UAE Medical Reimbursement Forms

Download and submit the correct medical reimbursement form from your insurer or TPA. Find your provider below and access their claim form instantly.

Reimbursement Forms by Insurer/TPA

Click View Form to download. Fill it in accurately using BLOCK CAPITALS. Check the form for submission instructions.

How It Works

Overview: What is medical reimbursement?

Medical reimbursement lets you claim back the cost of covered treatments, medicines, and hospital bills you paid yourself. It reduces your out-of-pocket spend and supports better access to care.

Step-by-step: Get and submit a form
  1. Confirm your insurer or TPA (e.g., ADNIC, NGI, MedNet, Daman, Dubai Care, NAS, FMC).
  2. Open the correct claim form on the insurer website or app.
  3. Fill in your details and ask your treating doctor to complete their medical section.
  4. Attach original itemized receipts, prescriptions, reports, and translations (Arabic/English) if required.
  5. Submit via app, website, email, or at a branch within the deadline (often 90 days).

The insurer may contact you or the healthcare provider for more information. If approved, the eligible amount will be processed for reimbursement.

Receive your refund

Once approved, your insurer will pay the eligible amount to your bank account or issue a cheque. Typical processing time is 7–30 working days, depending on the provider.

Important to know
  • Reimbursement applies only to covered services within your policy limits.
  • Some insurers may deduct a co-payment or administration fee.
  • Claims may be rejected if documents are missing or the treatment is not covered.
  • Always check your network and coverage rules before visiting an out-of-network clinic.
  • Note: This page is informational. Confirm the exact process and coverage with your insurer before treatment.