Claims Guide Lines

Medical Policies individual/group
Claims out of Medical network

› In case of doctor consultation reimbursement:

• All invoices paid by insured should be handed directly to the medical claim department in Syria International Insurance Company/ Arope Syria within two months from doctor consultation date.
• All invoices and bills should be the original
• The result of doctor examination.
• The reimbursement will be on basis of the policy conditions (maximum limit for doctor consultation) deducted as a penalty from the claim amount according to the policy conditions.
• The compensation will be within 14 working days from receiving the completed documents.

NOTE: ALL BILLS HAVE TO BE STAMED AND SIGNETURED BY THE DOCTOR.

› In case of medicine prescription reimbursement:

• All invoices paid by insured should be handed directly to the medical claim department in Syria International Insurance Company/ Arope Syria within two months from prescription date.
• The diagnosis should be mentioned in doctor prescription
• The date and the pharmacy stamp should be registered in bill.
• The reimbursement will be on basis of the policy conditions that may have a percentage to be deducted as a penalty from the claim amount.
• The compensation will be within 14 working days from receiving the completed documents and based on medical network tariff.

NOTE: ALL PRESCRIPTIONS HAVE TO BE STAMED AND SIGNETURED BY THE DOCTOR

› In case of diagnostic test (radiology or lab test) reimbursement:

• All invoices paid by insured should be handed directly to the medical claim department in Syria International Insurance Company/ Arope Syria within two months from the test date.
• The doctor request for the diagnostic test and the diagnosis and the medical case of insured should be mentioned in the request.
• The original bills and the diagnostic test result.
• The reimbursement will be on basis of the policy conditions that may have a percentage to be deducted as a penalty from the claim amount.
• The compensation will be within 14 working days from receiving the completed documents and based on medical network tariff.

› In case of hospitalization reimbursement:

• All invoices paid by insured should be handed directly to the medical claim department in Syria International Insurance Company/ Arope Syria within 20 days from discharge date if the insured received the medical care inside Syria and 30 days from discharge date or coming back to Syria if the insured received the medical care aboard.
• All medical reports and all lab tests and radiology tests done in hospital are required to compensate the claim.
• All invoices and bills should be the original and stamped by the hospital.
• The reimbursement will be on the basis of the rates charged by equal medical center contracted to BA Medical network in Syria.
• The compensation will be within four weeks from receiving the completed documents.

Claims in Medical network

All claims occurred within the Medical network should be managed by TPA (third part administration) and the insured has to pay only the deductible amount (percentage of claim amount) if there is, according to policy conditions.

Personal Accident Policies

› Personal accident policies:

Claims out of Medical network

• All invoices paid by insured should be handed directly to the medical claim department in Syria International Insurance Company/ Arope Syria within one month from the accident occurring.
• All medical reports that describe the accident and all lab tests and radiology tests done in hospital are requested to compensate the claim.
• All invoices and bills should be the original and stamped by the hospital.
• The reimbursement will be on the basis of the rates charged by equal medical center contracted to BA Medical network in Syria according to the maximum limit for the medical expenses mentioned in policy conditions.
• The compensation will be within four weeks from receiving the completed documents.

› Schooling policies:

• All invoices paid by insured should be handed directly to the medical claim department in Syria International Insurance Company/ Arope Syria within one month from the accident occurring.
• The bills should be attached with the personal accident declaration form that contains the name of the student who had the accident and the time and date and a full description for accident knowing that these kinds of policies cover only accident occurred in school.
• The form should be stamped by the school.
• All medical reports and all lab tests and radiology tests done in hospital are required.
• All invoices and bills should be the original and stamped by the hospital
• The reimbursement will be on the basis of the rates charged by equal medical center contracted to BA Medical network in Syria according to the maximum limit for the medical expenses mentioned in policy conditions.
• The compensation will be within four weeks from receiving the completed documents.

Claims in Medical network

All claims all claims occurred within the Medical network should be managed by TPA (third part administration) according to the policy conditions.

Work Man Compensation Policies
Claims out of Medical network

• All invoices paid by insured should be handed directly to the medical claim department in Syria International Insurance Company/ Arope Syria within one month from the accident occurring.
• The bills should be attached with the work man declaration form that contains the name of the student who had the accident and the time and date and a full description for accident knowing that these kinds of policies cover only accident occurred during the work.
• The form should be stamped by the work management.
• Arope Syria has the right to examine the workers schedules to make sure that the number of workers doesn't exceed the declaration number and also the company has a right to examine salary schedules.
• All medical reports and all lab tests and radiology tests done in hospital are required.
• All invoices and bills should be the original and stamped by the hospital.
• The reimbursement will be on the basis of the rates charged by equal medical center contracted to BA Medical network in Syria according to the maximum limit for the medical expenses mentioned in policy conditions.
• The compensation will be within four weeks from receiving the completed documents.

Claims in Medical network

All claims all claims occurred within the Medical network should be managed by TPA (third part administration) according to the policy conditions.

Life Policies

• All documents should be handed directly to the medical claim department in Syria International Insurance Company/ Arope Syria within one month from death.
• The death certificate and other documents related to life claim are required.
• The insurance company has the right to inspect the medical file of insured.
• The insurance company pays the sum insured to the beneficiary mentioned in life policy.