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How does this plan work?

Who is eligible for this plan? Hide

To join Bupa International’s Oil and Gas plan, you must work on oil rigs in the oil and gas industry. This is a group policy and must include three or more employees.

Where can I be treated? Hide

You can receive treatment from any recognised hospital, clinic, or legally qualified medical practitioner.

We also have a network of more than 5,500 hospitals and clinics, which we can often arrange to pay directly on your behalf (this is known as direct settlement).

Our Healthline service will help you find a suitable medical professional.

How do I arrange treatment? Hide

When you know that you need to seek medical advice and/or treatment, we ask that you contact us first. This allows us to check your cover, confirm that your proposed treatment is eligible for payment, and in many cases, contact your medical provider to arrange direct settlement.

How does the claims process work? Hide

There are two ways that your medical treatment can be paid:

Direct settlement

• You contact us to advise what treatment you intend to receive.
• We confirm that treatment is eligible and that we can ‘pre-authorise’ (guarantee payment) of it.
• We send pre-authorisation to you and the provider of your treatment.
  
• You complete and sign the pre-authorisation form.
• Your medical provider attaches the invoice(s) for your treatment and returns with the pre-authorisation documents to us.
• We process the claim and pay your medical provider directly.
• We send you a ‘payment statement’ advising when and how it was paid, and who received the payment.
• You settle any shortfall with your medical provider.

Pay and claim

• You contact us to advise what treatment you intend to receive.
• We confirm your cover and benefit limits.
• You receive treatment and pay your medical provider (usually at time of treatment).
• You and your medical provider fully complete a claim form and return the claim form to us.
• We process the claim and pay you*.
  
• We send you a ‘payment statement’ advising when and how it was paid, and who received the payment.

How does Bupa International make claim payments? Hide

Wherever possible, we will follow the instructions given to us in the payment section of the claim form.

• We can pay you, the principle member (applicant) or your medical provider.
• We can pay by cheque or by electronic bank transfer.
• We can pay in more than 80 currencies.

How do deductibles work? Hide

A deductible is the amount you must pay towards covered medical expenses before we will start paying for your treatment.

Once your deductible amount has been reached, all covered expenses will be paid in line with your policy’s benefit limits.

For example, if you have an annual deductible of £Sterling 500, the total value of your eligible claims must reach £Sterling 500 before we will pay any benefit.

The annual deductible applies separately to each person on your membership, and is not cumulative.

What treatment and conditions are not covered? Hide

Bupa International Company (Oil and Gas) plan covers you for the costs of specialist treatment of acute conditions. By this we mean treatment of diseases, illnesses or injuries which respond quickly to medical or surgical care and is likely to lead to a full recovery, or to restore you to your previous state of health, without you having to receive prolonged treatment.

The cover does not include treatment for chronic conditions. These are diseases, illnesses or injuries which are long-standing, such as diabetes or multiple sclerosis.

There are certain conditions and treatments that we do not pay for on any level of coverage. For further details on any of the exclusions below, please contact us.

Excluded conditions and treatments:

• AIDS/HIV
• addictive conditions/disorders
• ageing, menopause and puberty
• allergies/allergic disorders
• birth control, conception, sexual problems and sex changes
• chronic conditions
• complications from excluded or restricted conditions/treatment
• congenital and hereditary conditions
• contamination, wars and riots
• convalescence, rehabilitation, hospice and general nursing care
• cosmetic, reconstructive or remedial surgery – including breast reduction or enlargement
• deafness
• dental/oral treatment (such as fillings, gum disease, jaw shrinkage, etc.)
• dialysis
• donor organs
  
• experimental drugs and treatment
• eyesight (treatment to correct eyesight)
• footcare
• health hydros, nature cure clinics and similar establishments
• hormone Replacement Therapy (HRT) and bone densitometry
• learning difficulties, behavioural and developmental problems
• obesity
• physical aids and devices (for example, hearing aids, spectacles, contact lenses, crutches and walking sticks)
• pre-existing conditions (unless specifically agreed otherwise)
• pregnancy and childbirth
• preventive treatment
• self-inflicted injuries
• sexually transmitted diseases
• sleep disorders
• speech disorders
• travel costs for treatment
• treatment from unrecognised consultants, hospitals, family doctors, therapists, dental practitioners or complementary medicine practitioners
• USA treatment (unless USA cover is purchased separately)

Do you have a limit for the cost of treatment I may receive? Hide

Beyond the benefit limits of your policy, we only pay costs when the charges made by the provider of services are reasonable and customary. By this we mean that the charges are the same as those made to our members by the majority of other service providers in the same country; and also that they are not more than the provider would normally charge

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Services available to you

How can I track the progress of my claim? Hide

We will process your claim as quickly as possible. You can check the progress of claims* you have made via our MembersWorld website or by contacting General Enquiries on +44 (0) 1273 323 563.

