Private Health Insurance: How to claim

This example shows a typical claims journey you would experience with Private Health Insurance:

Phil twisted his knee playing rugby, and a couple of weeks later was still in pain. He visited his GP, who referred him to a specialist Consultant for further investigations. The Consultant advised Phil that he had a torn knee ligament and would need keyhole surgery to repair it.

With his Private Health Insurance, Phil didn’t need to wait for the operation on the NHS, and was treated quickly in the comfort of a local private hospital.

Step 1 – Consult your GP

Phil saw his GP, who referred him to a specialist Consultant. Phil called our Customer Care Team and was sent a claim form, just in case his Consultant advised he needed surgery. At Phil’s appointment, his Consultant confirmed that surgery was required, and they completed the claim form together.

Step 2 – Contact Westfield for next steps

Phil called our Customer Care Team to talk through his options.

Private Treatment

Phil sent us his claim form, and we requested his medical history from his GP.

NHS Treatment

If Phil had preferred to wait for NHS treatment, or if he’d been assessed as unsuitable for a private treatment package, an NHS Benefit would have been payable.

Once we received this we allocated a case manager to Phil who worked with him to arrange his private treatment package.

After Phil’s surgical procedure, a member of the NHS medical team or his GP, if they had the necessary information regarding the NHS treatment, would complete the relevant section of the claim form.

Phil should return his completed form to us within 26 weeks of the date of his surgical procedure. Once checked, we’d pay the NHS Benefit.