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Frequently asked questions
Reimbursement

You can submit your claim either through Daman app or Daman website along w/the documents relevant to your claim.

The required basic documents when you submit a reimbursement claim include an itemized invoice with the breakdown of each medical service, proof of payment, and a medical report of the diagnosis or description of the symptoms by the doctor.

You may be asked to provide additional documents depending on the type of service/nature of the claim as prescription of medications & medical appliances, referral letters, visa copy, airline ticket, death certificate.

Itemized invoice is the breakdown of medical services with a specific amount for each medical service you availed. Yes, it is required for every claim submission because it indicates each of the services you have taken, the date it was availed and the cost for each service. 

Yes, proof of payment is required for claim submission, it can be a credit card receipt or hospital receipt with paid stamp. Proof of payment is a guarantee that the member paid the services he/she availed.

A detailed medical report w/ discharge summary is required for all hospital admissions and some out-patient services such as therapy e.g., speech therapy, infertility services

 
If the hospitalizations require surgery additional report such as operative notes and anesthesia records should also be provided. The medical report comprises of diagnosis and explanation of the necessity of the procedure including the sign and symptoms. 

In addition to the basic documents such as itemized invoice, proof of payment, you will also need to submit a clinician referral, detailed medical report indicating the number of sessions and goal of treatment.

There is no coverage in advance for the future treatment/service. Only performed services will be reimbursed

You can submit your reimbursement request within 180 days from the date of service.

You can resubmit your claim by using resubmit option available in daman website and app.

You can check the status of your claim through the claim reference number in Daman app or Daman website

You can check your benefit from the schedule of benefit of your policy in Daman website and App.

You can review the list of providers within the network in Daman website and Daman App or you can call Daman customer service at 600 5 32626 within the UAE or +971 2 6149555 outside UAE.

Reasonable and Customary Charges

R&C charges refer to the average price of a particular treatment across the network of providers for a specific plan.  Daman applies R&C rates to claims incurred out of the plan’s network as non-network prices could be quite high and will impact the policy’s renewal premium.  So to maintain a balance between treatment access and cost, payment will be on a R&C basis and not on the actual out of pocket cost of the member.

We encourage members to seek treatments at Network Providers to receive the maximum benefits of your policy.  However, in the event that going to non network providers is non-avoidable, the member might not receive the full share of the cost at a non-network provider if the cost of a specific service of this provider is higher than other providers in your plan’s network. 

The below scenarios can assist you in understanding: 

  • Scenario 1 – If the R&C rate is less than the actual price charged by the Non-Network Provider, the R&C rate is applied in calculating the reimbursed claim payment.
  • Scenario 2 – If the actual price charged by the Non-Network Provider is less than the R&C rate, the actual price rate is applied in calculating the reimbursed claim payment.


This has been illustrated below, for a case where 20% co-insurance applies for all covered services in Non-Network Provider: Example - R&C: Consider that a cost for a particular surgery is AED 1000 at a network hospital.
 

 

  Paid amount After applying 20% co-insurance Maximum reimbursed claim payable to the member
R&C: For a particular surgery within your network AED 1000 AED 800 AED 800 (lower of R&C or Actuals after applying applicable Coinsurance)
Scenario 1: Claimed Amount (Amount Charged by Non-Network provider higher than R&C rate) AED 1500 AED 1200
Scenario 2: Claimed Amount (Amount Charged by Non-Network provider lower than R&C rate) AED 500 AED 400 AED 400 (lower of R&C or Actuals after applying applicable Coinsurance)

Ziyarah

Anyone who is planning to visit any Emirate in the UAE on a visit visa is eligible to purchase Ziyarah plans.

Ziyarah plan offers coverage for emergency inpatient medical conditions only.

Yes, a visitor can buy Ziyarah if he is already in the country.

No, you will need to buy a new Ziyarah plan.

Yes, Emergency hospitalization treatment for Covid-19 is covered.

