Claims Submission Process

Caribbean Insurers Staff MemberYou made a wise decision by choosing Caribbean Insurers (Health) Limited (“CIHL”) for your health insurance needs. As a valued customer, you have a dependable, quality health plan from a leading health insurance Carrier which provides peace of mind.

And when it comes to service, you have high expectations – CIHL strives to exceed them with extensive provider networks, prompt and fair claims payment and excellent customer service.

Important facts you should know about filing for a claim

To file a claim it is a requirement of your policy that CIHL (or your Policy’s Underwriter) must be provided with:

Failure to comply with the above claims reporting requirements will result in the claim being denied.

Date a Covered Medical Expense is incurred

Unless otherwise stated in your Policy, the date that a Covered Medical Expense is incurred is the date that the covered treatment, service or supply is rendered to the Insured Person provided that such date is on or after the Effective Date of Cover and prior to the expiry of this Certificate/Policy.


The Underwriters shall have the right at the Underwriters’ own expense and opportunity through their medical representatives to request a physical examination to the Insured Person when and so often as they may reasonably require for the duration of a claim hereunder, and also the right and opportunity to make an autopsy in the case of death where it is not forbidden by law.

Review of a denied claim

If a claim is denied, in whole or in part, Underwriters will advise the Insured Person and will specify the reason or describe any additional information required to complete the claim. All appeals should be submitted in writing, within 45 days after receiving the explanation of denial or benefits. Underwriters will re-evaluate the claim in question and give a final written decision on the re-evaluation within 45 days, or 90 days, if additional information is required, after such request is received. If, after the expiration of 90 days, the additional information has not been received, the appeal will be considered closed, and no determination will be made at that time.

Still have a question? Call one of our friendly Customer Service Representatives who will be ready to assist you.