Emergency hospitalization at a network hospital:
In case of an emergency if an insured member goes to a network
hospital and after giving initial treatment, the treating doctor
decides to admit the insured member based on the severity of illness,
he/ she will be required to present his / her original health card at the admission office.
The hospital will check the validity of the health card. The hospital will
itself notify EFU Health Ltd of the hospitalization.
Approval will be given as per policy terms and conditions.
Once the insured will be discharged it will be the hospital’s responsibility
to send the original bills along with all supportive documents and a copy
of the approved Pre authorization / Approval form to EFU Health
Ltd and payment would be made directly to the hospital.
Planned hospitalization at a network hospital:
If an insured is advised admission and plans to get hospitalized
at a network hospital then he /she will send a completely filled
Pre Authorization form to EFU Health Ltd two working
days prior to the admission for approval.
Completely filled Pre-authorization forms can be
submitted at the corporate office of the network
hospital and hospital can send the form to EFU Health for
approval or the insured member can send the Pre-authorization form to
EFU Health directly also. Approval will be given if the treatment is
covered as per the policy terms and condition.
Once approval is given the insured will get hospitalized at the network
hospital, take treatment and get discharged. The hospital itself will send
the original bills along with all supportive documents and a copy of the
approved Pre authorization form to EFU Health.
Payment would be made directly to the hospital.
In case of an emergency if an insured member goes to a network hospital and after giving initial ...
To avail inpatient hospitalization services, an insured can go to any hospital of his/her choice, ...
Here is the list of excluded hospital, kindly click on download button to view complete list.
A claim should be lodged with the following documents: ...
In case you are not satisfied with the decision taken on your claim ...
In case of any issue cutomer portal is there to help you ...
Our claim settlement procedure is prompt and hassle-free. It is advisable to consult our Customer
EFU Health is Pakistan’s First Specialized Health Insurance Company. Our financial stability and experience in serving all of our clients’ insurance needs form the basis of our customer oriented philosophy. Our structure and products are designed around our customers.