How to make a claim

How to make a claim

claim

CLAIM ONLINE 24 HOURS A DAY, 7 DAYS A WEEK

You can submit a claim online 24 hours a day, 7 days a week. It's secure, will only take a few minutes and we'll aim to get back to you by midday on the next working day.

Your claim will be assessed by one of our claims assessors who have on average five years' experience of looking after our members. They'll guide you through the next steps, so you don't have to worry about your cover - instead you can focus on getting better.

Step 1 Get a referral from your GP

If you're unwell, the first thing to do is to visit your GP. If they refer you for treatment, tell them you have cover with PruHealth and ask for the following:

  • Full details of your condition/injury, diagnosis and intended treatment.
  • Full name and address of the specialist or therapist and the hospital/clinic you've been referred to.

Any claims that you do need to make, may result in your no-claims discounts being decreased in the next plan year. If you do feel unwell, please do not delay seeking treatment because of the impact it will have on your no-claims discount.

Step 2 Get your claim approved

Once you’ve got a referral you’ll need to register your claim and check you’re covered. You can make a claim online 24 hours a day, 7 days a week on the Member Zone. It’s secure, will only take a few minutes and we’ll aim to get back to you by midday on the next working day. Once your claim’s approved we’ll send you an authorisation letter. You should take this letter to your appointment to show you’re covered.

You can also register your claim by calling us on the number on your membership card.

When you call, select the option to 'get authorisation for treatment' so that you go through to our dedicated Claims Team. Make sure you have your membership number on hand when you call. Our Claims Team is available Monday-Friday 8am to 8pm and Saturday 8am to 1pm. Please note our offices will be closed on bank holidays.

If you don't have your membership card to hand, is your cover through your or partner's employer?
  • Yes, Call us on 0800 028 5777
  • No, Call us on 0800 092 7333

Step 3 Book your appointment

As soon as we've approved your claim you can book your appointment with the specialist or other healthcare provider. They'll need your claim authorisation number so that they can bill us directly for your treatment. You'll find this on the front page of your authorisation letter, so remember to take this to your first appointment so show you're covered.

You'll need to contact us again if your specialist or other healthcare provider says you need hospital treatment as an in-patient or day-patient, further treatment sessions for which you are yet to receive our approval.

Step 4 Leave us to pay the bill

In most cases we’ll settle your bills direct with the healthcare provider. This means you can focus on getting better. If you have an excess on your plan you’ll have to pay this directly to your provider and we’ll let you know exactly when you need to pay this.

If you do make a payment yourself send us the proof of payment to the address below and we’ll pay you back.

Post: PruHealth Customer Services, Stirling, FK9 4UE,
Email: authorisations@pruhealth.co.uk
Fax: 0800 015 8700

Your hospitals

For a full list of the hospitals you have access to, visit the 'My hospitals' page when you log in to the Member Zone.

Vitality Partners

We make it easier and cheaper for you to get healthy with our Vitality partners.

Vitality Partners

PruHealth is a trading name of Prudential Health Limited