Submitting a claim on the Broker Portal

Modified on Tue, 25 Jul, 2023 at 4:22 PM

TABLE OF CONTENTS


Important considerations before registering a claim:

  1. Each admission or event must be registered as a separate claim. 
    1. Out-patient consultation prior to admission must be registered as one claim and the admission as a separate claim. Each subsequent check-up should also be registered as a new claim.
  2. Multi-day admissions must be registered using the first day of admission.


Registering a claim:

To register a claim against a risk (dependant), the first step is to find the specific policy and risk. For more information on navigating the broker portal please click here for our broker portal manual.


Once you have accessed the specific policy, look for the applicable dependant and select Actions>Register Claim



Complete the details relating to the claim and please note the below:

  • Risk Cover Type: Keep as default
  • Cause Code and Sub-Cause Code: Sirago Claim for both fields.
  • Claim Description: Provide a brief description of the claim together with the providers being claimed for.
  • Incident Date: Date of treatment. For multi-day admissions, please use the first day of the admission.
  • Time of Incident: Can be left as 00:00
  • Estimated Amount: Please provide the closest estimate of the value of the claim. This is only used for reserving and will be adjusted once claim is assessed.
  • Estimated Excess: Keep as R0.00
  • Incident Address: Can be defaulted from customer by clicking on the Default From>Customer button.

Once all the fields have been completed, select register.


Depending on the regional settings of your computer, you may see an error when completing the estimate. To correct this, simply re-enter the estimate and click on the grey-space below the detail fields before selecting register.




If the below error is received, please change estimate to R0.00 and register


Once registered you can select the view summary button to access the claim to get the claim number. This will be required to submit the supporting documents.




Upload Supporting Documents:


To upload documents to the claim navigate to the documents tab and select the upload document icon.


Select the relevant document(s) and select Type as External and Sensitivity as None. Provide a Description and Comment and select Upload.



For password protected documents, please complete the Password in the comments field.



Supporting documents can also be emailed to [email protected] with the claim number in square brackets in the subject example: "[CL68374] Supporting Documents".


Once submitted the documents will be added to the claim and can be viewed from the documents tab on the claim.



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