Emergency hospitalization and in-patient treatment are covered under your plan. Following services are excluded:

  1. Cases not requiring hospitalization
  2. Quarantine
  3. Any outpatient treatment and outpatient pharmaceuticals
  4. All types of testing related to Covid-19

Coverage for pre-existing conditions is limited to medical emergency only. Any further treatment after your condition is stabilized is not covered in case of pre-existing condition.

There is no premium and VAT refund under this plan.

Yes, please approach the nearest Daman Branch for assistance.

Yes, you can have your claims paid amount transferred to an international bank account. 

You can file your claim through email travel.claims@damanhealth.ae and in Daman’s branches service or points.

The following are the required documents:

  1. Original claim form
  2. Copy of your passport
  3. Proof of travel (boarding pass, flight tickets etc.)
  4. Original itemized invoice with service date
  5. Original prescription for medication
  6. for procedures exceeding AED 1,000, provide investigation results and/or reports (lab tests, x-ray etc.)
  7. Additional requirements for inpatient (hospitalization cases): Original medical report and / or discharge summary stamped and signed by the treating medical practitioner and health care provider maybe requested by Daman’s claims team.

Reimbursement of claims will be finalized within 15 days after successful submission of all required documents.

You must submit your reimbursement form to Daman within 180 days from the last treatment date for services availed in the UAE.

Resubmission or appeal of reimbursement claims in case you disagree with a partially paid or rejected reimbursement claim. You have the right to appeal the decision. You can resubmit your claim with the supporting document(s)/justification(s) within 180 calendar days from the date of notification of partial payment or rejection.

Covid-19

Novel Coronavirus strains are spread from person to person through contact with contaminated respiratory droplets from an infected person (through coughing or sneezing) or contaminated hands. The virus can spread through touching a contaminated surface. People can also catch COVID-19 if they breathe in droplets from a person with COVID-19 who coughs out or exhales droplets. Therefore, it is important to stay more than 1 meter (3 feet) away from a person who is sick.

The main symptoms of the disease include fever, cough and, in the most severe cases, shortness of breath. Some patients may experience aches and pains, nasal congestion, runny nose, sore throat or diarrhea. These symptoms are usually mild and begin gradually.

No vaccine or specific treatment for COVID-19 is available. The treatment of COVID-19 depends on enhancing the immunity level of patients, treating the symptoms and easing complications, as there is no specific treatment for the virus to date.

  1. Avoid contact with people suffering from respiratory infections exhibiting COVID-19 symptoms
  2. Avoid handshakes, nose-to-nose greetings, hugging or kissing others and maintain at least a two-meter distance between yourself and anyone who is coughing or sneezin
  3. Frequently wash your hands with soap and water for at least 20 seconds. Use an alcohol-based hand sanitizer if soap and water are not available
  4. Avoid touching your eyes, nose or mouth without washing your hands
  5. Clean surfaces regularly
  6. Avoid close contact with live or dead farm or wild animals and avoid eating animal products that are undercooked
  7. Cover your mouth and nose with your bent elbow or tissue when you cough or sneeze. Then dispose of the used tissue immediately
  8. Make sure to get enough rest and consume large amounts of fluids
  9. Adhere to all instructions issued by the local authorities and governments

We urge you to isolate yourself from other people and call your healthcare provider. Before visiting the hospital or clinic, ensure that you call ahead and tell them the reason that you are visiting. On the way, avoid contact with others and cover your mouth and nose with your sleeve or a tissue when coughing or sneezing.

We also encourage you to verify your symptoms by using our Coronavirus Assessment Tool before contacting a healthcare provider.

If you show COVID-19 symptoms, your policy will cover medically required services requested by a treating physician until a diagnosis is established. We hope in such cases that your test results return negative. However, in the unfortunate event your test turns out positive for COVID-19, the healthcare provider will facilitate the treatment together with local authorities in line with their regulations.

COVID-19 tests and treatment undergone abroad are not part of your health policy.

We will only cover medically necessary testing, when medically indicated for patients with COVID-19 symptoms referred by a medical physician and in an approved medical facility.

