Aafiya is a leading third party administrator who manages the client policies and health care process on insurance company’s behalf.
Since we are a TPA, we are not authorized to process the same. You may contact the primary insurance company.
You may avail medical health benefits at the provided network as per your policy.
Reimbursement is done on insurance company’s discretion upon receipt of all the required documents.
You may download the reimbursement form from [link]
You must submit the claim to the primary insurance company within 60 days from the date of treatment for services obtained in UAE and outside UAE within 90 days.
You must submit the claim to the primary insurance company/ HR/Insurance Broker
Network coverage may apply as per your policy and network benefits.
The complete list of network is provided during policy enrollment with the location of all the network providers including Hospitals, Clinics and Pharmacies.
In case of an emergency you may choose to go to any hospital/clinic for initial stabilization, please ensure to notify Aafiya (firstname.lastname@example.org) within 24 hours of admission. For urgent assistance, you may reach out to our 24×7 helpline number: +971 4 2630666
Waiting period is the time span during which one cannot claim some or all benefits pertaining to any Pre Existing and Chronic conditions, Waiting period of 180 days from policy enrollment.
Any condition which lasts for the long-term Treatment will fall under Chronic e.g. Hypertension, Diabetes etc. Any other critical condition which was present or any pre-existing condition prior to policy inception which however doesn’t last for the lifetime will fall under the Pre Existing Condition e.g. injury, surgery, maternity.
Detailed Medical Reports clearly specifying the Diagnosis, date of onset of disease, similar disease in the past. Previous & current treatment details including the prescribed medications, investigations and prognosis.
- Original Itemized Invoices or receipts for the amount claimed (invoice must show cost per service).
- Police Report /First-hand information report in case of accident related claims.
- Copies of results of diagnostic tests
- Referral Letter from the treating physician in case of prescribed physiotherapy
- Valid Prescription from the treating physician for the prescribed medication
- Discharge summary/Operative notes in case of Hospitalization or surgery.