Report to Fortune Care the loss of your membership ID Card thru our hotline after which you are required to submit the following:
           a. Duly accomplished LOST ID FORM (click here to download the form)
           b. Photocopy of any valid ID
           c. Processing fee of P 50.00 (fifty pesos)

Replacement ID will be released within seven (7) days from date of receipt of all required documents.

A Fortune CARE member may file a claim for reimbursement of expenses for covered emergency treatment/ hospitalization in a non-accredited hospital, or when the member had paid for charges incurred under covered services.

       I.   Claim must be filed within 10 days after the services or date of discharge.
       II.  Documents required:

             A. For OUT-PATIENT REIMBURSEMENT:
                1. Request letter for reimbursement signed by the member/payor
                2. Medical Certificate with indication of vital signs and final diagnosis
                3. Original copy of the official receipts both for hospital bills and professional fees
                4. Copy of operation record and histopath report in case a minor surgery is done.
                5. Referral slip by accredited Fortune CARE physician if referred to a non-Fortune CARE
                    physician
                6. Police report for vehicular accident and Incident Report for self accident
                7. Result of Diagnostic Procedure done (MRI, CT-Scan, X-Ray, etc.)

             B. For IN-PATIENT REIMBURSEMENT:
                1. Request letter for reimbursement signed by the member/ payor.
                2. Detailed Clinical Discharge Summary with indication of vital signs and final diagnosis
                    duly signed by the attending physician.
                3. Operative Record and Histopath Record (if Surgery was done)
                4. Original copy of Official Receipt (For Hospital Bill & Doctor’s Fees)
                5. Itemized summary of statement of account and/or invoice
                6. Pharmacist's certification on non-availability of stocks identifying the
                    medicines not available with doctor's prescription of medicines bought outside.  
                7. Referral slip by accredited Fortune CARE physician if referred to a non-Fortune CARE
                    physician
                8. Police Report and Incident Report (For vehicular accident / self accident - submission
                    of incident report is required)
                9. Result of Diagnostic Procedure done (MRI, CT-Scan, X-Ray, etc.)
                10. Hospital’s certification of non-availability of room.
                11. Birth Certificate for Maternity Cases.
                12. Death Certificate or Marriage Contract for Deceased Patient.

             C. FOR THIRD PARTY & WORK-RELATED ACCIDENTS
                1. Police Report/ Affidavit of the Claimant
                2. Medical Bills and ORIGINAL Official receipts both for hospital bills and professional
                    fees
                3. Physician’s prescription
                4. Certificate of No Claim from Insurer of adverse party
                5. Employer’s Certificate (for work-related cases)
                6. Other documents to be required when necessary

       III. Additional requirement for emergency hospitalization expenses in a foreign country:
             - A certification from the Philippine Consulate that states all submitted documents are
                truthful and genuine.

                Send to: FORTUNE MEDICARE INC.

                               Claims Department

                               3rd Floor, Citystate Centre 709 Shaw Blvd., Pasig City 1630

             - All documents for expenses incurred in foreign country must be in English.


       IV. Fortune CARE will pay validated claims within 30 days after receipt of complete             documents.

       V.  Approved claims will be payable directly to the member or the PAYOR if the patient is a
             minor dependent. Once the claim has been reimbursed, Fortune CARE will no longer be
             obliged to pay for any liabilities related to the charges.

       VI. Receipt of payment of the claim discharges/ releases Fortune CARE from all obligations
           and liabilities related to the charge subject of the stated hospital and physician services.

       VII. Information on disapproved or reduced reimbursement claims will be conveyed to the
             member together with the reason for said action by Fortune CARE.

       VIII. Where a claim for reimbursement has been denied, the member or his authorized
             representative may appeal the decision by filing a written request for reconsideration
             within 30 days from receipt of the denial stating new or additional information or reasons
             in support of said appeal.

The following documents are required in claiming your financial assistance benefit:
        A. REQUIREMENTS FOR FINANCIAL ASSISTANCE CLAIMS
            1. Death Certificate
            2. Police Report if claim is accident related
            3. Notarized Affidavit of the Claimant if death is due to illness
            4. Proof of Relationship of Beneficiary
            5. Certificate of Insurance to surrender Fortune CARE ID
            6. Other documents to be required when necessary

        B. DISABILITY CLAIMS
            1. Police Report if claim is accident related
            2. Notarized Affidavit of the Claimant if due to illness
            3. Operation Record
            4. Detailed clinical summary
            5. Certificate of Insurance
            8. Picture of whole body with that body part missing or disabled
            7. Abstract or Discharge Summary indicating the functional level of the injured/lost body
                organ
            8. Other documents to be required when necessary

Death and disability claims must be filed within 30 days from date of death or accident by the legal beneficiary and member, respectively.

No, group and corporate accounts should settle membership fees through a centralized and duly appointed authority.

Restoration of benefits for an approved request for reinstatement shall commence after 72 hours from the date of reinstatement.