Claims guide

Let's concentrate on what's most important – helping you access the benefits of your policy. We understand that, if you need treatment, you may not be feeling 100%. We'll do our best to help the claims process go as smoothly as possible. Our 4-step claims guide is below, but if you have any questions you can always call us on 0800 158 3333. If you have questions about making a claim, you may find answers on our FAQs about claims page.

Step 1 – when you feel unwell…

See your GP. Let him or her know that you have a policy with Aviva. If you're asked to have tests or treatment, you can check your policy schedule to see if you're covered or contact us first to make sure.

Step 2 – contact us about your claim…

Call us. Most of the details we need can be taken over the phone, and over 90% of claims can be approved straight away.

Your claims team number: 0800 158 3333

Monday to Friday
8.00am – 8.00pm

8.00am – 1.00pm

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

It's helpful if you have this information to hand when you call:

  • Your personal details including your policy number and your company's name
  • A description of your symptoms and condition, and what your GP has told you
  • The name of the specialist you've been referred to, and where they practise

Some points to remember:

To confirm that you're covered, we'll need all necessary medical information at least five working days before proposed treatment. We'll let you know by phone, and in writing, if your claim is authorised.

If we can't authorise your claim over the phone, we'll send you a claim form. You may need to ask your GP or specialist to sign a relevant section on this form, your policy does not cover any charges for this service.

We'll let you know if your preferred specialist generally charges within our fee guidelines. If not, then you could be liable for any shortfall. We can supply a copy of our fee guidelines on request.

If you have an 'open referral', we'll need to know which kind of specialist you want to see. Sometimes we may ask for more information from your GP, but we'll do our best to make this happens quickly.

Step 3 – get a diagnosis, treatment, care or surgery…

Get the care you need. It's important to make sure that, if you need to be admitted to hospital, your specialist treats you at a hospital on the hospital list that's been chosen by your company. If you're in any doubt about this, you can always call us, speak to your Group Administrator or refer to our guide showing which hospitals are included on your policy (PDF 1.70MB). If your specialist recommends treatment for a diagnosed condition, we'll need to know:

  • Where you would like to be treated
  • When you plan to have your treatment
  • If surgery is required we'll need the procedure code for this treatment

It's useful to take your company scheme Membership Card and Confirmation of Cover letter with you when you go for treatment. You may not be asked for them straight away, but if you are, the details on those documents can help everyone involved reduce the administration with your claim.

Step 4 – let us pay the bills…

Relax, and concentrate on recovering. If you send us the invoices, then we can take care of most costs directly with the hospital and medical staff that treated you. Alternatively, you can settle bills yourself and make a claim using your own receipts.

If you have an excess on your company policy – please don't pay any bills yourself. Forward them directly to us (it's a good idea to note the details and take photocopies), and we'll pay the balance of any amount due minus the excess. Please make sure that all bills sent to us quote your policy number and assessment number.

We'll then send you a letter explaining what we've paid, and what's left for you to pay. You'll need to send that amount directly to the provider.

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