If you have any further questions, we encourage you to contact the UAE authorities:

    1. Ministry of Health & Prevention - call 80011111
    2. Abu Dhabi: Department of Health - Estijaba service – call 8001717
    3. Dubai: Dubai Health Authority – call 800342

We have moved our operations online. Simply go to www.damanhealth.ae sign-in to your “MyDaman” account and access the following services:

  • Add or delete members, or change data
  • Download documents and access information: invoices issued, travel and insurance certificates, members’ digital cards and statements of accounts
  • Payments: pay your premium via credit cards, bank transfers or bank deposits. Additionally, send proof of payment to cashier.hq@damanhealth.ae

For more information about how to use our online services mentioned above, please read the service manuals available here.

Customers who used to visit our branches to:

  • Enroll or renew their insurance policies
  • Request Insurance Continuity Certificate (COC)
  • Request and renew Aounak Health Insurance Card
  • Submit their claims above AED 15.000

You can easily submit your request here.

Signed LOA and POA are to be sent from your official company email to  Distribution.Support@damanhealth.ae.

You can find our bank account details below to be used for bank transactions: 

For Dubai Click here

For Abu Dhabi Click here

 

You can easily log in to Daman Mobile App or sign in to your account on www.damanhealth.ae to access the following services:

  • Daman Digital card details
  • Know your benefits (Schedule of Benefits and General Exclusions)
  • Track your preapproval request
  • Submit and track your reimbursement claim
  • Access Telemedicine (call a Doctor) for non-emergency cases

As the situation develops, we will follow it closely and inform you as soon as possible of any developments that may impact our services, in compliance with instructions from the relevant health authorities.

For elective surgeries in Abu Dhabi and other emirates:

Please consult your doctor.

For elective surgeries in Dubai:

The DHA (Dubai Health Authority) postponement of elective surgeries until further notice only applies to DHA licensed medical providers and/or professionals and Dubai Healthcare City licensed medical providers and/or professionals. Dental centres and clinics in health facilities are limited to receiving urgent cases only, such as acute dental pain, pus infections, injuries etc. And all other appointments are to be postponed till further notice.
 

Reimbursement claims can be submitted from the comfort of your home. There is no need to come back to the UAE.

To submit a claim, log into Daman mobile app and click on "My claims”. Or sign in to www.damanhealth.ae and click on reimbursement claims.

To submit your claim, log into Daman mobile app and click on "My claims”. Or sign in to www.damanhealth.ae and click on reimbursement claims.

Kindly click here, then choose Abu Dhabi Basic Plan (Individuals).

Kindly click here, then choose Abu Dhabi Basic Insurance Plan (Group) and complete your application.

Yes, if the network hospitals are not available due to the current COVID-19 virus outbreak, you can avail services from the nearest non-network hospital and such services will be covered on reimbursement basis.
 

To know all the services which are covered under your insurance plan, you can access your benefits and exclusion list through Daman mobile app. Go to the main screen and click on "My insurance" and then "Schedule of Benefits". Or, you can sign-in to Daman Website at www.damanhealth.ae and go to “Benefits”.

Yes, you will be receiving an email and will be contacted by our sales agents and you will have more clarification about the missing documents.

VAT

Value Added Tax is an indirect tax that is being introduced by the UAE Government, which will be payable by both businesses and individuals.

Yes, unless there is an exception under the Federal Law that VAT does not apply to a particular set of goods and/or services. Exceptions are published by the Federal Tax Authority.

There is a possibility for business owners to claim back their VAT contribution, provided they have registered for VAT and meet the requirements. For further information, please visit www.tax.gov.ae

No, there are also certain rules that apply for transition policies i.e., ongoing policies where the policy coverage extends to 2018.

The current understanding is that VAT will also be payable for that period. Where the insurance policy is issued in 2017 and expires in 2018, tax will be applicable for the time period where health insurance coverage is provided in 2018.

For example, where a policy is issued on the 1st of October 2017 and expires on the 30th of September 2018, VAT at the rate of 5% will be pro-rated for the nine (9) months (1st of January 2018 – 30th of September 2018) that the policy is in effect.

