Healthy employees are key to a healthy business and Blue Collar Medical Insurance offers your employees private healthcare from diagnosis to treatment.
What am I eligible for under this scheme?
Your medical insurance covers:
- Cost of medical treatment
- Cost of covered services needed to receive medical treatment
- Cost of covered services needed to assist you after receiving medical treatment. We describe these in the insured’s schedule of benefits
- Uncovered treatments are listed in the non-exhaustive exclusions table
Where can I receive treatment?
We have agreements with selected medical providers that will be shared with you within your insurance pack. You may elect to use any of them unless there is a specific reference to an exclusion in the benefits table.
To receive treatment, simply show your digital card at a provider's reception, pay any applicable deductible and the co-insurance and proceed to receive your eligible treatment.
Can I pay in cash and claim the amount from the insurance company?
Unfortunately, reimbursement is not covered under your medical scheme and thus we always advise you to visit one of our network providers in case any treatment is required.
How can I claim a covered benefit?
I have a chronic condition, how is chronic medication dispensed?
- Visit your consulting doctor
- Complete the application for chronic prescription medication and get it signed and stamped by the treating physician
- E-mail the completed form email@example.com
- In your email, please advise us from which pharmacy you would prefer to collect your medication
- A Seib Insurance customer service ofﬁcer will process the approval within 1 working day
The above chronic medication approval process is allowed for up to 3 months in all clinics and up to 6 months at Hamad Medical Center.
My policy restricts cover on pre-existing/chronic conditions, please explain the term?
Pre-existing condition is an illness, injury, condition or symptom that originated prior to the insured coverage date (policy enrolment date). This restriction applies to all insured in line with policy wording whether a diagnosed condition is known or unknown to the insured prior to the policy enrolment date; however, considered as medically pre-existing (present/manifested in the body prior to the commencement of insurance cover).
I am confused with “pre-authorization” or “prior approval”. Isn’t this time consuming?
Look at the prior approval process in this way:
- Not every treatment requires approval
- Most out-patient services do not require prior approval
- Prior approval is limited to hospital admission (as in-patient) and a few other outpatient services such as physiotherapy, MRI, etc. and is also linked to a certain cost schedule
- A medical provider may request prior approval if in doubt of the treatment under your insurance coverage
- In case you experience any delay, please be patient and contact us via our 24/7 helpline on +974 444 55 999
Our claims administrator replies to almost 97% of requests within 20 minutes which helps in:
- Reducing your waiting time at the providers
- Giving you the necessary medical attention quicker
Does the same procedure apply in emergencies?
Your health is a priority. A medical condition that may lead to disability or loss of life will not wait for our approval. Please let us know a day or two after the admission. This helps us assist you much faster and reduces any future misunderstanding. Wherever you are in the world, Seib Insurance covers you for emergency treatment.
What is the general waiting time for a pre-approval?
The waiting time for an approval depends on the type of service requested. Generally speaking, the following timings apply:
- 2 – 5 minutes automatic approvals. This is for consultations, medications and other straightforward treatment requests such as X-Rays, blood tests and eligible medicine dispensation
- 30 minutes approvals for minor out-patient day care cases and/or surgeries
- 1 working day approvals for in-patient cases.
Documents provided by the clinic/hospital need to be complete in order for the above timings to be met. If the file was submitted incomplete, this could lead to a delay and a breach of the above timings. We urge all insured persons to call our 24/7 helpline number should they feel they are experiencing a delay at any time, in order for the team to accelerate the process.
Is there any exclusion under my insurance?
Yes, examples of common exclusions are mentioned within your schedule of benefits. Please refer to your insurance policy wording for all applicable exclusions.
What is the period of insurance cover?
One year from the date of policy issuance unless a different period of insurance was agreed with you specifically.
How can I file a complaint?
Should you have a complaint about deficiency in the services or the products offered, please contact our Compliance & AML Manager by phone on the following numbers: (+974) 4402 6807 or (+974) 4402 6888 or by mail to the following postal address: Seib Insurance and Reinsurance Company, P.O. Box 10973, Doha Qatar, or by email to firstname.lastname@example.org, setting out clearly the exact details of your complaint.
We handle customer complaints fairly, efficiently and with due diligence as per the complaints procedure. If you remain dissatisfied with our response, you have the right to refer the complaint to the QFC Customer Dispute Resolution Scheme either by email to email@example.com or by post to “The Customer Dispute Resolution Scheme”, P.O. Box 22989, Doha Qatar.