Health Insurance Claim

Health Insurance Claim

  • Report the loss to Seesam at the first available opportunity, but no later than upon the expiry of the insurance period. A loss adjustment form can be completed directly on the Seesam homepage. From the menu selection below you will also find information about how to act following the occurrence of an insured event.

    To apply for health insurance indemnity, please do not forget to submit:

  • documents evidencing the costs of medical service (e.g. receipts, invoices, payment orders);
  • if the invoice does not display content of the treatment, an extract from the medical history of the person who received treatment;
  • a copy of the family doctor’s or specialist’s referral in the event of tests and analyses;
  • in the event of rehabilitation, a referral from a doctor or another medical document that reveals the prescription of the rehabilitation by a doctor;
  • in the event of indemnification of the cost of glasses and contact lenses, a prescription for glasses and purchase documents of the glasses or contact lenses, which have been issued during the insurance period;
  • a copy of the prescription in the case of indemnification of prescription medicines.


Most of the necessary documents are available at www.digilugu.ee and www.eesti.ee

For health insurance questions, contact tervis@seesam.ee. You can view the limits, submitted applications and conditions conveniently in our Seesam app.

Contacts
Phone: +372 628 1700 Email: kahjud@seesam.ee

How does the indemnification of health insurance claims take place?

Choose a suitable medical institution

  • In the case of an illness or another need for treatment, the insured person may choose a suitable medical institution.
  • A visit to a specialist doctor can be made without a family doctor’s referral. A doctor’s referral is necessary for tests unless otherwise agreed in the insurance contract.

    Pay for the treatment at first yourself

  • Upon using medical service, the insured person must at first pay for the treatment themselves.

Submit a loss adjustment form and necessary documents to Seesam

  • The expenses are indemnified according to the chosen insurance covers and to the extent of the sum insured, and excess is deducted from the indemnity.
  • In the case of an insured event of health insurance, all the information is managed only by the insurance company. You do not have to submit your expense receipts and medical records to the employer, but send them directly to Seesam.

Partners

Has your health been impacted?

 

You can also contact one of our partners directly, speeding up the process even more and letting you focus on getting better.

 

If you use the services provided by our partners, you’ll only have to pay the excess, and you won’t need to lodge a separate claim (except in the case of Meliva dental services).

 

Our partners:

Meliva Digital Clinic – to have your health concerns promptly seen to, you can visit the Meliva Digital Clinic for an online consultation. 

Meliva – Meliva offers health care services for prevention, diagnosis and treatment in Tallinn, Tartu and Pärnu.

Pirita Dental Clinic – this clinic provides a wide range of dental services, including primary care in Tallinn.

Valvekliinik – for prompt, personalised, same-day medical care. It offers online consultations around Estonia and in-person appointments in Tallinn.

Claritas – provides psychological and psychiatric counselling for adults and young people in Tallinn.

If you would like to use Seesam’s direct billing option, please book your appointment by phone or email:
600 1015 or info@claritas.ee

Innomedica – provides medical care for various health concerns as well as health check-ups for disease prevention and early detection. Appointments take place in Tallinn.

Treatment and Diagnostic Centre
Sports Medicine and Rehabilitation Centre
Online registration