Complete guide to making health insurance claims with all major NZ providers. Learn the process, avoid common mistakes, and get your claims paid faster.
Before seeking treatment, verify that your policy covers the service and check for any waiting periods, annual limits, or pre-authorization requirements.
For hospital treatments and some expensive procedures, contact your insurer before treatment to get pre-authorization.
Present your membership card at participating providers for direct billing, or pay upfront if direct billing isn't available.
Upload receipts and documentation through your insurer's mobile app, online portal, or submit by email/post.
Monitor your claim status online and receive payment directly to your nominated bank account.
MySouthernCross
5-7 business days
Extensive network
Use app for fastest processing. Pre-authorization required for hospital claims over $500.
nib App
3-5 business days
Growing network
Submit photos via app. Claims under $200 processed within 24 hours.
Accuro Mobile
2-5 business days
Selected providers
Simple claim process. No pre-authorization needed for most treatments.
AIA Vitality
5-10 business days
Premium network
Earn Vitality points for claims. Use online portal for tracking.
Failing to get pre-authorization for hospital treatment can result in reduced benefits or claim rejection.
Incomplete receipts or missing provider registration numbers delay claim processing.
Not tracking annual benefit limits can lead to unexpected out-of-pocket expenses.
Submitting claims before waiting periods expire results in automatic rejection.
Treatment from unregistered practitioners may not be covered under your policy.
Most insurers require claims within 12 months of treatment date.
Most insurers process mobile app claims faster than postal submissions.
Include all required documentation the first time to avoid delays.
Use providers offering direct billing to avoid upfront payments.
Maintain digital copies of all receipts and documentation.
Monitor annual limits and waiting periods through your member portal.
Call your insurer promptly if claims are delayed or rejected.
Compare all major NZ health insurance providers and find the right coverage for you