WHO TO CONTACT?
Who do I contact in an EMERGENCY situation?(24/7)
If you require emergency medical transfer or evacuation, or if you need emergency hospitalisation, call the JW Seagon Team on +254 729 666 333 and they will tell you what needs to be done.
The team is on call 365/24/7 to support you.
Who do I contact for general administration or membership queries?
Please contact the JW Seagon Team and we will be happy to assist. The contact details are: phone: +254 709 455 301, email: [email protected]
Who do I contact to make a claim?
Please contact the Henner Client Services Team on +254 709 992 001/2/3 and an expert adviser will be happy to help. Alternatively you can email the team on [email protected]
YOUR MEMBERSHIP CARD
What do I use the Africa Wellness Solutions (AWS) membership card for?
We recommend you keep your AWS membership card with you at all times. It has all the contact details you need for general queries, making a claim or in an emergency situation.
The card also has important information that medical providers need in order to administer your treatment. It is important that you take the card with you when visiting a provider for treatment to ensure the best experience.
What do I do if I lose my card?
Don’t worry, just call the JW Seagon Team and they will be able to issue you a replacement.
YOUR HENNER ONLINE ACCOUNT
How do I access my Henner Online Account on the Henner web site?
To access your account for the first time click here for instructions.
Otherwise go to: https://www.henner.com, click on ‘private access’, enter your login (this is the Henner ID number that can be found on your Membership Card) and then enter your password.
Your Henner Online Account is for you and any dependants, using the same login and password.
Can I manage my claim online?
Yes, you can submit claims, follow your claims history and track any reimbursements through your Henner Online Account on the Henner web site.
What else can I do using my Henner Online Account?
Your Henner Online Account allows you to follow your claims history, track any reimbursements and locate appropriate healthcare professionals within the Henner network. Plus you can download forms and submit claims.
WHAT AM I COVERED FOR?
Which documents do I need to refer to?
Your Certificate of Insurance clearly sets out the cover you have purchased. For each person covered on your policy the certificate specifies the plan (Elite or Primary), the programme (Essential, Balanced, Best), the area of cover (Africa and India or Worldwide excluding the USA) and any deductible you may have chosen.
Please refer to the Membership Guide for a detailed explanation of what is and what isn’t covered under AWS.
Are my pre-existing medical conditions covered?
This depends on how you have been underwritten. Please refer to your Certificate of Insurance which will clearly state if any pre-existing conditions have been excluded from cover.
Are chronic conditions covered?
Yes, AWS provides cover for chronic conditions – please see the Table of Benefits for full details.
Are hazardous pursuits covered?
AWS cover is not restricted if you take part in hazardous pursuits, such as, for example, mountaineering. Professional sports are however excluded. Please refer to the Membership Guide for a full list of exclusions on the policy.
HOW TO CLAIM
Who manages my claim?
Henner is the claims and provider management partner for your AWS plan.
Henner has developed unique expertise in the administration of benefit plans. Presently it administers claims for insured members in 190 countries for clients such the African Development Bank, the European Investment Bank and OECD. It has locations around the world including Nairobi.
Henner’s advisers are highly knowledgeable about your healthcare plan and they are available 24/7 to answer questions about any claims for treatment.
Who manages emergency medical transfers and evacuation?
Emergency medical transfers and evacuations are included on all AWS plans. When appropriate medical facilities aren’t available locally, we use Amref Flying Doctors or Allianz Global Assistance to arrange patient transfers on our behalf; both organisations are used to working in high-pressure situations and there’s nobody we’d trust more to look after our customers.
When do I contact Henner?
If you need to find an appropriate consultant, make a claim or arrange reimbursement of medical expenses, simply call the Henner Client Services Team on +254 709 992 001/2/3 and an expert adviser will be happy to help. Alternatively you can email the team on [email protected]
Where can I get treated?
You can get treated by any qualified medical practitioner and at any recognised medical facility in your Area of Cover.
