Filing a BVCare (New) Claim: Documents, 15 Working-Day Payout and Complaints

When health risks arise, preparing an accurate and complete corporate health insurance claim file is the golden key to help the insured and the company receive timely and full reimbursement. To avoid delays or administrative hurdles, here is the complete guide on the documents, timelines, and complaint procedures under the BVCare (New) policy.

📁 BVCare (New) Claim Documents: What Do You Need to Prepare?

Each risk event requires different medical and legal documentation. Below is the checklist of general and specific documents for common situations:

1. General and Medical Documents

The insured person (NĐBH) or their legal representative must prepare the following documents in Vietnamese or English:

• Claim Request Form: Standard policy template, signed and stamped by the employer/purchasing unit (BMBH) if the insured is an employee.
• Payment Receipts: Actual cost invoices, receipts, and standard VAT invoices (hóa đơn GTGT) where applicable.
• Medical Records: Hospital discharge summary, prescriptions, lab tests, and imaging diagnostics (X-ray, MRI, CT, ultrasound) prescribed by a doctor, all stamped and signed by the medical facility.

2. Specific Documents for Common Claim Scenarios

• Accidents:
  • ☐ Personal/Non-work accident: Witness statement (no confirmation from the employer or local authority required).
  • ☐ Work-related accident: Witness statement confirmed by the employer.
  • ☐ Traffic accident: Witness statement; police accident resolution report (if police were involved or in case of fatality); Vehicle registration and driver’s license (if driving a motorized vehicle, excluding scooters under 50cc).
• Permanent Disability: Medical certificate of disability and assessment report from the provincial medical council.
• Income Loss / Salary Allowance: Doctor’s recommendation for sick leave; leave approval sheet or timesheet; salary sheet stamped by the employer; labor contract (if any).
• Death: Medical history prior to death (if available); official death certificate and cause of death report; will or official confirmation of legal heirs.

⏰ Submission Deadline and Fast Payout Process

To protect your benefits, please note the following critical deadlines:

Submission Deadline

The claim file must be submitted in Vietnamese or English within 1 year from the date of:

• The date the insured person’s treatment stabilized;
• Or the date of hospital discharge;
• Or the date of death (for death claims).

Note: If the documents are in a foreign language, the insured person is responsible for providing a certified Vietnamese/English translation at their own expense. Claims submitted after the 1-year deadline will be partially or fully rejected, except in cases of force majeure (bất khả kháng).

Payout Timeline

After receiving a complete and valid claim file, the insurance company is responsible for processing and disbursing the benefit in cash or via bank transfer within 15 working days.

⚖️ Complaints and Protecting Your Rights

BVCare corporate health insurance is committed to transparency and protecting your interests. If you disagree with the claim decision, you have the right to:

1. File a complaint within 6 months from the date you receive the insurer’s decision notice.
2. No complaint can exceed 3 years from the date you knew or should have known about the violation of your legal rights.

If the dispute cannot be resolved amicably, the parties will proceed to resolve it at the Vietnamese courts in accordance with Vietnamese law.

💡 Important Tips for a Smooth Claim Process

To ensure a fast and smooth reimbursement, keep the following tips in mind:

• ☐ Always keep the original copies of all medical documents and payment invoices.
• ☐ Carefully check that the hospital discharge summary and prescriptions have the official stamps and doctor’s signatures.
• ☐ For accidents, write a detailed, objective, and timely witness statement describing the exact events.

Understanding the process and preparing your documents carefully ensures that medical treatment and recovery for your employees proceeds without administrative disruption. For more details on corporate health insurance benefits, please refer to the related articles in the BVCare series.

See also:

• What Does BVCare (New) Enterprise Health Insurance Cover?
• Claim Documents in a Foreign Language? Certified Translation Rules
• 5 Common Mistakes When Submitting a Health Insurance Claim