Yes. Where a policy is issued on the 1st October 2017 and expires on the 30th September 2018, VAT at the rate of 5% will be pro-rated for the nine (9) months (1st of January 2018 – 30th of September 2018) that the policy is in effect.

The invoice will display the VAT charge based on the final number of members enrolled under the policy at the time of enrolment.<br><br>For transition policies, a revised invoice will be issued to you on or after 1st of January 2018 setting out the pro-rated VAT charge.

Yes, terms and conditions in the policy wording have been amended to include provisions on VAT.

A copy of the policy terms and conditions can be found here

Yes, the TRN is required so that it is reflected on our invoice. The inclusion of your TRN on our bill is required for you to recover the incurred VAT within your VAT return. We will contact you shortly for this information.

Please visit the website for the Federal Tax Authority – www.tax.gov.ae

Obstetric Ultrasounds

Effective from April 1, 2019, Daman will cover up to a maximum of three (3) procedures within all three (3) trimesters of your pregnancy, with one (1) procedure performed per single trimester as long as the ultrasound procedure is part of your maternity benefits in your insurance policy. For more information please click here.

Emirates ID and mobile app

We stopped printing health insurance cards. Members can access their health insurance details from their Daman mobile app. You can download your digital insurance card and use it in place of your physical insurance card, The Emirates ID card will also qualify members to access healthcare services at providers under Daman’s network. 

Yes, Daman members will be able to use their digital card found on their Daman app and Emirates ID at medical facilities under the Daman network. The Daman app will give you access to features on the move such as your policy number, and schedule of benefits and nearest providers.

When you visit health providers in your network you have an option of providing your digital card number in the app or your Emirates ID as Daman has trained the health services providers on using a secure online platform where they can match the Emirates ID number with the member’s health insurance file that is available in Daman data base.

You can register to Daman’s app using your Emirates ID number and policy number, if you do not have your policy number click on “I don’t know my policy number” and fill in the necessary information to select the policy you wish to link with your mobile app. You can also ask your sponsor or employer who bought the policy for this number. If you have more than one health insurance policy, you will have to create multiple accounts to be able to access each insurance benefits separately.

If you do not hold your Emirates ID and wish to register on the Daman app, please call 800432626 and ask about your Daman card number and policy number. Once provided by our call center agent, you can use the Daman card number and policy number to create an account on Daman app or Daman’s website.

In exceptional cases our members will receive a physical Daman insurance card, you can register to the app using the information printed on your insurance card.

Yes, if you already have a MyDaman account created on Daman’s website, you will be able to use it to login to the Daman app. If you don’t have a MyDaman account yet, you can register on the Daman app directly using only your Emirates ID number and policy number. In case you don’t have your policy number, you can click on “I don’t know my policy number” and the Daman app will list the available insurance policies under your details.

You can do so by downloading Daman app where you can have access to your policy number, schedule of benefits and access to the providers click here to update your Emirates ID number on our website.

If you do not have your Daman’s card number, you can reach our call centre on 800432626 to get your card number and then update your Emirates ID here

 

No they are not linked. Each must be renewed separately.

No it will not. We use your Emirates ID number to check if you have valid health insurance coverage. You can still use your digital card found on your Daman mobile app. 

It is recommended that you download and register to the Daman mobile app. The Daman app provides you your health insurance details, including your Daman card number. Daman members who have international emergency coverage need to contact the number via the app and provide the Emirates ID number for emergency medical assistance.

MENA Region: In Patient and Outpatient services – please share your digital card and EID with the provider that offers direct billing in the network.

India: Only in-patient, elective treatment is covered on direct billing. Please contact the provider, as per the website, and provide your Emirates ID number.

International Providers, excluding MENA: The member need to approach Daman International Assistance services minimum 5 days prior to availing the treatment. Daman will validate your eligibility and provide necessary approvals for the treatment to be carried out at the selected provider. For any enquiries, please email intl_assistance@damanhealth.ae.

The use of Emirates ID is available for use in any provider across UAE in the Daman Network as per your plan. You can also use the Daman app to check and/ or search for an in-network healthcare provider near you.

