Salama Insurance Claim Form

By PolicyBazaar
  | Published: 17 June 2021

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Salama Insurance is one of the top takaful providers in the UAE with a paid-up capital of AED 1.21 billion. It is not only the largest but also the oldest existing takaful provider in the world making its place an undeniable benchmark for all takaful providers in UAE. Salama is an Islamic-cum-Arab Insurance Company that offers all kinds of general takaful services and products including health, auto and family. Just like the operations, the Salama Insurance claim process for reimbursement claims is also a bit different and eccentric as compared to the other insurance providers in UAE. Let us find out everything that you will need to successfully fill out the Salama insurance claim form.

Download NAS Reimbursement Claim Form PDF

Complete claim process

Salama insurance claim process for reimbursement claim is based on the type of network providers your health insurance plan falls under. Once you have the right form from your network provider, the complete claim process will have a total of 3 main steps involved in the completion:

  • Step 1: Filling out the form. Since there are going to be different forms for each network provider, you must follow the steps designed for each of the respective forms. The complete form filling guide is given below.
  • Step 2: Collecting the documents. Despite the forms being different, the documents to be submitted will be pretty much the same for all network providers. The required documents are to be attached with the completed form to complete the set.
  • Step 3: Submit the Salama claim form. Once you have everything in front of you, you can submit the claim form using the available offline and online methods.

How to Fill Salama Reimbursement Claim form

Given following are detailed steps to help you fill out the different reimbursement Salama Insurance claim forms as per the network provider of your plan:

Salama Insurance claim form for Neuron Network

  • Download the Salama insurance claim form for Neuron network provider from a trusted source like PolicyBzaar.ae or Salama Insurance website itself. You will find the link to the form on the bottom of the Salama website under the sub-categorisation of Health Claims.
  • Start filling the form by adding the member’s details in the first section. This will include all the personal information about the claimant such as insurance membership number, name of the member, email address, etc.
  • Add “relationship to the member” if the insurance is registered under someone else’s name. Make sure the member details are also about the registered insured person too and must match the insurance card provided by Salama insurance.
  • Move on to the medical section next. Add the name and address of your doctor, phone number and fax number, if any.
  • Add the date on which symptoms of the condition in consideration appeared at first. The next column is for the signature, declaration and stamp of the medical practitioner.
  • Follow the upcoming section to fill out the details of the condition and treatment. The first column will have a brief introduction to the treatment, the next one will have the date of the first consultation for the condition (with the current or any other doctor) and the next one will contain the detailed description of the treatment.
  • Finish up the form by ensuring whether you (the claimant) are covered under any other insurance plan and add your signature and date to the assigned column.
  • Leave the last box empty for Neuron use.

Salama Insurance claim form for NextCare Network

  • Download the Salama insurance claim form for NextCare network provider the same way – from Policybazaar.ae or Salama insurance website claim form portal.
  • The NextCare provider form for the Salama insurance claim process begins with administrative details that contain the Provider’s name, patient’s name, date of treatment/service, phone number, insurance card number, insurance company name, etc. Make sure to fill out all the fields in this form as they all are marked as mandatory.
  • The next section will contain a brief of the condition as described by the patient or the claimant. Add the date when the symptoms first appeared and the date of the present symptom onset. Move on to add the type of treatment/medicines/therapy that you are undergoing right now.
  • The next section should either be filled by your treating doctor or supervised by them at least. Here, add the clinical determination of the condition, vital signs and confirmed or suspected diagnosis of the doctor.
  • Move on to the next section to add all medicines/treatments/services that you are claiming reimbursement for. This section will include only pharmacy bills and lab tests/diagnosis test and their total cost in the assigned section. Enter the total cost of all the services and tests you added in this section above.
  • Complete the form by having your doctor add any further required treatment that may come next and sign and stamp the form in the given space at the end.
  • Attest the form yourself with your signature and date and complete it.

Salama Insurance Claim Form for MedNet Network

  • Follow the above-given steps to download the Salama Insurance claim form for Mednet Network.
  • Start the from with entering details of the Salama insurance cardholder such as name, card number, expiration date, and phone number.
  • The next section is to be completed by your (claimant’s) treating doctor. The first column will include the diagnosis of the patient by the doctor in detail. Moving forward, we will add the date of the onset symptoms, hospitalisation and discharge date (if applicable), details of the treatment and the costs of the treatment as shown in hospital records.
  • The next section will contain all the diagnostic tests done for the condition and the prescription medicines taken.
  • Finish up the form with your signature and date under the tests and medicine section and have the form stamped and signed by your doctor in the next assigned section.

