›How to Claim?

How to Claim

Claiming for your medical expenses is quick and user-friendly.

Claiming made quick and easy

Choose whichever method is easiest for you - in most cases no claim form is needed.

Scan & Email

Profmed App

  • Take a photo of the claim with your phone
  • Upload it directly via the App

Snail Mail

  • You can post your claim to the address below
Profmed Claims Department
Private Bag X1031
Lyttelton, 0140

Claims paid by you

When submitting a claim you have already paid for, include a valid invoice and receipt, or clearly mark the invoice “PAID. PLEASE REIMBURSE MEMBER.” A receipt submitted without a valid invoice cannot be processed.

Claims not submitted within 4 months of the date of service are considered stale and cannot be paid.

In most cases your healthcare provider submits claims electronically. Please check your Claims Advice to confirm that only services rendered to you are being claimed for. If there are any discrepancies, contact the service provider or Profmed Client Services.

Acknowledgement of receipt

Once we have received your claim you will get an acknowledgement of receipt email, followed by a Claims Advice once the claim is processed. If you do not receive either of these, please query receipt of the claim by calling Client Services on 0860 679 200.

Re-imbursement of claims

Claims payments to members and providers take place every week. If you bank with a different bank to Profmed, the payment will reflect in your account 3–4 days after the payment date.

Changed your banking details? Please remember to let us know so we can reimburse your claims without delay.

GET THE PROFMED APP

Manage your healthcare on the go with the Profmed App, designed to give busy professionals instant access to emergency assistance, Scheme information, family support tools, and more, all at the touch of a button.

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