Claims and excesses
- An excess is the first part of any insurance claim that you have to pay yourself.
- An inpatient excess is the amount you might pay on private hospital claims.
- An out-patient excess is the amount that is deducted from the amount payable to you.
You will have to pay for the treatment first, keep a receipt and claim at the end of your policy year. Features of this cover often include the following:
- There is often an amount payable in relation to total out-patient claims per year.
- There is often an annual excess i.e. an amount that is deducted from the amount payable to you. If there is more than one person on your policy, the insurer may apply a larger family excess to your claims. Where there is more than one adult on a policy, you will need to consider whether it is more cost effective to have each adult on a separate policy with an individual excess, or all on the same policy with a family excess applied to all outpatient claims.
- Usually, you can only claim for a portion of the cost of the visit to your practitioner. This is called the ‘allowable expenses'. For example, a GP's visit may cost €50 but you may only be allowed to claim €20. The €20 is the allowable expense.
Some policies will have all three of these features. It could be the case that even though the total of your outpatient expenses is more than the out-patient excess, you might still not be in a position to claim because your total allowable expenses have not yet reached the level of the out-patient excess.