Health insurance claim
ERGO Estonia health application
To submit an application for indemnity, fill in the claim form in the ERGO health app or on the ERGO website.
Health care from Meliva digital clinic 7 days a week, wherever you are.
What to do if you need medical attention?
Choose a health care provider
Choose a medical institution from the list of ERGO’s medical partners or contact another treatment provider that suits you. Coordinate scheduled hospitalisation with ERGO in advance.
Payment for medical services
If you are using the services of ERGO’s medical partner, inform the medical institution that you have ERGO health insurance. ERGO pays the cost of treatment covered by the insurance contract directly to the medical institution. You must pay the deductible specified in the insurance contract and the part exceeding the indemnity limit on the basis of an invoice issued by ERGO or a medical institution. If you are using a medical institution that is not on the ERGO medical partner list, first pay the invoice for the treatment service yourself and then submit an application for indemnity to ERGO.
Application for indemnity
If you contacted ERGO’s medical partner, you do not have to submit an application for indemnity to ERGO. When using a service provider that is not included on the list of ERGO’s medical partners, submit an application for indemnity to ERGO on the ERGO mobile app or website.
Supporting documents for an application for indemnity
ERGO will send you a notification about the need for clarifications or additional documents by email.
Indemnity decision
ERGO will make an indemnity decision within 10 working days of receiving the necessary documents. The indemnity decision will be sent to your email address. If you have any questions related to the indemnity decision, please send an email to ravi@ergo.ee.
Digital clinic
The digital clinic has easy access to general and family medicine 7 days a week, including evenings and holidays.
In the digital clinic, you can get answers to simpler health-related questions without leaving your home.
ERGO medical partners
Good to know
Supporting documents for an application for indemnity
The supporting documents necessary for an indemnity decision may be:
- invoice for treatment provided;
- extract from the medical history;
- copy of the vaccination card or the corresponding entry on the Health Portal;
- extract from the Health Portal or the occupational health doctor’s decision on the need for rehabilitation treatment;
- documentary evidence of change in visual acuity, prescription;
- copy of the prescription for a medicinal product.
You can find most of the required additional documents at www.terviseportaal.ee and www.eesti.ee.
Waiting period
Upon the first signing of an insurance contract, a waiting period will apply, wherein no indemnity will be paid for insured events occurring during such period.
Deductible
After the use of a medical service, the insured person must pay the deductible specified in the insurance contract and the cost of uninsured medical services themselves, based on the invoice provided by ERGO or the medical partner.
Good to know
The supporting documents necessary for an indemnity decision may be:
- invoice for treatment provided;
- extract from the medical history;
- copy of the vaccination card or the corresponding entry on the Health Portal;
- extract from the Health Portal or the occupational health doctor’s decision on the need for rehabilitation treatment;
- documentary evidence of change in visual acuity, prescription;
- copy of the prescription for a medicinal product.
You can find most of the required additional documents at www.terviseportaal.ee and www.eesti.ee.
Upon the first signing of an insurance contract, a waiting period will apply, wherein no indemnity will be paid for insured events occurring during such period.
After the use of a medical service, the insured person must pay the deductible specified in the insurance contract and the cost of uninsured medical services themselves, based on the invoice provided by ERGO or the medical partner.