How can I contact Bupa International? Hide

As a Bupa International member, you can call our Medical Centre at any time of the day or night, all year round and speak to medically trained people who understand your situation and can give you the healthcare advice, support and assistance you need.

We also have a team of expertly trained people ready to help with any general enquiries you may have.

Medical Centre: +44 (0)1273 333 911

General Enquiries: +44 (0)1273 323 563

Email us via our MembersWorld website

What is your complaints process? Hide

We are always pleased to hear about aspects of your membership that you have particularly appreciated, or that you have had problems with. If something does go wrong, here is our simple procedure to ensure your concerns are dealt with as quickly and effectively as possible.

Getting in touch

If you have any comments or complaints, you can call the Bupa International customer helpline on +44 (0) 1273 323563, 24 hours a day, 365 days a year. Alternatively, you can email via www.bupa-intl.com/membersworld, or write to us at:

Bupa International

Russell Mews

Brighton

BN1 2NR

UK

We want to make sure that members with special needs are not excluded in any way. For hearing and speech impaired members who have a textphone, please call +44 (0) 1273 866557.

We also offer a choice of Braille, large print, or audio for our letters and literature. Please let us know which you would prefer.

Taking it further

If we have not been able to resolve the problem and you wish to take your complaint further, please call the Bupa International customer helpline on +44 (0) 1273 323 563 or write to the Head of Customer Relations at:

Bupa International

Russell Mews

Brighton

BN1 2NR

UK

It’s very rare that we can’t settle a complaint, but if this does happen, you may refer your complaint to the Financial Ombudsman Service.

You can:

write to them at:

South Quay Plaza

183 Marsh Wall

London

E14 9JR

Call them on:

0845 080 1800 (from inside the UK only)

+44 (0) 20 7964 1000 (from outside the UK)

Find details at their website:

www.financial-ombudsman.org.uk

Please let us know if you want a full copy of our complaints procedure. (None of these procedures affect your legal rights).

Can I access my plan online? Hide

Yes, as a Bupa International member you will have access to our MembersWorld website where you can:

• view your plan
• update your personal details
• make payments online
• track the progress of your claims**
• search our international hospital directory
• download claim forms and other useful documents
• talk to us online using our free Webchat service

As a group secretary, can I manage the group plan online? Hide

Yes, as a group secretary of a Company plan, you will have access to our CorporateWorld website where you can:

• manage employee details
• manage payment details
• access useful documents such as membership guides and claim forms

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Managing your plan

How are subscriptions paid? Hide

Your sponsor (your organisation) has to pay any and all subscriptions due to Bupa International, together with any other charges (such as insurance premium tax) that may be payable.

How can I renew my plan? Hide

The renewal of your membership is subject to your sponsor renewing your membership.

Can I add other people to my plan? Hide

If your sponsor agrees, you may apply to include any of your family members under your membership as one of your dependents. To apply, you will need to complete an Additional Members form.

Newborn children can only be included on your membership from their date of birth once you have complete an Additional Members form, provided the child has not been adopted or born to a surrogate.

Newborn children adopted or born to a surrogate can be included once they are 90 days old on completion of an Additional Members or Enrolment form.

What is a group insurance plan? Hide

The Bupa International Company plan is a group insurance policy. You are therefore one of a group of members, which has a sponsor (normally the company you work for). The person who runs the membership within your organisation is usually referred to as the group secretary.

The plan is governed by an agreement between your sponsor and Bupa International, which covers the terms and conditions of your membership. This means that there is no legal contract between you and Bupa International. Only the sponsor and Bupa International have legal rights under the agreement relating to your cover, and only they can enforce the agreement.

As a member of the plan, you do have access to our complaints process. This includes the use of any dispute resolution scheme we have for our members.

How is the policy cancelled? Hide

Your sponsor (organisation) can end your membership, or that of any of your dependents, from the first day of a given month by writing to us. We cannot backdate the cancellation of your membership.

Can I transfer to a personal policy if my group policy ends? Hide

Yes, if your group policy ends, you can apply to transfer to a personal Bupa International policy. You can also apply for your dependents to transfer with you.

I haven't been able to find the answer to my question Hide

We regularly update this website and apologise if you haven’t found the information you were looking for on this occasion.

For the information you require, please contact us on +44 (0)1273 208200 or send us an email enquiry.

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