With some products it is difficult to see exactly how much you can benefit from this cover as it can be quite complex. You will have to pay for the treatment first, keeping a receipt and claim at the end of your policy year. Features of this cover often include the following:
- There is often a maximum level of benefit that is paid in relation to out-patient cover.
- There is often an annual excess i.e. an amount you must pay before you can claim anything.
- 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 expenses.
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 excess, you might still not be in a position to claim because your total allowable expenses have not yet reached the level of the excess. For example, consider a case where the allowable amount for a visit to your GP is €20 and the outpatient excess is €300 in each year. Then assuming that your only out-patient expenses relate to your GP visits, you will not be able to make a claim from your insurance company unless you have made 15 visits to your GP in a year (i.e. 15 X €20 = €300). Thereafter you will only be able to claim €20 per visit even though the visits may cost you €50.
If there is no excess on your policy you may claim immediately according to the benefits on your policy.