Claim Filing and Appeal Deadlines by Insurer

Seguros360 · Practical guide

How much time you really have to file your claim

The claim filing and appeal deadlines of six international health insurers, with the policy wording article that sets each one.

Most of the claims that reach our analysis aren’t lost because of what the policy says about the illness. They’re lost because of the calendar. Here we’ve gathered what the 2026 policy wordings in force establish, with the exact reference, so you can check it yourself in your own contract.

Deadline to file the claim

Insurer	Deadline	Counted from	Article
Best Doctors	12 months	the date of service	12.1
VUMI	180 days	the date of service	4.23 or 4.24 depending on the plan
EVER Health	180 days	the event	Proof for filing
BMI	180 days	the event or service	Proof of Claim
American Fidelity	180 days	the treatment or service	5.3
Bupa Global	180 days	the treatment or service	11.4

For maternity, BMI counts the 180 days from the date of birth.

The fact that rescues the most claims: Best Doctors is the only one of the six that gives you 12 months. And its guarantee of payment letters mention 180 days, because they’re an administrative document, not the contract. If you were told your deadline has passed and your policy is with Best Doctors, go back to article 12.1 before writing it off: you may have twice as much time as you thought.

If you’ve already been denied: the appeal

Insurer	Deadline to appeal	They respond within
American Fidelity	30 days from the decision	30 days
EVER Health	60 days from notification	30 days · 60 if the reimbursement has already been received
Best Doctors	the contract sets no deadline	30 days, with a reasoned response
Bupa Global	the contract sets no deadline	30 days · a written appeal is a mandatory prior step
VUMI	The policy wording doesn’t provide for an appeal procedure. The route is to deal directly with the insurer.
BMI	The policy wording doesn’t provide for an appeal procedure. The route is to deal directly with the insurer.

American Fidelity has the shortest clock of the six: thirty days from when you’re notified of the decision.

What it costs not to request pre-authorization

Insurer	Reduction of the benefit
BMI	30 % or the adjustment to the usual and customary rate — whichever reduces it more applies. Notify 72 hours in advance; 48 in an emergency
Best Doctors	30 % (11.1)
VUMI	30 %
American Fidelity	30 % (4.3)
EVER Health	The policy wording doesn’t set a general percentage
Bupa Global	The policy wording doesn’t set a general percentage

Before citing an article in a letter, open the policy wording for your specific plan. VUMI, for example, numbers the same clause 4.23 in some plans and 4.24 in others. And the edition that governs is the one in force at the start of your policy year, not the most recently published one.

FAQ

When does the deadline start counting? From the date of service or of the medical event, not from when you receive the bill or when the insurer responds to you.

My guarantee of payment letter says 180 days and my policy is with Best Doctors. Which one governs? The policy wording governs. The guarantee of payment letter is an administrative document; article 12.1 of the contract sets 12 months.

What happens if I didn’t request pre-authorization? With Best Doctors, VUMI and American Fidelity the benefit is reduced by 30%. With BMI, either 30% or the adjustment to the usual and customary rate applies, whichever reduces it more. That’s not the same as an outright denial.

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Table prepared by Seguros360 based on the 2026 policy wordings in force of the six insurers. Updated August 19, 2026. This is general information to guide you: what always decides is the policy you signed. If you spot a difference with your contract, write to us and we’ll correct it. See also our Claims Observatory.

Do you know how many days you have left?

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