Health and travel insurance claim documents
An insurance claim pack combines the medical certificate, treatment summary, receipts and an itemised bill. Claims to a foreign insurer usually require translation and the certification the policy specifies.
A medical claim rests on two halves: the clinical side explaining what happened and how it was treated, and the financial side showing what was paid. Insurers compare both against the policy, so a pack missing one half attracts follow-up requests and delay.
On the financial side receivers usually want the original receipts and an itemised bill separating room, medication, procedure and physician fees. On the clinical side they want the medical certificate and a treatment summary giving the diagnosis and treatment dates.
For a foreign insurer, translate into the language the policy specifies. Many insurers ask for certified copies or a certified translation, and some require consular legalisation, so obtain the document list in writing before ordering translations.
Claim data is health data and therefore sensitive personal data under section 26 of the PDPA. Give consent to disclose in writing and define its scope: which period, for which purpose.
Documents to prepare
- The insurer's claim form, completed and signed
- A medical certificate stating the diagnosis and treatment dates
- A treatment or discharge summary
- Original receipts and an itemised bill
- A copy of the policy schedule, passport and travel evidence for travel insurance
Step order
- Ask the insurer in writing for the document list and the filing deadline
- Collect the clinical and financial documents from the facility in one visit
- Have copies certified by the facility or a Notarial Services Attorney as the insurer requires
- Translate into the language the policy specifies and certify the translation where required
- File within the deadline and keep proof of every submission
Pre-filing checklist
- Receipt totals reconcile with the itemised bill
- Treatment dates agree across every document
- The insured's name matches the policy and the passport
- The claim form is signed by both the insured and the doctor where required
- Filing occurs within the deadline stated in the policy
Practical tips
- Copy every original receipt before sending, since insurers usually keep originals
- Ask the hospital for an English itemised bill on the day of payment where that service exists
- For multiple episodes, group documents per episode with an index so the assessor can work quickly
- Keep travel evidence such as boarding passes and entry stamps for travel policies that cover a defined trip
Common pitfalls
- Sending receipts without clinical documents, leaving the insurer nothing to assess
- Filing after the policy deadline, which can affect the claim
- Translating only some pages and skipping the billing pages
- Sending original receipts without keeping copies, so a second receiver cannot be served
- Giving open-ended consent to disclose health data instead of limiting the period and purpose
Frequently asked questions
Are original receipts required, or will copies do?
Most insurers require originals to prevent duplicate claims. If several receivers are involved, tell the insurer in advance and ask for written guidance.
Must claim documents be translated into English?
It depends on the policy and the insurer's country. Some accept Thai documents with a translation; others require a certified translation.
Is consular legalisation of the translation needed?
Only where the insurer or receiving authority requires a legalised document. Otherwise a certified translation is often enough — obtain the requirement in writing first.
What happens if the claim is filed late?
Most policies set a filing period and late filing can affect the claim, so notify the insurer in writing as soon as a problem is known.
What if the hospital does not issue an itemised bill?
Contact the hospital's finance department for a retrospective itemised statement, attaching receipt copies and visit details so the record can be located.
Can the insurer demand the entire medical record?
Disclosure of health data needs a legal basis or consent under the PDPA, so the insured can limit consent to what is necessary for assessing the claim.
For a document review before you file, contact us on LINE @nycli, call +66-83-249-4999 or email nycli@ilc.ltd. Our team will confirm the steps, any missing documents and a realistic timeline for your case.