What to Do in Case of an Insurance Claim in Georgia: A Clear Guide

In case of sudden illness or injury, call the GPI medical assistance line: +995 32 2 505 111. Provide the insured person's first and last name, policy number, location, what happened, and when you sought or plan to seek medical care.

If the condition is life-threatening, the person is unconscious, there is severe bleeding, a fire, a traffic accident, or another immediate danger, call 112 first. This is Georgia's single emergency number for ambulance, police, and rescue services.

After making the emergency call, notify GPI at the first objectively possible opportunity. The contract allows late notification only when there are documented circumstances that genuinely prevented you from contacting the insurer.

Have your policy and passport ready. The operator needs accurate information to locate the contract and register the request. Do not present a suspected diagnosis as an established fact: describe your symptoms, injury, and any medical information you have already received.

For hospitalisation, outpatient care, or dental treatment, GPI asks you to provide the insured person's name, policy number, name of the medical facility, and the time of the visit. If you have not yet chosen a clinic, provide your address and ask the operator to help you find a suitable facility.

Write down the time of the call and the instructions you received. If the operator directs you to a specific clinic or approves a particular service, keep the message or reference number. This will help establish the sequence of events when the documents are reviewed.

• insured person's first and last name;
• policy number;
• brief description of the event and symptoms;
• exact location;
• name of the clinic, if already selected;
• time when medical assistance was requested.

If GPI directs you to a partner clinic, the insurer pays the facility directly for the covered part of the service. The patient does not need to pay in advance the amount that the contract requires the insurer to reimburse.

Direct payment does not override the policy terms. The clinic and insurer still check the medical indications, limits, and required approval. If part of the service is not covered, is subject to a deductible, or exceeds a sub-limit, the patient may have to pay that part themselves.

Show the clinic your passport and policy. Clarify before the procedure exactly what has been approved. The statement "we accept your insurance" does not necessarily mean that a particular examination or medicine has been approved for payment.

At a non-partner clinic, the patient generally pays for the medical assistance in full and then applies for reimbursement. Under the GPI terms, the documents must be submitted within 30 days after receiving the service.

Do not choose this option unnecessarily if you can contact the insurer in advance. GPI expressly states that medical expenses incurred without the required notification are not reimbursed. An exception may apply if there was an objectively documented inability to notify the insurer.

Ask the clinic to provide all documents before you leave. Reconstructing a detailed calculation, doctor's signature, or stamp later can be more difficult. Check that the amount on the receipt matches the calculation and that the patient's name is written correctly.

For reimbursement at a non-partner clinic, GPI specifies the original policy, an identity document, Medical Form No. 100 with a detailed description of the service, a detailed cost calculation, and a cash receipt. Medical documents must be signed and issued by the medical facility.

Form No. 100 is a medical certificate in which the doctor describes the diagnosis, examinations performed, and medical assistance provided. A bank charge or a brief receipt without medical justification is not sufficient to assess the insurance claim.

For urgent dental treatment, X-rays taken before and after the treatment will also be required. If payment was made by card, still request a cash receipt and an itemised statement. A bank statement confirms the payment but does not explain what medical service was provided.

• policy;
• passport or another identity document of the insured person;
• Form No. 100 describing the medical assistance;
• detailed cost calculation;
• cash receipt;
• X-rays before and after treatment in the case of dental care.

In a traffic accident involving injured persons, call 112 first and provide the location, type of incident, and condition of the people involved. Do not move an injured person unless necessary, unless there is a fire or another immediate danger.

After calling the emergency services, notify GPI about the medical assistance under the travel insurance policy. If a vehicle with foreign registration is involved in the incident, separate rules regarding compulsory motor third-party liability insurance and notification of the Compulsory Insurance Centre also apply.

Keep medical documents and materials confirming the circumstances of the incident. The insurer may request information necessary to verify the cause of the injury and the amount of expenses.

Do not delay contacting the insurer in order to search for a clinic yourself if the situation allows you to contact them. Do not promise a doctor that the insurer will pay for any service: approval must be confirmed by the operator or the company itself.

Do not discard original documents after sending copies. Do not alter medical documents yourself and do not conceal the circumstances of the incident. Incorrect information may be grounds for refusing reimbursement.

Keep the policy and assistance number until the end of your trip. After reimbursement or a refusal, check the written decision. If you disagree, request an explanation referring to the specific clause of the contract and use the official complaints procedure.