Medical Insurance Claims Procedure

MEDICAL INSURANCE ADMISSION, PRE-AUTHORISATION & CONFIRMATION GUIDELINES

Emergency/Non-Scheduled Admissions

The insured can be admitted by using his photo identity card and then our offices to be intimated as soon as possible by the hospital as initial emergency treatment is going on.

Preauthorization Form

A duly completed Admission Pre-Authorization Form should be sent by the Service Provider by fax to our offices not later than 24 hours of admission. On weekends or Public holidays the form should be sent within the next working day.

Non-Emergency/Scheduled Admissions

Non-emergency/Scheduled/Planned admissions require advance pre-authorization by Saham Insurance Company Ltd before admission.

• A duly completed Admission Pre-authorization form or a medical report on the condition should be sent by the Service Provider/admitting Doctor to Saham Insurance Company Ltd
• The patient should identify him/herself by producing a valid Saham Insurance Company Ltd photo-card (where the Service Provider is in doubt, call our office or Nurse/Medical Assessor).

  Our offices contact numbers during working hours Monday - Friday 8 a.m. to 5 p.m:

During non-working hours/weekends and public holidays our Nurse/Medical Assessor can be contacted on 0720 717580

N.H.I.F Rebate

The Company's liability in claims settlement in Kenyan Currency shall be determined in accordance to the Policy Terms and Conditions. Benefits shall exclude National Hospital Insurance Fund.

The patient should therefore submit the NHIF card to the admitting hospital upon admission

SERVICE PROVIDERS - (FOR INPATIENT ONLY) HOSPITALS

We currently have credit arrangement with the following hospitals: