How to Make an Insurance Claim When You Are Abroad

Insurance only proves its value when you claim, and claiming from abroad adds complications: a hospital that wants payment upfront, invoices in another language, a different currency and an insurer in a different time zone. The good news is that most claim problems are avoidable if you know the steps.

This guide explains what to do in an emergency, how direct billing and reimbursement work, which documents to collect and what to do if a claim is delayed or refused.

The short answer

1. In an emergency, get care first. Then contact your insurer’s emergency assistance line as soon as you reasonably can.
2. For planned treatment, get pre-authorisation before the appointment or admission, if your policy requires it.
3. Ask the hospital whether it can bill your insurer directly.
4. If you pay yourself, collect complete documents: itemised invoice, proof of payment and a medical report.
5. Submit the claim quickly, within the policy deadline, with translations if requested.
6. Follow up in writing and keep a record of every contact.
7. If refused, ask for the reason in writing, appeal, then complain to the relevant ombudsman or authority.

Before anything happens: prepare

Five minutes now saves hours later:

• Save your policy number and the 24/7 assistance phone number in your phone and in a note offline.
• Install the insurer’s app if it has one and log in once.
• Find out which hospitals near you offer direct billing with your insurer.
• Keep a copy of your policy wording and benefit table.
• Know your deductible and whether it applies per claim or per year.

In an emergency

1. Get medical help. Call the local emergency number or go to the nearest emergency department. No insurer requires you to delay emergency care.
2. Contact the assistance line as soon as possible, or ask a hospital staff member or companion to do it. Many policies require notification within a set time for hospital admissions.
3. Give the hospital your insurance details and ask whether they work with your insurer.
4. For evacuation or repatriation, the insurer’s assistance team usually has to organise and approve it. Do not book a medical flight yourself without approval if you expect it to be covered.

Planned treatment: pre-authorisation

Many international health insurance policies require pre-authorisation for hospital admissions, surgery, scans such as MRI and some therapies. Without it, the insurer may reduce or refuse payment even if the treatment is covered.

To request it, you usually send the insurer:

• the doctor’s referral or treatment plan;
• the diagnosis;
• the hospital or clinic and the planned date;
• a cost estimate.

Wait for written approval, and check what it covers and up to what amount.

Direct billing vs reimbursement

	Direct billing (direct settlement)	Reimbursement
How it works	The insurer pays the hospital directly, often after issuing a guarantee of payment	You pay the provider, then claim the money back
When it is used	Mostly hospital stays and larger bills at network providers	Doctor visits, pharmacies, smaller bills, non-network providers
What you pay	Usually only your deductible or co-payment	The full bill upfront, then you wait for the refund
Watch out for	Costs the guarantee does not cover	Exchange rate differences, refund delays

Documents to collect

For every claim, collect:

• Itemised invoice showing the provider’s name and address, your name, dates, each service and its price. A total-only receipt is often not enough.
• Proof of payment: card receipt, bank statement or payment confirmation.
• Medical report or doctor’s note with the diagnosis and treatment.
• Prescriptions for any medication, plus pharmacy receipts.
• Referral letters for specialists or tests, if your policy requires them.
• Police report for injuries from crime or road accidents, if relevant.

Take photos of everything immediately, and keep the originals until the claim is paid.

Submitting the claim

1. Use the insurer’s app or online portal if available; it is usually faster than email.
2. Fill in the claim form fully, including when symptoms started. Gaps cause delays.
3. Attach clear scans or photos of all documents.
4. Add translations if the insurer asks for them. Some insurers accept documents in major languages without translation.
5. Choose the currency and account for reimbursement carefully. Ask whether they pay in the invoice currency or convert, and at what rate. A multi-currency account can avoid an extra conversion.
6. Submit within the deadline. Policies often set a time limit after treatment, commonly several months.

After you submit

• Keep the claim reference number.
• Note every call: date, time, the name of the person and what they said.
• If the insurer asks for more information, reply quickly and completely.
• If you hear nothing within the time stated in the policy, follow up in writing.

If your claim is delayed or refused

1. Ask for the decision and the reason in writing, with the policy clause it relies on.
2. Check the wording yourself. Was the treatment excluded, was pre-authorisation required, was a document missing?
3. Appeal internally, with any missing evidence and a short explanation. Ask your doctor for a supporting letter if medical necessity is disputed.
4. Use the formal complaints procedure. Insurers must have one and must tell you about the external route.
5. Escalate externally to the ombudsman or regulator in the country where the insurer is regulated. In the UK, for example, this is the Financial Ombudsman Service; other countries have their own schemes. See the FCA’s guidance on how to complain about a financial firm.

Frequently asked questions

Do I need to call my insurer before going to hospital?

Not in a genuine emergency; get care first. Notify the insurer as soon as reasonably possible. For planned treatment, contact them first to get pre-authorisation if required.

How long do reimbursements take?

It varies by insurer and claim. Simple claims with complete documents are often paid within days or a few weeks; complex claims or missing documents can take much longer.

What if the hospital insists on payment upfront?

Ask the insurer’s assistance team to contact the hospital and arrange a guarantee of payment. If that is not possible, pay with a card that has a good exchange rate and claim reimbursement.

Will I be reimbursed in my currency?

Many insurers reimburse in several major currencies; some convert to the policy currency. Ask before you submit and choose the option that avoids double conversion.

Final thoughts

A smooth claim starts before anything goes wrong: save the assistance number, know your deductible and know which hospitals bill directly. When something happens, get care first, notify the insurer, follow the pre-authorisation rules and collect complete documents. If a claim is refused, ask why in writing and use the appeal and complaint routes. To pick a policy with a good claims process, see how to compare expat health insurance plans.

This article is general information, not insurance, legal or medical advice. Claims processes vary by insurer and policy. Information reviewed October 23, 2026.