Instructions: To begin the claim process, it is necessary to fill out the Claim form for cancer, organ transplant and critical illnesses. [To download the pdf document and print it, go click on]. In addition, you must have available the following documents, as the case may be.
Medical recommendation and prognosis of the patient to be eligible for transplant, with date of surgical intervention.
• Support documents for the payment of benefits:
→Invoices from:
• Investigation of potential donors.
• Acquisition of organ and tissue.
• Services and materials supplied for the culture of the bone marrow.
• Airline ticket for the person receiving the transplant.
• Airline ticket and lodging and meal expenses for the adult companion.
• Transplant center with daily detail of services received.
• Expenses incurred in private nurse during the transplant period.
• Any other services or materials supplied to the person receiving the transplant or related to the transplant.
Documents which certify that the private nurse was recommended by the specialist physician and that she is a registered nurse.
Note:
All claims must be presented with the corresponding Claim Form duly filled out and signed. The following information is of vital importance.
● Complete and legible postal address.
● Social Security of the person paying for the policies.
All the invoices must include the date of the incurrence, must be duly identified by the provider, medical description and the charge for the services received.
*Please include copy of your last voucher as evidence of the withholding or any other evidence of payment.
IMPORTANT NOTICE
Any person who knowingly and with the intention to defraud presents false information in an insurance application or, who were to present, help or make to present, a fraudulent claim for the payment of a loss or benefit, or were to present more than one claim for the same damage or loss, shall incur in a serious crime and if convicted, shall be sanctioned for each violation with a penalty of a fine no lesser than five thousand (5,000) dollars, nor greater than ten thousand (10,000) dollars or penalty of prison for a fixed term of three (3) years, or both penalties.
If there were aggravating circumstances involved, the established prison term may be increased up to a maximum of five (5) years; if there were mitigating circumstances involved, it could be reduced up to a minimum of two (2) years.
