The services of medical insurance are basically established upon the nature of the relationship between the insurance company and medical providers. Tawuniya’s commitment to pay full reimbursement of the medical expenses provided to the insured is positively reflected on the provider’s interaction with our customers. In addition, Tawuniya uses Waseel system to link with medical providers and as to accomplish a record time of fast handling, processing and reimbursing the providers’ claims. The medical claim unit also undertakes reimbursing the customers for their prepaid medical expenses of treatment received in non-appointed providers in emergency cases.

Beneficiaries of Balsam Plan

  • All employees who are actually on the job

  • Husband or wife

  • Infant from birth

  • Unmarried children not exceeding 25 years

  • Unmarried and unemployed daughters, widows and divorcees of the Insured Person who are totally dependent on the employee
    Insurance
    Balsam
    Cooperative health insurance

Things to know before you submit a claim:

  1. All tests for sight and hearing correction and audiovisual aids, unless ordered by a licensed physician.

  2. Any medical expenses related to Kidney dialysis.

  3. All services and treatments related to dental implants or prosthesis or orthodontics or bridges fixed or moving, except occasioned by violent external means.

  4. Devices, medicines, procedures and/or hormone treatment related to birth control, contraception or conception, sterility, impotency or infertility, and in- Vitro fertilization or any other artificial insemination procedures.

  5. General health examinations, vaccinations, drugs or prophylactics which are not required for medical treatment of an ailment provided for herein (excluding the preventive measures specified by the Ministry of Health such as vaccinations, maternity care and child care)

Documents required when submitting a claim:

  1. Detailed medical report.

  2. Laboratory results and x-ray reports ( if the service provided)

  3. Original invoices and receipt of payments.

  4. Copy of the medical insurance card

  5. Copy of re-entry visa ( if treatment outside KSA) with tawuniya acceptance letter.

Note: Reimbursement of medical expenses will only apply to cases submitted within 30 days as specified in the policy. Claim procedure is done:
  • By E-mail or through the free phone number

  • Branches

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