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Direct billing claims
Please visit Medical Provider Network to get the map of Direct Billing Facilities which provide Cashless Services to customers of Pacific Cross Insurance.

Remember: show a valid Coverage Card issued by Pacific Cross Insurance and photographic ID (or Passport) when visiting a Clinic/Hospital which is in the list of Medical Providers for Direct Billing Services.

Please complete page one of the Notification of Claim Form; request a chance to check your Invoice to ensure all information is accurate and, if possible, sign the Invoice after receiving all medical services.
Self-payment & claim
A claim can be made with the following supporting documentation:

- Notification of Claim form: completed by Claimant and Attending Physician
- Medical Report: completed by Attending Physician;Copy of all lab tests and/or reports Prescriptions
- Official original Receipts with an itemized or detailed breakdown of charges.

This applies to all pay and claim situations, but is not necessary when direct billing service is used.

Further documents may be required for claims involving Accidents or Alternative Treatments. See details below:
Claims after an accident
Please enclose the following documents to your claim

- Police Report (for traffic accident)
- Incident Report Form, completed by Claimant (for all other accidents)
Claims for Physiotherapy / Chiropractics / Acupuncture / Chemotherapy / Radiotherapy:
Please enclose the following documents to you claim

- Treatment Plan Form: completed by Attending Physician (as form)
- Progress Report: completed by Attending Physician (when a new treatment plan is required after finishing the previous treatment plan).
In-patient claims & death claims
- Discharge Certificate. Note: Pacific Cross Insurance may require further documents which is necessary for the claim to be processed and completed.
- Death Claim Form: completed by the Beneficiary
- Attending Physician’s Statement for Death Claim, completed by Hospital/Attending
‍- Police Report
- Official original Receipts with detailed and breakdown of charges;
- Copy of Declaration of Death or Death Certificate.
Dental claims
- An Oral Examination Report: completed by Attending Physician/Dentist, required for submission of the first dental claim
- For all ensuing Dental Claims: Dental Examination Report completed by Claimant and Attending Physician/Dentist;Official original Receipts with detailed and breakdown of charges.Required for submission of the first dental claim:
Travel claims
Travel Claims: A claim file includes following documents:Travel claim form: completed by Claimant;Travel Certificate;Boarding Pass;Copy or scan of all pages of Passport;Copy of air ticket booking;Official original Receipts with a detailed breakdown of charges.Further documents will be required for the following claims:

1. Claim for Baggage Delay:
Irregularity Report;Luggage Delivery Report;Official original Receipts with a detailed breakdown of charges.

2. Claim for Travel Delay:An Official Document from the transportation Carrier clearly stating the cause, date, time and duration of the flight delay.

3. Claim for Personal Accident:Police Report;Incident Report: completed by claimant;Attending Physician’s Statement for Death Claim: completed by Hospital/Attending Physician giving details on the nature of the injury or the extent and period of disability;Copy of Declaration of Death or Death Certificate

4. Claim for Medical expenses:Medical Report: completed by Attending Physician;Copy of all lab tests and or reports;Prescriptions;Official original Receipts with a detailed breakdown of charges.

Note: Pacific Cross Insurance may require further documents which is necessary for the claim to be processed and completed.
Timelines for claim submission
Timelines for claim submission:

- Travel Claim: within 30 days from the policy expiry date
- Personal Accident Claim: as soon as possible and not exceed 45 days from the incurred date
- Health insurance claims should be sent to us as soon as reasonably possible and in any event notification of a claim should be given within 90 days of the loss or incursion of expense.

Failure to submit a claim will not affect the claim if it was not possible or reasonable to submit it on time, in any event claims must be submitted within 365 days of loss or incurred date in order to be accepted by the company.

Timelines for claim response: Pacific Cross Insurance will adjudicate claims within 5 working days from the date of receiving all required documentation and information.
Claim payment & rejection
Claim payment: By transfer in US$. Local currency reimbursement is available in some territorries, but cannot be guaranteed.

For scanned and imaged copies of claim files, please send to
claimsubmission@pacificcross.com
For any further question or clarifications, please contact us via inquiry@pacificcross.com
You need help and guidance?

As part of the enrollment with your insurance coverage, an Insured Person has access to emergency medical services:

To access the assistance program, simply call the numbers of the Operation Center listed on the Insurance Coverage Card. The Company is responsible for the cost of all assistance services on the provision that the services are provided and or arranged by Pacific Cross Insurance (hereinafter called “PCI”). PCI will answer the phone call 24/7/365 and based on the need will provide the services and consultations needed, either directly or through an International Emergency Services Assistance Company, currently Asia Assistance. PCI uses an international professional Emergency Assistance Services company to ensure the services rendered are of the highest international level of professionalism and quality, to ensure the expertise is medically sound and verifiable. The services can be given in any language anywhere in the world.

Scope of services


Medical assistance

Telephone Medical Advice

PCI will arrange for the provision of medical advice to the Insured Person over the telephone.

Medical Service Provider Referral

PCI shall provide to the Insured Person, upon request, with the name, address, telephone number and, if available, office hours of physicians, hospitals, clinics, dentists and dental clinics (collectively “Medical Service Providers”). PCI shall not be responsible for providing medical diagnosis or treatment.<