Private Health Insurance Claim Documents: What to Prepare

The documents needed for a private health insurance claim depend on the insurer, benefit and treatment. Ask the insurer for its current checklist before booking; an incomplete claim can delay a decision.

Common information an insurer may request

You may need your policy or membership number, a referral or clinical information, details of the proposed consultant and hospital, an estimate, and receipts for eligible expenses. For a claim after treatment, the insurer may request an invoice, treatment notes or evidence of payment.

Keep a clear record

Save the authorisation reference, approval scope, emails, letters and the names and dates of calls. Check that invoices identify the patient, provider, service and date. Send information through the insurer’s approved channel and keep copies.

Does a referral guarantee payment?

No. A referral is clinical information; the insurer separately decides whether the claim meets the policy terms. Obtain pre-authorisation where required.

Read our pre-authorisation guide and claiming guide.

Sources checked 18 October 2026: PHIN: Paying for treatment with private medical insurance · Bupa By You policy guide