What happens when someone needs help.

Emergency

Get help first. Then the card. Then us.

If it is an emergency, seek treatment. Call the assistance number on the membership card. Then tell Cogotec — email or WhatsApp — so we are on the file, not discovering it at billing.

Planned care · GOP · pre-authorisation

Send the pack. We lodge it.

Surgery, admission, or a guarantee of payment: we submit to the insurer and chase the response. A specialist reviews the pack, usually within a working day. That is not a 24/7 claims desk, and it is not a promise on the insurer’s turnaround.

Who does what

We coordinate. They decide.

• Policy number and insurer
• Who was treated, and where
• Date of incident or admission
• Invoices, discharge notes, prescriptions
• Any assistance-case or GOP number already issued

Delayed or declined

We escalate on the wording.

• We confirm what is missing and send it.
• We chase the assistance case and the claims handler.
• We put the delay or decline in writing, with the policy wording.
• The insurer still decides. We do not pay the claim.

Anonymised example

A hardship posting. One activation.

A member in a remote posting needed movement, not a GP visit. Assistance ran the medical case. Cogotec stayed on the file: documents, insurer, billing after discharge. The insurer authorised the movement. We did not pay it.