Daman adjudication rules

Here we publish Daman Adjudication Rules (AR). The AR's make transparent how and when Daman covers and show under what conditions healthcare services are payable. This decision making process is called "Adjudication Process". The AR's are written mainly for healthcare professionals with a short summary for readers without a medical background. These AR's are drafted based on international best practice guidelines and evidence-based medicine in conjunction with Daman's schedules of benefits and UAE regulations.

Daman is to date the only insurance company in the region that publishes its rules in the public domain. We believe such transparency will help our stakeholders to understand Daman's coverage criteria and will improve the consistency in adjudication process across the region.

The adjudication rules should only be used for the purpose of reference or guidance for the adjudication process (refer to the disclaimer below).

Adjudication rule categories : MEDICAL | PHARMACEUTICAL | DENTAL | BILLING | HEALTH TECHNOLOGY ASSESSMENT

Adjudication rules are published on a quarterly basis, tentatively in March, June, September and December and are effective one month after publication to allow market consultation. Stakeholders are invited for feedback at any time, ideally during the above mentioned advisory period. For all your questions and comments, please contact our customer services at 800-4-DAMAN (32626).