Salama Insurance Claim form for NAS Network

  • Download the Salama Insurance claim form using PolicyBazaar.ae or Salama insurance claim portal.
  • Start out filling the form with patient details like insurance company name, membership number on the insurance card, patient’s name, phone number, etc.
  • Move to the medical section which shall be filled by the treating doctor only. This section will contain the complete detailed diagnosis of the condition, date of the initial symptom appearance, hospitalisation and discharge date (if required), and treatment as taken on by the doctor.
  • Add to the section the declaration, sign and stamp by the doctor.
  • Ask the doctor to further fill the next section with a complete medical history of the condition and investigation along with any potential future treatments. End the doctor’s section by adding the total cost of the medical treatment taken.
  • Sing and date the form yourself (the claimant) and date.

Documents Required for Salama Insurance Claim Forms

Given following is the complete list of documents that you will need to attach with your Salama insurance claim form, regardless of the network provider. Note that this list applies to all four different claim forms for Salama reimbursement claims:

  • The detailed report, medical history, and investigation report prepared by your medical office or treating doctor for the condition in concern.
  • Bills and invoiced related to all prescription medicines take during the treatment.
  • Prescription of the doctor for the same medicines.
  • All reports of the lab tests and diagnostic tests done for the condition.
  • Ambulance bill – if applicable
  • Hospitalization bills and discharge documents – original copies.
  • If the treatment involves an accident, copy of the police report.
  • Personal/maternity/dental SOAP

The forms designed for NAS and MedNet networks come with a checklist on them for you to keep track of the documents required to be attached with the reimbursement forms. Make sure that all the invoices, lab tests, bills, etc. are provided in their original form and reflect your name on them. Even the slightest of discrepancies can result in claim rejections. The bills that are paid in cash must have the “paid” stamp on them while the one paid with a card must be submitted with the receipts.

How to Submit Salama Insurance Claim Form

The most common and easiest way to submit your form is via offline methods or email. Depending on the type of medical network you have, your form will be submitted as per the prescribed methods which are given below:

  • Neuron Network Claim Form: You can submit your claim form via mail and send it to the claim settlement office of Neuron Medical Claim Department in Dubai. The full address can be retrieved from the bottom of the form itself. Neuron Salama Claims must be submitted within 90 days of the treatment received for settlement.
  • NextCare Network Claim Form: The NextCare claim form for Salam insurance claim can be sent to the NextCare claims office via FAX and the number is +971 4 2708592. The FAX number is also given on the top of the form for your convenience.
  • MedNet Network Claim Form: MedNet Salama insurance claim forms can also be sent via FAX and the number is 800 4883, also given on the form itself. You can also submit MedNet claims online using the MedNet claim portal.
  • NAS Network Claim Form: NAS Salama insurance claim forms are to be submitted to Salama head office itself. Forward the completed claim documentation to the head office located in Dubai via mail or forward the forms via fax.

Things to Keep in Mind When Filling Salama Reimbursement Form

  • Make sure that the Salama insurance claim forms are prepared without any errors. Even the smallest of error would have the forms rejected by the administrative system. You will have to prepare all the documents and the claim form again and repeat the submission process as well.
  • Notify Salama insurance as well as the network provider before submitting the claim so that your arrival is anticipated.
  • All the reimbursement claims must be filed within 60-90 days for all four network providers. The timeline differs slightly, for example, Neuron claims can be submitted within 90 days but MedNet and NAS claims must be submitted within 60 days.
  • Make sure that the form is either filled in English or Arabic.
  • All the documents that you submit with the reimbursement form must also be in English or Arabic. If they are in any other language, have them translated by an official public translator and then attach the translated copy with the original ones.
  • Use a separate form for every individual claimant.
  • The claim application can be tracked on the Network provider’s portal using the claim number.
  • You will receive the details of the claim approval and settlement on your phone as well.

Conclusion 

As long as you have the right kind of form with you and follow the right steps, filling out a Salama insurance claim form for reimbursement claims is a rather easy process. While the process may seem a bit confusing at the first glance, the process is rather simple. Start by determining your network provider and downloading the dedicated form. Fill out the form as per the instructions mentioned above for the provider, attach the documents and you are ready to go. Just make sure that you have all the necessary info and authentic Salama insurance claim form and you will be set to initiate your healthcare claim.