Skip to content

How to make a claim

You might need to make a claim after going to hospital, being transported in an emergency ambulance, using a service from your Extras cover, or if you're an international member, for services such as seeing a General Practitioner.

Most of the time you won’t even realise you’re claiming - just scan your card after treatment to claim on the spot. If you do need to submit a claim, most the time you can take a photo of your receipt to claim in the nib App or Online Services. If you have any questions about claiming, we’ve got the answers here.

Claiming after a hospital visit?

You generally won’t receive a hospital bill if: your procedure was included on your health cover, you went to an nib Agreement Hospital and your doctors participated in MediGap. If you did receive a bill, please see our Hospital billing for how to claim it.

How do I make an Extras claim?

Scan your nib card

The easiest way to claim is to scan your nib card after appointments like dental check ups or physio visits. If your provider has this service available, just scan your nib card at their temrinal after your treatment. The amount nib covers you for will be automatically calculated so you just pay the gap.

Claim online or in the app

If claiming on the spot isn’t an option for you, you can use the nib App or Online Services from your computer, phone or tablet to submit your claim.

Simply take a photo of your receipt, making sure it’s not blurry and that all details can be read, and submit. We’ll pay Extras benefits like dental and chiro straight into your account within five working days.

Visit an nib Retail Centre

Our friendly consultants will talk to you about the convenient ways you can claim. Find your nearest nib Retail Centre.

By mail

Complete and return an nib Claim Form with all of your original receipts.

Before you make a claim, you should check if any waiting periods apply, that your provider is a recognised provider with nib and if you have used your annual limits.

What details need to be included in my claim?

Use our checklist to make sure your claim meets all of the claiming criteria:

  • You’ve provided the original documents, not copies.
  • The account is itemised with all items and their charges listed separately on the account.
  • The account has been paid in full.
  • It’s on the provider’s official stationery or has the provider’s official stamp
  • For doctors' or specialists' bills, make sure you claim these with Medicare first. We can only pay a benefit for the services of doctors or specialists that you received while you were an admitted private patient in hospital.
  • For healthier lifestyle claims, ask your doctor to complete a Health Management form and submit this with your claim.
  • Make sure everything is written in English so we can process your claim faster.

How can I find out how much I have left to claim?

You can check your remaining annual limits by selecting My Usage tab in Online Services or in the nib App, or you can contact us.

Is there a time limit I need to make my claims by?

We only pay claims within 2 years of the date you had the service, so don’t delay.

Where can I see my claims history?

You can log in to Online Services or the App to view your claims history.

What happens after I make a claim?

Claims will be processed within five business days, or two weeks for international members. You’ll receive a text message once the claim has been paid into your account. If your claim has been rejected, you’ll receive a claim rejection letter via your preferred method of contact. To check or update your contact details, head to Personal Details in the My Policy section of Online Services or the nib App.

Why was my claim rejected?

According to our claims team, in 2018* the top reasons a claim was rejected were:

  • We don’t cover the service e.g. aromatherapy, hypnotherapy or swimming lessons.
  • Information is missing from the receipt/s provided.
  • You don’t have the service included on your cover.
  • The photo of your receipt was blurry.
  • The service is covered by Medicare which means you must submit to Medicare first, and then complete your claim with us.

If you are unsure why your claim has been rejected, please contact us.

*Data from 1 January 2018 to 1 October 2018

Continue to the next page

Related articles

How do I claim Medicare and can I do it online?

Why do I have to pay a gap when being treated in hospital?

How is a health insurance claim assessed?