How to File a Claim

Call first, pay second

At the first sign of a medical problem, call the assistance line — the number is on your certificate — and give your name, your contract number and what is wrong. The assistance company then arranges treatment and settles with the clinic directly, which is the difference between cashless care and chasing reimbursement afterwards.

This matters beyond convenience: repatriation organised without the assistance company is not reimbursed at all.

If you paid the clinic yourself

You have 30 calendar days from the date you sought medical help to send the insurer a complete set of documents:

• a written claim application in the insurer's form;
• your identity document, and tax number if you have one;
• an extract from the medical records or a hospital report with the diagnosis and the services provided;
• an invoice or statement of services with itemised costs;
• fiscal receipts from the clinic or pharmacy (plus a sales receipt where the fiscal one does not name the items);
• the doctor's prescription, if you are claiming for prescription medicines.

Documents can go in person or by post to the insurer's Kyiv address, or by email for preliminary review. Electronic submission does not remove the obligation to produce originals on request.

The decision

The insurer decides within 15 working days of holding the last required document, and issues a formal act. A refusal must be communicated in writing within 5 working days of the decision, with reasons. Payment is made in hryvnia, and each payout reduces the remaining sum insured for that person.

The decision can be deferred where documents are incomplete or their authenticity is in doubt — up to six months in the worst case. Complete paperwork the first time is the single biggest thing you control.