But to benefit from direct settlement of bills you must use a healthcare provider that is part of the Henner Medical Network which includes hospitals, medical centres, laboratories, radiology clinics, pharmacies and doctors.
What does Direct Settlement mean?
If you use a healthcare provider in the Henner Medical Network the provider is reimbursed directly by Henner, which means you do not need to pay the provider and seek reimbursement later.
How do I know which healthcare providers are part of the Henner Medical Network?
To find out more about the Henner Medical Network, visit www.henner.com or search for network providers in your Henner Online Account.
HOW TO CLAIM USING A PROVIDER IN THE HENNER MEDICAL NETWORK
How is treatment paid?
Providers in the Henner network are paid directly by Henner but you must pay the medical provider any additional charges not covered by your AWS plan.
How do I claim for emergency in-patient treatment?
For emergency hospitalisation you are covered for the first 48 hours. However, please update Henner within the first 48 hours of being admitted to hospital, so they can arrange to extend cover if necessary.
How do I claim for scheduled in-patient treatment?
For scheduled in-patient treatment you must apply for Prior Agreement from Henner. Download a Prior Agreement Form from your Henner Online Account and ask your treating Physician to complete and sign it. Then post or email the form to Henner. You will receive an email reply within 5 days of Henner receiving your request. Before receiving your treatment, show your AWS Membership Card and a photo ID to your medical provider.
How do I claim for out-patient treatment?
For out-patient treatment, before receiving your treatment, show your AWS Membership Card and a photo ID to your medical provider.
Where do I send a Prior Agreement Form?
Either by post in an envelope marked confidential and addressed to Henner, for the attention of the Medical Advisory Board, 14 boulevard du General Leclerc 92200 Neuilly-sur-Seine, France, or by e-mail directly to [email protected]
Alternatively, the document can be scanned and emailed to Henner via [email protected]
HOW TO CLAIM USING A PROVIDER NOT IN THE HENNER MEDICAL NETWORK
How is treatment paid?
For providers not in the Henner network you pay the provider and claim reimbursement from Henner.
How do I claim for emergency in-patient treatment?
For emergency hospitalisation you are covered for the first 48 hours. However, please update Henner within the first 48 hours of being admitted to hospital, so they can arrange to extend cover if necessary. The facility may not agree to direct settlement, in which case you will need to pay for your treatment and claim reimbursement.
How do I claim for scheduled in-patient treatment or out-patient treatment?
First download a Claim Form from your Henner Online Account and ask your treating Provider to complete and sign it. You need to sign the form too. You may claim your medical expenses by sending any documents by post. Alternatively upload the documents directly to your Henner Online Account but you must keep the original documents for 24 months and send them to us within 30 working days if requested. Correctly submitted claims are processed within 5 business days, excluding postal and transfer times.
What do I need to provide when making a claim?
So that we can reimburse you as quickly as possible, please ensure you provide us with all of the documents listed below:
- Henner claim form – you can download this form in PDF format here
- Medical prescriptions
- Original itemised paid invoices – photocopies cannot be accepted and for optical expenses, the price of glasses and frames must be listed separately
- Original statement of any other healthcare system to which you may have subscribed
- Copy of Prior Agreement from Henner – for treatments and procedures that are subject to the Prior Agreement
- Your bank details* including:
- Name of the account holder
- Beneficiary’s Postal Address (unfortunately PO BOX and company addresses are not accepted)
- Telephone number of the account holder
- Bank details: bank name, bank code, branch code, full branch address/ beneficiary’s bank location (country)
- Currency of the account
- Account Type (savings account/checking account/current account)
- Full account number or International Bank Account Number (IBAN)
- Swift code (or BIC code) and IBAN if applicable
* Please note:
- we cannot send funds to credit card accounts and non-banking accounts ;
- the account holder should by default be the main member’s bank details ;
- you do not need to provide your banking details every time you submit a claim unless you have changed your bank in which case please let us know or update the details on your Henner Online Account.