Support resource

Claims & Support Centre for Employers

Claims are time-sensitive and policy-specific. This centre helps employers and employees prepare the right information, find the relevant ClearCover channel and understand what to check before contacting the insurer, TPA or broker support team.

Policy wording, insurer requirements and claim circumstances determine the documents and outcome. This page is general guidance and does not promise claim approval or a settlement timeline.

Existing client action

Claim intimation

Use the client claim-intimation route to notify ClearCover of a claim event.

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Guide

Group health claim process

Read a practical explanation of cashless and reimbursement claim stages.

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Escalation

Escalation matrix

Find the published escalation route when a client needs additional support.

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Before you intimate a claim

Collect the policy and incident information first. This helps the right support team identify the applicable process quickly.

  • Policy or e-card details, employee/member name and contact information.
  • Incident, admission or loss details with relevant dates.
  • Available documents, bills, reports, invoices or supporting records.

Use the channel that matches the claim

Medical cashless, reimbursement, employee accident and commercial-property claims can have different insurer requirements. Follow the policy-specific instructions and ask for clarification where needed.

  • Do not delay an intimation while waiting for every document.
  • Keep copies of submitted documents and communication.
  • Use the published escalation route if the required support has not been received.

Support for HR and employers

HR teams can reduce friction by sharing claim contacts, policy terms, e-card access and employee communication before a claim happens.

  • Maintain an up-to-date employee census and contact list.
  • Explain cashless and reimbursement steps during onboarding.
  • Document recurring questions for the next renewal review.

Frequently asked questions

Frequently asked questions

Does ClearCover approve insurance claims?

No. The insurer assesses claims under the applicable policy wording. ClearCover can help clients with claim-intimation guidance, documentation and communication through the available support process.

What documents are needed for a claim?

Requirements vary by policy and claim type. Keep policy details, member information, incident dates and relevant bills, reports or records available, then follow the insurer or TPA instructions.

What should an employer do if a claim needs escalation?

Use the published escalation matrix and include the policy details, claim reference, timeline and prior communication so the issue can be reviewed with the relevant team.

Need a tailored insurance recommendation?

Share your organisation’s requirements with ClearCover for a policy discussion based on the cover you need.