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Claims & Support

Claims made easy

We aim to make the life claims process as simple and easy as possible

Know what kind of medical claim you’re making?

Hospital claims
I’ve already paid my bills and I want to be compensated for what I spent

Submit these documents within 90 days after discharge from the hospital or the date of treatment.

  • ID copy of life assured and policy owner

  • Original hospital bill(s), Discharge Summary and original medical receipt(s), with the following information clearly indicated:

    • Consultation date (for outpatient)

    • Admission date / discharge date (for inpatient)

    • Name of patient

    • Diagnosis

    • Breakdown of charges(for reimbursement only)

  • Copy of supporting document(s), e.g. laboratory / X-ray / CT scan / MRI / pathological report, etc. (please do not submit any film and specimen.)

  • Copy of settlement advice from another insurance provider, if any

  • Completed hospital claim form

 

For SmartAppoint service claims only

Along with the completed SmartAppoint service claim form, please also include these additional documents:

  • Proof on mental incapacity of policy owner by 2 medical practitioners (one should be from the policy owner’s attending doctor)

  • Identity Card of Designated Person

  • Relationship proof between the policy owner and Designated Person

 

Learn more about SmartAppoint service

Dental benefit claims & outpatient benefit claims
For PRUmyhealth Prestige Medical Plan only

Submit these documents within 90 days after the date of treatment.

  • ID copy of life assured and policy owner

  • Original medical receipt(s), with the following information clearly indicated:

    • Consultation date

    • Name of patient

    • Diagnosis

    • Breakdown of charges

  • Copy of supporting document(s), e.g. laboratory / X-ray / CT scan / MRI / pathological report, etc. (please do not submit any film and specimen.)

  • Copy of settlement advice from another insurance provider, if any

  • Completed claim form:

 

 

Pre-authorisation for cashless treatment
I don’t want to pay ahead and get reimbursed. I want Prudential to pay on my behalf
For hospitalisation

Applicable to PRUmyhealth Prestige Medical Plan only.
Submit the completed Pre-authorisation form.

For minor surgical outpatient procedures

Eligible to customers enrolled specified medical insurance plans

You can enjoy cashless service for the following day surgery specialities:

  • Oesophago-gastro duodenoscopy (OGD)
  • Colonoscopy
  • Eye surgery
  • Skin surgery

 

Submit your completed pre-authorisation form to receive treatment at one of our designated medical centres.

Learn more about Cashless Arrangement for Outpatient Surgery

 VHIS
What is my claimable amount? I need an estimate
Our turnaround time

Submit your completed claim amount estimate form and we will respond to you within 3 working days.

Submission instructions

Via eClaim:
Log in to submit a claim.

Demo Video

 
Via your financial consultant:
Send claim form and relevant documents to your financial consultant and they will manage the claims for you.
 
Via Post or in person:

Our mailing address

P.O. Box No. 28058, Gloucester Road Post Office, Hong Kong

You can also visit us at one of our customer service centres near you.

 
Via Hospital-to-Prudential:

Only applicable to Gleneagles Hong Kong Hospital in Wong Chuk Hang and Union Hospital in Shatin.

Frequently asked questions

Hospital-to-Prudential (H2P)
How does this service work?

Currently, the Hospital-to-Prudential (H2P) claims service is only available for:

  • Gleneagles Hong Kong Hospital in Wong Chuk Hang
  • Union Hospital in Shatin
 
Before admission

Contact your financial consultant. He/she will assist you through the process of completing and signing the necessary paperwork through our digital platform.

After successful submission of your request, an SMS with your H2P reference number will be sent to your mobile phone number.

After discharge

After your discharge from the hospital, the hospital staff will hand in any relevant claim forms, your medical certification, invoice and receipts, discharge summary and medical reports (if any) .

The hospital will submit the claims application to Prudential within 7 working days upon discharge directly.

The original receipts will be submitted by the hospital to Prudential via electronic means and will NOT be provided to you. However, you can request the hospital to provide you with a copy of the receipts for your own record.

We may request for additional information during the claims process.

Things to note

This service supports all types of individual hospital reimbursement claims (except outpatient) or hospital cash claims (except medical policies of general insurance and all direct marketing policies).

Help with claim forms
How do I fill in my claim form?

Need help with the forms? We’ve prepared some sample claim forms to assist you.

Sample forms

These samples are for reference only. They do not guarantee successful claims or constitute any contract or any part thereof between Prudential Hong Kong Limited and any other parties.

 

Original medical receipts
Can I get them back?

Yes, you can. Remember to complete the Request form for certified true copy of medical receipts and submit it along with your claim form and original medical receipt(s).

Please specify your preferred return delivery option and provide a valid correspondence address.

If you’re from mainland China, you can only request for the return if your medical receipt is issued by a hospital in mainland China. Do reach out to your financial consultant for more details.

Must a doctor complete part II of the claim form?

Yes, it is mandatory in order for us to assess your claim. Unfortunately, you bear the cost of consultation. We may waive part II if client can submit sufficient supporting document eg. discharge slip with final diagnosis for Hospital Authority admission.

Frequently asked questions about hospital claims
General submission instructions and overseas hospitalisation
When should I make my hospital claim?

You're required to submit your claim to us within 90 days from your date of discharge.

Can I claim for my hospitalisation overseas?

Yes, just provide us will all the relevant documents along with your claim form. Only under special circumstances will your claim not be processed.