How to Submit a Claim

This guide is designed to help you navigate eClaims—our desktop claim portal—and the UNSMIS mobile application with ease, ensuring that you can manage your data and health insurance claims efficiently. At the end of this article, you will also find information on how to submit claims in paper form by regular mail, if necessary.

UNSMIS mobile application

Our mobile application is available on both Google Play and the App Store—just search for “UNSMIS”.

eClaims Portal

Access by clicking here.

Although the eClaims platform is compatible with all browsers, we recommend using Google Chrome for the best experience.

To log in to either platform, members should use their insurance number, username, and password.

The insurance number can be found on your insurance card or on your reimbursement advice.

username

If you have forgotten your credentials, click on ‘Issues logging in?’ and follow the instructions provided.

How to submit an online claim? 

  1. Once on the home page, click on the Submit a Claim tab.
submit

Please inform UNSMIS if, while using the eClaims portal, you discover that any of your information is outdated. You can do so by using the Contact form easily available from the home page.

  1. In the Select insured person list, select the person for whom you are claiming medical expenses.
select
  1. In Claim Details, answer the three questions. Note that:
  • For claims related to accidents, you will need to attach a Declaration of Accident Form, the template for this can be downloaded directly from the 'Forms to Download' section;
  • For details about submission of service incurred accidents, please refer to the section 'Service Incurred Accident or Illness – Appendix D'.
  • Please only select "Yes" for the question "Are you entitled to reimbursements from any other source?" if your primary source of reimbursement is another health insurance provider (e.g. a national health insurance or subsidy). In this case, please attach a proof of the reimbursed amount to the claim.
    If your primary source of reimbursement is UNSMIS, and you have a complementary health insurance plan (e.g. GPAFI), please select "No".
claim
  1. In Amounts claimed, enter all the details of each invoice you will submit: date of invoice, currency, amount, nature of expenses and if appropriate, any additional information.
amounts

By default, one row is displayed but you can add more using the Add invoice button or remove existing rows by using the Delete button.

  1. Next, attach the original scanned version of each paper invoice, or the digital invoice, in the Attachments section. You can click the Upload a file button or simply drag and drop your files into the box.
attachments

To facilitate the processing of your claim, each attachment should contain only one invoice and its supporting documents (prescription, proof of payment, etc.)

  1. Enter any additional information regarding your claim in the Remarks field.
  2. Save the claim as a draft to be submitted later (1) or carefully review and then Submit the claim immediately (2) to UNSMIS for processing. Once you have chosen to submit it, the system will ask you to review and accept the conditions of use.
savesubmit

Please ensure that you:

  • Submit a separate claim for each insured family member.
  • Attach all original invoices, prescriptions, receipts, and supporting documents.
  • Submit claims regularly to avoid delays.
  • Keep copies of all documents for your own records (if submitting physically).
  • Obtain prior authorization from the Medical Adviser when required; authorizations are valid for six months.
  • Avoid cash payments for amounts above USD 500.-.
  • For pharmaceutical claims, attach the till receipt and packaging stickers.
  • Submit claims within 24 months of the billing date.
  • Note that UNSMIS cannot accept instalment schedules or statements of account as invoices.

Below, we also outline the main functionalities of each platform, highlighting their similarities and differences.

Similarities and differences between eClaims and the UNSMIS mobile app

Use the mobile application to:

  • Access your digital insurance card 24/7.
  • Submit smaller claims containing only one invoice (e.g., pharmacy bill) each. Supporting documents, including the prescription and invoice, can be uploaded by taking clear photos with your camera. You may attach up to five photos per submission.
  • View your credit balances, past claims, and reimbursement advices.
  • View and download your up-to-date attestation of coverage.
  • Contact us by completing the contact form.

Use the eClaims portal to:

  • Submit claims with up to 10 attachments.
  • Update, correct, or withdraw submitted claims. Claims can only be withdrawn if they have not yet been assigned to a claim agent.
  • Find contracted providers and initiate direct billing requests for medical providers within our network.
  • Book individual online consultations via Teams with our client service team.
  • View and download your up-to-date attestation of coverage and annual tax attestations.

Submitting a Claim in Paper Form

Claims may also be submitted in paper form by regular mail. You may find our mailing address here. In case you wish to submit hard copies, please do not forget to fill out and sign the Claim Form. However, we strongly urge all members to move from paper submissions to online submission through the eClaims portal or the UNSMIS mobile app.