Your Guide
Claims Procedures

For emergency situations, you will be required to pay for the cost of your treatment/confinement if such treatment/confinement is in a non-affiliated hospital and/or by a non-affiliated physician. In these cases you may apply for reimbursement of your expenses:

1. Secure the prescribed claim form either from our PhilamCare U.N. office or at the PhilamCare clinic in Makati. Fill up the appropriate blanks. Ask your attending physician to make a medical account of your treatment on the "Attending Physician's Report" portion of the claims form.

2. Request for reimbursement should be submitted to PhilamCare's Claims Department within 6 months from the date of your discharge from the hospital. Request must be in duplicate on the prescribed claim form to which should be attached the following documents:

  • Original official receipt(s) of all payment(s) made to the hospital, medical center or clinic pertinent to the confinement.

  • Original official receipt(s) of all payment(s) made to the doctor(s).

  • Original statement of accounts ; and

  • Original charge slips. If none, itemized breakdown of charges.

  • Admitting History Report for inpatient calls

  • Operative record including the histopathological report if surgical procedure was performed.

3. We can process your application for reimbursement only when all requirements have been submitted and hospitalization bills are sent to us by the hospital. We may request additional medical information pertinent to the evaluation of your claim. Our Claims Department will inform you of any additional requirements, if any, that you will have to comply with.





You may check the status of your claim from Membership Relations Department after 10 working days from submission of complete forms and documents.

Please call our 24-hour Nurse Call Service for any of your medically related inquiries or problems. The number is 892-88-41. You may also call the Membership Relations Department during office hours at 523-60-02 locals 758, 759 and 760.