How we support your employees when they need to make a claim
First, your employee needs to see a GP 
This can be in person or virtually. If their GP suggests seeing a specialist, your employee should let them know they have health insurance with us. It’s simpler for them to ask for an open referral, so we can help them find the best facility and consultant covered by your policy.
Next, they need to chat to our claims team 
Once your employee has a referral from their GP, they can register a new claim through MyAviva or by giving us a call.
They can reach us on 0800 158 3344 8am to 6.30pm Monday to Friday and 9am to 1pm on Saturdays.
We may monitor and/or record calls to and from Aviva.
We'll take care of the rest 
When it comes to payment, we'll usually settle all eligible bills directly with the treatment provider, often the hospital or specialist. That way, your employee can just focus on feeling better.
Expert support when it matters most
After they make a claim with us, we do all we can to get your employees the healthcare they need, as soon as we can.
We know they may not be feeling 100% when they call, so our dedicated claims team are here to look after them throughout the process. We take great care to make sure they get a sensitive, personal service every step of the way. And we aim to get a resolution for them as quickly as possible.
With clinicians on hand to give our claims teams detailed support and medical insight, we’re making sure your employees get the right support when they need it.
Watch this video for more detail about what happens when your employees make a claim with us.
Transcript for video How to make a claim
How do you make a health insurance claim?
When you’re unwell and need to make a claim on your health insurance, we’ll do all we can to get you the healthcare you need, as soon as we can.
Here’s how you make a claim in four simple steps – and a few things to keep in mind along the way.
1. Ask your GP for a referral
First of all, see your GP, or use our digital GP app, and they’ll refer you for any investigations or treatment you need. Be sure to tell them you have private health cover with us.
There are two types of GP referral:
• An open referral is where your GP says what kind of treatment you need, but doesn’t name a particular specialist or hospital.
• A named referral is where your GP gives the name of a specific specialist, at a particular hospital. Though you’re not bound by this, and we can offer you other options, if needed.
It’s a good idea to ask for an open referral, so there’s more flexibility with where you’re treated. If you have Expert Select or Optimum Referral, you’ll need an open referral.
If your cover includes BacktoBetter or our Mental Health Pathway, you don’t need a GP referral to make a claim for musculoskeletal or mental health symptoms – just contact us direct through MyAviva - your secure online account, or by phone.
Remember! Get in touch with us before you have tests or treatment, so you know they’re eligible for cover. That way, you won’t have any unexpected costs.
2. Start your claim and we’ll get things moving
The easiest way to start your claim is through MyAviva. When you log in simply select your policy or scheme and you’ll see the option to start your claim. Alternatively, you can also start a claim over the phone.
Whichever way you choose, we’ll ask you about your symptoms and explain the best next steps, in line with your cover. We’ll also guide you through the process and answer any questions you have.
Sometimes, we ask for more information to get a better picture of your condition. Otherwise, we aim to make a decision on your claim straight away, explain which tests and treatments we can pre-approve and connect you with the hospital or clinic to book your appointment there and then.
Where will you get your treatment?
You’ll either see a specialist at a hospital on your list, or, if you have Expert Select or Optimum Referral, at a choice of hospitals we’ll help guide you towards. If it’s available, you could get treatment at a facility that has expertise in treating specific conditions, like cataracts or knee pain.
The nationwide hospitals we use are based on ratings from independent regulators, like the Care Quality Commission – with most rated outstanding or good. We’ll also only recommend specialists who meet the standards of their relevant professional governing bodies, like the General Medical Council. So you know you’ll get the high standard of care you’d expect.
3. If you’re referred for more treatment
Hopefully by now you’ll be starting to feel better. But if your specialist refers you for more treatment we haven’t already approved, let us know, so we can check it’s covered. In MyAviva you can submit your update or start a Live Chat to speak to someone in the claims team there and then. You can also call us, if you’d feel more comfortable talking over the phone, or email us with any questions you may have.
Remember! For some treatments and tests, we’ll ask you for a procedure code. So check with your specialist, and have it handy when you get in touch.
4. And finally, we’ll settle the bills
Once you’ve had the care you need, we’ll settle bills we’ve authorised directly with your provider – so you don’t have to worry.
We’ll let you know through MyAviva if you need to pay any part of a bill, like if you have an excess or benefit limit. If any bills are sent your way, just send us a copy and we’ll do the rest.
Here’s a quick recap of how to make a claim:
1. Ask your GP for an open referral – and get in touch with us before you have any tests or treatment. For BacktoBetter or Mental Health Pathway, just contact us direct.
2. Start your claim and book your appointment at an agreed hospital.
3. Let us know if you’re referred for more treatment – and check for a procedure code.
4. We’ll settle authorised bills direct, so you don’t have to worry.
And that’s it! Four easy steps, and a friendly claims team on hand for guidance and support each step of the way.
So you can focus on your treatment, and getting back to health.
