The type of benefits provided by PREVIDIR varies according to the insurance option chosen by the Insured.
By clicking on each option, the insured can access more detailed information and a useful guide on what to do and what documentation is required to take advantage of the services provided by PREVIDIR.
In the event of hospitalization in a public or private facility, or in the event that the insured requires a specialist doctor’s visit, diagnostic testing, medical assessment, dental services, etc… the insured has the option to stay in the PREVIMEDICAL network or not:
- In the first case, benefits can be provided for under a direct assistance scheme ; the Insurer shall directly pay the network facility . In this manner, the insured does not anticipate any amounts , to exclude deductibles and overdrafts which remain at his expense. to obtain authorization, the insured needs to contact the Operations Center in advance :
- for calls from Italy and abroad: +39.0422.17.44.065
- from the reserved area enrolled in the “Direct agreements” section
In the event of an emergency, it is mandatory to complete the requested forms provided by the Operations Center and send it by fax or Email attaching the physician’s request for services to be provided to the insured.
For requests other than the activation of the direct payment service, or for any additional information, please contact email@example.com or firstname.lastname@example.org addresses.
- In the second case, the reimbursement will be provided by an indirect payment assistance scheme; the Insured will receive the reimbursement of expenses incurred, within the limits of the option of coverage selected by the Insured. Once the medical service has terminated, the Insured must submit the relative documentation on line as indicated in the claims handling procedure , indicated in the “Confidential Reserved Area“. The Insured may also track down the status of his reimbursement in this area . As an option, the Insured may also complete the request for reimbursement by attaching complete medical documentation to his email or regular mail.
Claims must always be accompanied by official documents regarding expenses incurred and submitted to PREVIDIR in one of the following ways:
- by email, uploading the documentation on the refund request section of the web site; documents will need to be scanned and then processed;
- by paper and standard mail, simliar as above, BUT never original documents.
The copy of the expense documentation must be complete with stamp marks in the regulatory cases and in any case the documentation must be fiscally in accordance with the legal provisions time in place, subject to inadmissibility of the claim.
Otherwise, the claim will be rejected; it is possible to re-apply for reimbursement only if the Policy holder can submit expense documents / invoices , through an Eligible Company with a document issued by the local office of the Revenue Agency. Alternatively, the application for reimbursement is allowed to be re-proposed in the event of the cancellation and reissuance of the expense document, in the cases that are legally permitted, provided that it is branded with a stamp and issued in accordance with the provisions of the tax fiscal laws. In that case, the invoice must still show the date on which the services were rendered.
The Fund, after verifying the validity of the requests and the completion of complete proper documentation, loads them into its management system, in accordance with those of the Insurance Companies responsible for covering the risk.
In the “loading” phase of the requests, the management system is able to determine the exact amount to be reimbursed, obtained by applying the “rules” related to the option chosen by the Insured. (e.g. deductibles, the level of “consumption” of the limits of coverege provided for each service, etc.).
Having carried out this procedure, which can be treated as a kind of “preliquidation“, the Fund, on a weekly basis, transmits by computer all requests submitted to the Insurance Companies for indemnifying the insured based on the option chosen for coverage . The latter then handles administratively the payment of the claim, and arrange for the amounts owed to insureds to be paid by issuing the relevant bank tranfer in favour of the insured.
The subscriber has the opportunity to monitor the “progress” of their requests and check the accuracy of the fulfillments through their “Confidential Area“.
In cases where the “standard procedure”, for any reason (e.g. doubtful compensation, contrast on exact quantification, computer problems, etc.) Fund operators are responsible for providing members with all the assistance they need to solve the technical solution of unresolved cases.
- Using The Contracted Health Facilities
Within the site, in both the public and confidential sections , all the necessary and useful information is available for the proper use of the services indicated in the area “ Direct Convention.”( IN NETWORK )
In addition, to learn more about public and private clinics , including Dental Offices , under contract with the Previmedical S.p.a. network, click on the area “Conventional Health Facilities” to activate the service toll-free phone number 800.994.880. We remind enrollees that it is possible to propose to their specialist doctor and/or dentist to accredit themselves to the Previmedical network by submitting the request to https://www.previmedical.it/accreditamento_centri.html
For further informations you can consult the Service manual
In the event of a claim, the following documentation is required:
- A detailed report on the dynamics of the event;
- A health certificate from a physician, together with any additional medical documentation which may follow the event;
- Medical reports, diagnostic testing, if available;
- Medical prescriptions /certification that justify medical expenses incured, to be compensated under this policy;
- In the event of a motor accdident, copy of the driver’s license is required and a copy of the traffic accident report.
