UAP INSURANCE KENYA

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Health Insurance FAQs

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How does group health insurance differ from Individual Health Insurance?

Individual health insurance can be purchased by an individual or family after completing the laid down formalities like medical examination. Individual has to pay the complete premium himself upon qualification.

Corporate Health Insurance caters for employees of a company plus their dependants, usually a minimum of 10 employees per group. If you are a member of a corporate health insurance established by your employer, your employer pays all or a certain portion of your insurance premium.

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What is a pre-existing condition?

These are conditions for which symptoms have been shown at some point during the 3 years prior to commencement of cover, irrespective of whether any medical treatment or advice was sought.

Any such condition or related condition about which you, knew or could reasonably have been assumed to have known, will deemed to be pre-existing.

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What is a chronic condition?

A chronic condition is one that requires regular medical attention and goes on for a long time and for which there is no cure. For example; Arthritis, Cancer, Hypertension, Diabetes & Asthma

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How do I access medical services at the hospital or doctor's office?

UAP issues you with a smartcard that contains your biometrics for identification in hospital and all our appointed clinics.

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Am I covered if I get sick while out of the country?

UAP will cover you for a period of SIX weeks (42 days) while you are out of the country if your cover is 2m and above.

Report your admission and then bring your original receipts for refund when you return.

It is recommended that you consider taking the travelsure cover whenever you travel as this provides comprehensive coverage.

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Am I covered if I go overseas for treatment?

If the treatment for the specific condition is not available locally as determined by an independent doctor appointed by UAP Insurance, UAP will pay your treatment costs subject to the overall cover limit. UAP must be advised prior to travelling abroad per treatment, to grant necessary approval.

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What are the hospital admission procedures?

Complete the pre-authorization form and submit it to UAP before the admission date, take the UAP letter of undertaking with you to the Hospital. Show your UAP medical card, At the time of discharge, fill and sign the UAP claim form .The Hospital will forward the claim form and bills to UAP for payment.

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Can I use my own doctors?

UAP has a panel of well qualified, recognized doctors to treat you on credit basis to ensure fast and reliable service to you. UAP has negotiated discounted rated with the panel doctors. This ensures that your benefit is used in a cost efficient manner and does not run out before the cover period expires. 

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Can anyone else apart from me use my medical card to access medical services?

No, the insurance cover is for the insured person on the policy document per insured year. In the event of an incident UAP will terminate the contract with the insured person and delete it from the cover with immediate effect and No premium refund.

UAP reserves the right to institute legal proceedings where a member is found to be involved in fraudulent activities with regard to the insurance covers issued.