Reimbursement Procedures
When you pay for medical services out-of-pocket, you can claim reimbursement from your Takaful fund through NAS Neuron. This process ensures fair distribution from the Tabarru' pool while maintaining Sharia compliance.
When to File for Reimbursement
- Treatment at non-network providers
- Emergency care where direct billing wasn't available
- International medical expenses
- Network provider system issues
- Medications purchased out-of-pocket
- When specific gender doctor unavailable for direct billing
- Pre-approved treatments paid personally
Takaful Reimbursement Principles
- Transparency: Clear documentation of all expenses
- Fairness: Equal treatment for all members
- Mutual Benefit: Protecting the Tabarru' fund for all
- Sharia Compliance: All claims reviewed for compliance
Reimbursement Timelines
| Action | Timeline | Sharia Review (if needed) |
|---|---|---|
| Submit claim | Within 30 days of treatment | - |
| Acknowledgment | Within 48 hours | - |
| Standard processing | 5-10 working days | +2-3 days |
| Payment after approval | 3-5 working days | - |
Step-by-Step Reimbursement Process
Step 1: Gather Required Documents
- ✓ Completed NAS Reimbursement Form (Takaful version)
- ✓ Original itemized invoices with provider stamp
- ✓ Detailed medical report in English/Arabic
- ✓ Prescription for medicines/treatments
- ✓ Diagnostic test results
- ✓ Copy of Emirates ID
- ✓ Copy of Takaful card
- ✓ Bank account details (no interest-bearing accounts)
Step 2: Complete Reimbursement Form
Essential information to include:
- Member name and Takaful certificate number
- Treatment dates and provider details
- Diagnosis and treatment description
- Declaration of Sharia compliance
- Total amount paid in AED
- Signature and date
Step 3: Submit Your Claim
Online Submission (Fastest):
- Log into myNeuron app
- Select "Reimbursement Claim"
- Upload all documents (max 10MB)
- Confirm Sharia compliance declaration
- Submit and save reference number
Email Submission:
- Email: reimbursement.claims@neuron.ae
- Subject: [Name] - [Member ID] - Takaful Reimbursement
- Attach all required documents
- Include contact number for queries
Physical Submission:
- NAS Neuron Health Services
- Attention: Takaful Claims Department
- P.O. Box 72071, Dubai, UAE
- Use registered mail for tracking
Sharia Compliance Review
Certain claims undergo Sharia review:
Automatic Review Triggers:
- Cosmetic procedures
- Mental health treatments
- Fertility treatments
- Gender reassignment related
- Alternative medicine claims
- Accident circumstances unclear
Review Process:
- Medical necessity verified
- Treatment method assessed for compliance
- Circumstances of injury/illness reviewed
- Sharia Board decision if needed
- Member notified of outcome
Reimbursement Calculations
Standard Takaful Plan Example:
| Total medical bill | AED 1,000 |
| Less: Deductible | -AED 50 |
| Remaining amount | AED 950 |
| Less: Co-takaful (10%) | -AED 95 |
| Reimbursement amount | AED 855 |
International Claim Example:
| Emergency treatment (USD) | $2,000 |
| Converted to AED (rate 3.673) | AED 7,346 |
| Out-of-network coverage (80%) | AED 5,877 |
| Less: Deductible waived (emergency) | -AED 0 |
| Reimbursement amount | AED 5,877 |
Special Reimbursement Situations
Chronic Medications:
- First claim requires full medical documentation
- Request recurring approval for 6 months
- Subsequent claims need only receipts
- Halal alternatives reimbursed at same rate
Maternity Claims:
- Submit all pregnancy-related expenses together
- Include delivery report and newborn records
- Home birth with licensed midwife covered (Standard/Comprehensive)
- Traditional post-natal care eligible if medically supervised
Alternative Medicine:
- Hijama (cupping) with certified practitioner
- Herbal medicine from licensed providers
- Prophetic medicine treatments (pre-approved)
- Ruqyah therapy for mental health (specific providers)
Common Rejection Reasons
| Reason | Prevention |
|---|---|
| Late submission (>30 days) | Submit immediately after treatment |
| Treatment from Haram activities | Ensure compliance with Islamic principles |
| Missing documents | Use checklist before submission |
| Non-covered service | Verify coverage before treatment |
| Exceeded limits | Check remaining limits on app |
| Invalid provider | Ensure provider is licensed |
Tracking Your Reimbursement
Online Tracking:
- Log into myNeuron app
- Select "Track Claims"
- Enter reference number
- View status: Received → Review → Sharia Check → Approved → Paid
SMS Updates:
- Automatic updates at each stage
- Final amount and payment date
- Rejection reasons if applicable
Appeals Process
For rejected claims or partial payments:
- Review rejection reasons carefully
- Gather additional supporting documents
- Submit appeal within 30 days
- Include doctor's justification letter
- Request Sharia Board review if religious matter
- Final decision within 10 working days
Payment Methods
Reimbursements paid only through Sharia-compliant methods:
- Direct transfer to Islamic bank accounts
- Transfer to conventional banks (non-interest accounts)
- Manager's cheque for large amounts
- No cash payments
Important Guidelines
- Keep copies of all submitted documents
- Original receipts may be required for amounts over AED 5,000
- For Hajj/Umrah medical expenses, special provisions apply
- Zakat eligible on out-of-pocket medical expenses
- Surplus distribution considers claims history
Tips for Faster Processing
- Submit claims promptly after treatment
- Ensure all documents are clear and complete
- Include provider license numbers
- Provide accurate bank details
- Mention any urgency with valid reason
- Use online submission for quickest processing