- Medical certificate/declaration of closing the claims file
- A statement from the employer which declares the employment of the injured party, their category of employment, date of the accident and the total gross annual salary of the insured at the time of the acccident.
In the event of a claim, the following documentation is required:
- A declaration of the prognosis of the presumed illness / disease, which, according to an official medical opinion, may result in Permanent Disability;
- This claims file must be accompanied by:
- medical certificate indicating detailed information regarding the nature, type and possible consequences of the disease
- copy of medical records and any other documents to help assess the disease and/or debilitating aftermath.
After a period of no less than 12 months following the claims declaration date, and no more than 18 months, the insured must present a medical certificate which indicates the degree of permanent disability the insured has incurred.
Group and Individual Life Insurance
In the event of death, the following documentation is required:
- A copy of the death certificate;
- A copy of the coroner’s death report;
- ISTAT form “ declaration of the health authorities (ASL), or alternatively a medical certificate attesting the cause of death (this may also be released by a hospital or clinic, if this is where the deceased patient was hospitalized)
- For each beneficiary, copy of ID identification (i.e. passport or other document);
- For each beneficiary, indivisìdual tax ID numbers.
IN THE PRESENCE OF LEGITIMATE HEIRS AND THERE IS NO WILL IN PLACE:
- A document notarized by a public notary which indicates the facts of the event
IN THE PRESENCE OF LEGAL HEIRS:
- An Authentic copy of the will and testament which specifies the benefits of this insurance; Or
- A legal document which may substitute statement a will and testament which names who the Beneficiaries are
IN THE PRESENCE OF ANY MINORS OR INCAPACITATED BENEFICIARIES WHO REQUIRE SOCIAL SUPPORT ADMINISTRATION:
- An authentic copy of the judicial decree which indicates the names of the individuals in question and authorizes their legal representative to collect any and all amounts due on their behalf, exempting the policy holder from all liability in relation to the payment,which shall be made directly to the accounts indicated in this request.
Life Insurance to include Total Permanent Disability
In the event of a claim, the following documentation is required :
- Claims declaration;
- Copy of the insured’s ID identification or passport;
- Copy of the Policy tax code;
- Copy of the medical report issued by INPS (Italian State Social Labor Office), INAIL (Italian State Workers Compensation Fund) or any similar competent office;
- Declaration from the insured’s physician regarding the cause and course of the injury or disease that resulted in the disability, to include any and all medical records related to hospitalization;
only for non-executives:
- An employer’s declaration on company letterhead that states the initial date of employment, and if applicable, date of employment termination.
Following the declaration of “non self sufficiency“ of the insured, the Policy Holder (or other people representing him) must request in writing the request for reimbursement by completing the following documents:
- Claims declaration form or equivalent document that contains the same information requested in the official claims declaration form, completed by the policy holder or the insured individual;
- A complete medical questionnaire to be completed by the general practitioner or physician who treated the insured for the pathology for which non self sufficiency has been requested. Clinical reports and medical charts are required to support this request.
Temporary Travel Insurance: Business Pass
In the event of a claim it is necessary to contact the Assistance Operations Center at the following numbers:
- from abroad: +39.02.58245942
- toll-free number from Italy: 800.083.723
At the time of the request, the insured must provide the following data:
- name and surname;
- personal address, place from which you call;
- cause of the accident
- policy number;
The Insured must follow the instructions received from the Operations Center.
All expenses will be reimbursed only if authorized, approved and coordinated by the Operational Assistance Center.
When necessary, the Operations Center, on behalf of the Company, will directly bear the costs of hospitalization for the treatments and actions indicated by the doctor who assists the patient.
- Monitoring claims and claims payment status
- Request medical authorization
- Immediate contact with the Service Center
- Membership card
- Location of the doctor/hospital facility, including network partner