as well as the specialism and sub-specialism of the specialist you need to see.

Then when you have your referral letter please call us to discuss the details of your claim and to check that the costs will be covered under your healthcare policy.

Remember if we have a network for your condition or suspected condition you’ll still need to use a specialist or practitioner from our network rather than your recommended specialist.

Download the App here

What are exclusions, do I have any?

Your personal exclusions will be based upon your medical history and the underwriting of your policy. Check your policy schedule along with your terms and conditions to see if you have exclusions, or call us to check for you.

Do I need to fill in a claim form? If so, where do I find it?

Our claims team can assess most claims over the phone without you having to fill out forms, but there are times when we need a little more information to ensure we make the correct decision. If we do need you to fill in forms, you can download them using the links below or we can send copies to you in the post.

Where can I get treatment?

Our complete list of hospitals (PDF2.03MB) can help you see which are available to you on your policy and in your local area. Your policy schedule will detail your chosen hospital list.

If you have an open referral letter from your GP please call us to discuss the details of your claim and to check that the costs will be covered under your healthcare policy.

Remember if we have a network for your condition or suspected condition you’ll still need to use our network facility for your treatment rather than a hospital on your chosen list.

How does my policy excess work?

If you chose to have an excess on your policy you will receive a discount on your premiums. The excess is payable for each member on your policy, each policy year (from your renewal date) should a claim be made. So if you have a £100 excess and your claim comes to £1,000 you pay the £100 excess to your specialist and we pay the other £900.

Can I make a claim if something happens while I'm abroad?

We recommend that you take out comprehensive travel insurance because Healthier Solutions isn‘t designed to provide the same kind of cover. If you need emergency treatment as an in-patient or day-patient, some of your costs may be covered by Healthier Solutions but please refer to your policy‘s terms and conditions which contain details and any exclusions. To make a claim when you‘re abroad, call our overseas emergency assistance provider.

  • Call +44(0)2381 247290, the line is open 24 hours, 365 days of the year. Calls may be monitored and/or recorded.
  • Give them your name, Aviva policy number and tell them what‘s happened to you.

What is my no claim discount, how does it work?

A no claim discount (NCD) could help you save money on your policy at renewal if you don't make a claim in the previous policy year.

Your discount increases by one level each year you don't claim, up to 15 levels and a maximum of 75%. If you make a claim over £250 you'll move down the scale by three levels, but for a small additional premium it may be possible to protect your NCD. Then, if you do make a claim, you won't drop down the scale at renewal. With a protected NCD, once you make a claim your NCD protection will be removed and so a claim the following policy year will affect your NCD. Your NCD will never reduce by more than three levels in one year.

If you make a claim during one policy year and it carries over into the following year, we'll treat this as one claim.

Would my no claim discount be affected by every claim?

If you claim for NHS cash benefit, NHS cancer cash benefit, hospice donation, baby bonus, GP referred speech therapy for children, or the 'dental and optical' options, then your no claim discount wouldn't be affected. This is also the case if your claim is under £250, or less than the amount of your policy excess, if you have one. All other claims will affect your no claim discount unless you choose to protect it.

Is there a maximum amount I can claim each year?

No. With Healthier Solutions there's no limit to the number of times you can make eligible claims in any policy year. There's also no ceiling to the value of your claims for eligible private treatment at a hospital from our networks or your chosen hospital list, but there are limits to specific benefits.

What is a network?

We’re developing a number of networks of facilities, specialists or other practitioners that we recognise to provide the treatment required for a specific condition or suspected condition.

By creating networks, Aviva has more control over the treatment pathway. This means we can drive better commercial deals, which helps us maintain affordable prices. What’s more, by controlling the treatment pathway we can give our customers greater assurance when it comes to clinical quality and treatment, and ensure that more treatment can be covered before benefits limits are reached.

Our networks are updated frequently as we work to ensure we get the best possible service for our customers. We regularly add or evolve networks, or in the event that a facility/specialist is no longer suitable for a network we may remove them. Please contact our claims team before arranging any treatment.

Contact our claims team on 0800 158 3333. Our lines are open from 8am-8pm Monday to Friday and 8am-1pm on Saturdays.

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