Daman processes allows you to just present a copy of your Emirates ID or show your Daman digital card (through the Daman App) to the provider to avail medical services.

Daman will continue printing cards for its members who do not hold an Emirates ID cards

We recommend that you download the Daman app as it has all of your insurance details. If you or the healthcare provider have the Emirates ID card’s copy or its number, they can check our system if you are eligible for coverage using the number. However, healthcare providers may need to see another form of valid identification document, so it is advisable that your carry your Official identification.

Travel Health Insurance Plan

If you claims falls below AED 15,000, you can file your claim through email travel.claims@damanhealth.ae and in Daman’s branches. If your claim is AED 15,000 or higher, please file it at one of our branches.

  • Original claim form
  • Copy of your Emirates-ID
  • Original itemized invoice with service date
  • Original prescription for medication
  • Investigation results and/or reports (lab tests, x-ray etc.) should be attached for procedures exceeding AED 1,000
  • Additional Requirements for Inpatient and Day Care (Hospitalisation Cases): Original Medical Report and / or Discharge Summary stamped and signed by the treating medical practitioner and health care provider. 
  • Proof of travel ( boarding pass, flight tickets etc.) 

You must submit your reimbursement form to Daman within 180 days from the last treatment date for services availed outside of the UAE.

Resubmission/Appeal of Reimbursement Claims - in case you disagree with a partially paid or rejected reimbursement claim, you have the right to appeal the decision. You can resubmit your claim with the supporting document(s)/justification(s) within 180 calendar days from the date of notification of partial payment or rejection.

Reimbursement of claims will be finalized within 15 days after successful submission of all required documents.

Kindly contact the Customer Service team in case of any questions about your claims: 

+971 2418 4888

After your claim was rejected because of various reasons, you still have the chance to resubmit your claim, adding missed out documents or new crucial information. Please contact our Customer Service: +971 2418 4888.

The TAT on claim reimbursement will be 15 days

Yes every UAE resident with a valid Emirates ID is eligible.

No, Travel health insurance plan must be purchased before you travel out of the UAE.

Before Inception of Policy, Policyholder can request for cancellation of the Policy or deletion of the Eligible Person based on the below conditions.

  1. Visa is rejected
  2. Certified by Physician that Eligible Person is not medically fit to travel. For such cases Policyholder will be entitled to a refund of premium subject to the deduction of AED 100 per Eligible Person as Administration fee.

Kindly note that for Single Trip Policy, Deletion is allowed only before inception of the Policy.

The  coverage is for 90 days from the policy effective date selected by customer and applicable for a single trip only. Any treatment starting after the expiry date of policy is not covered. 

Yes, you will be covered for all medical expenses until your state is stabilised and you are fit for travel.

"Emergency" - The acute onset of a medical or surgical condition manifested by acute symptoms of sufficient severity, including pain, that the absence of immediate treatment at health facility could reasonably be expected to result in placing the patient’s health or bodily functions in serious jeopardy or dysfunction of any body organ or part.

Any expenses arising due to pregnancy, childbirth, miscarriage or abortion is not covered under your plan exception any emergency treatment required due to accidental injury. 

Only emergency dental treatment is covered under your plan.
Example: to relieve immediate pain only 

Yes, Your plan offers coverage for Medical Evacuation. In case of an emergency if required, you will be transported by the most appropriate mode of transport to the nearest healthcare facility where appropriate medical care is available. Please contact emergency assistance service provider at +971 2 418 4888 and they will arrange for the same.

Coverage for pre-existing conditions is limited to medical emergency only. Any further treatment after your condition is stabilized is not covered in case of pre-existing condition.

No, medical emergency treatment while travelling in the UAE is not covered.

No, repatriation to the UAE is not covered.

In case of emergency, 
a) Call an Ambulance
b) If you don’t have the ambulance number, call on international assistance company on +971 2418 4888

For an insured member, in cases of medical necessity at the recommendation of the treating doctor extra charges for the room for one companion accompanying the insured member in hospital will be covered up to a maximum limit as described in Schedule of Benefits. This benefit can be availed on reimbursement basis only.

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