Helping your employees get the treatment they need
Making a claim through BacktoBetter
If your employee is suffering from a musculoskeletal condition affecting the back, neck, muscles or joints, our BacktoBetter service can help. There's no need for a GP referral, your employees will be referred to one of our third-party clinical providers to guide them down the right treatment pathway.
Getting your employees BacktoBetter
- Your employee should submit a claim online through MyAviva or call our claims team on 0800 158 3344.
- Our claims consultant will chat through your employees' needs and either transfer them to a provider to complete an assessment or send your employee a link to complete it online.
- A third-party case manager may then share a treatment plan and online support for managing the symptoms, or refer them to a physiotherapist and/or specialist for further treatment or tests.
- If your employee's referred for physiotherapy, their physiotherapist may send them exercises to do at home to help with recovery. Their clinical case manager will keep up with their progress throughout the claim.
- We’ll settle all eligible bills directly with the treatment provider, so your employee doesn't need to worry. If the policy has an outpatient limit, it won’t apply to physiotherapy through BacktoBetter.
How to make a claim through Mental Health Pathway
If one of your employees is struggling with their mental health, they can refer themselves for an assessment by a mental health practitioner without a GP referral through Mental Health Pathway.
They'll only need to contact our claims team once, then a third-party clinical provider will oversee their treatment. With a wide range of practitioners and treatments available, including cognitive behavioural therapy (CBT), Eye Movement Desensitisation, face-to-face treatment and more, our mental health pathways get your employee the help they need.
Mental Health Pathway claims
- Your employee should call our claims team and our advisers will transfer them to our independent third-party clinical provider for an assessment, or arrange a good time to call back.
- After the assessment, the provider will recommend the best treatment for your employee’s needs, from self-directed online support through to remote talking therapies, face-to-face treatment or further assessment by a psychiatrist, if clinically necessary.
How to make a claim through Cancer Care
A cancer diagnosis is a life-changing moment, so we have a dedicated team trained to help.
When one of your employees is diagnosed with cancer, we’ll put them in touch with our specialist claims team. Our oncology claims team have been specially chosen for their understanding, patience, and empathy. They’ll take the time to get to know your employee, their individual needs and history, and take care of them throughout the process.
We suggest ways to make things easier for your employee and everyone involved, wherever we can. For example, if the specialist agrees that any treatments, like chemotherapy, can be done in the comfort of your employee’s home, we may be able to cover it. This cover may also extend to giving treatment at work or even on a holiday that's taken in the UK.
For us, this is a vital part of easing the transition between each stage of treatment and making your employee as comfortable as possible when they’re battling cancer.
Oncology claims
- If one of your employees needs to start a cancer claim, they can call our oncology claims team on 0800 158 3397
- Our oncology claims team will take the time to understand your employee’s personal circumstances and then offer a choice of suitable specialists and support
Claims and treatment for other conditions
If one of your employees is unwell and gets a referral from a GP, we can help them with any further secondary care tests, treatments or procedures they may need. When they have a referral, they’ll need to call us to set up their claim. Most cases can be approved over the phone.
It’s really important that employees get in touch with us before attending any further appointments so we can make sure their claim is covered.
We may need more information at any point of the claims process, but we'll do our best to make sure paperwork doesn't hold things up. And if we can't approve your employee's claim because it's not eligible under the policy, we'll explain to them why it's not covered.
How to make a claim for all other conditions and hospital lists
- When your employee has been referred to a specialist for further assessment or tests and want to use our networks, they need to get an open referral.
- Then, they need to call us to set up their claim.
- If we have a network for the treatment recommended, we’ll offer suggestions where they can have their treatment.
- If we don’t have a network for their condition, we’ll use our specialist finder database to find a specialist and/or hospital for them.
- If they have a named referral or want to be treated elsewhere, we’ll check we recognise the specialist they’ve been referred to.
- After their appointment, your employee will need to ask for a procedure code (CCSD code) for any hospital treatment the specialist may recommend.
- Your employee then needs to share that code with us. We’ll confirm if their treatment is covered and, if it is, let them know where they can be treated.
- Most eligible bills are settled directly with the hospital. Specialists usually send their bills straight to us, but if you or your employee gets the paperwork, you can forward it to us by post or email.
You can send it on to us at:
Bill Payment Team
Aviva Health UK
Unit 1A, Hampshire Corporate Park
Templars Way
Eastleigh
Hampshire
SO53 3RY
Or email us at HCTEAM1@aviva.com
Support for your employees throughout a claim
From the moment they make a claim, we do everything we can to get your employees the healthcare they need, and support them on the road to recovery.
If one of your employees needs to talk to someone about a claim, they can get in touch with our claims team using the details below.
Chat to our claims team 
If an employee needs to speak to us about a claim for themselves or a dependant, more information can be found on our claims page, or we can be contacted on the details below.
Give us a call on 0800 158 3344
Monday to Friday 8:00-18:30
Saturday 9:00-13:00
Calls to and from Aviva may be monitored and/or recorded.