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Group Medical Portal
Welcome to TMF(HK) - Group Medical Portal

Group Medical Insurance – Claims – Frequently Asked Questions
1.
When and how should I submit my claim for benefits under group medical insurance policy?
All claims should be submitted to us within 90 days of consultation/treatment or discharge from hospital/clinic unless it is otherwise specified in the Policy. When submitting a claim, a completed set of the prescribed medical claim form together with original copy of medical receipt(s) and relevant supporting documents are required.
  • For Out-patient medical claims, please complete "Out-patient Medical Claim Form".
  • For Dental claims, please complete "Dental Claim Form".
  • For Hospitalization & Surgical Operation claims, please complete "Hospitalization & Surgical Claim Form".
 
2.
If I want to check my claim status, how can I do?
You may visit http://www.tokiomarine.com.hk/gh/ and login under TMF(HK) - Group Medical Portal with your Login Name and Password to check the status and details of your and your dependent(s)' claims that have been made in the past 24 months. You may also contact our Medical Claims Unit via telephone no. 2529-4401 during office hours for enquiry.
 
3.
Are photocopies of my medical receipts and documents acceptable for the purpose of processing my claim?
No, original medical receipts and supporting documents are required.
 
4.
If I want to get back original copy of my submitted medical receipts, how can I do?
You may request for return of the original receipt by ticking the box or indicate the request on the medical claim form for return of original receipt when submitting your claim. We will return the original receipt to you after your claim is processed.
 
5.
If I have already made a claim under other insurance company, can I make a claim to you for the balance amount?
Yes, please submit original copy of medical receipts together with a claim payment statement issued by your insurance company.
 
6.
When should I submit a doctor referral letter?
A valid referral letter issued by a Registered Medical Practitioner is generally required to be submitted when making a claim for expenses incurred on consultation with a Specialist, Diagnostic X-ray/laboratory tests or Physiotherapy treatment unless it is otherwise specified in the Policy.
 
7.
What is a valid doctor referral letter?
Expenses on consultation with a Specialist - A referral letter which is issued by a Registered Medical Practitioner with the specification of diagnosis and the related specialty. It is valid for 90 days from the date of issuance or last visit for follow up visit.

Expenses on diagnostic X-ray/laboratory tests - A referral letter which is issued by a Registered Medical Practitioner with the specification of diagnosis and details of X-ray/laboratory test(s) recommended. It is valid for 90 days from the date of issuance and for one-off use only.

Expenses on physiotherapy treatment - A referral letter which is issued by a Registered Medical Practitioner with the specification of diagnosis. It is valid for 90 days from the date of issuance or last visit for follow up visit.
 
8.
What kinds of Chinese Medicine Treatment are covered?
In general, only Chinese herbal treatment, bonesetting treatment and acupuncture treatment are covered. Other kinds of Chinese medicine treatment are excluded unless it is otherwise specified in the Policy.
 
9.
How can I search for the lists of Registered Chinese Medicine Practitioner and Listed Chinese Medicine Practitioner?
You may visit the website of the Chinese Medicine Council of Hong Kong via http://www.cmchk.org.hk/ for searching the list of Registered Chinese Medicine Practitioner and the list of Listed Chinese Medicine Practitioner.
 
10.
How can I search for the List of Registered Doctor with Specialist Registration?
You may visit the website of The Medicine Council of Hong Kong via http://www.mchk.org.hk/doctor/index.htm/ for searching the List of Registered Doctor with Specialist Registration.
 
11.
How can I check the cashless network doctors?
You may visit http://www.tokiomarine.com.hk/gh/ and login under TMF(HK) - Group Medical Portal with your Login Name and Password. Then, please click the button of "Cashless Doctors" to search for the details of cashless network doctors.