Making a claim.

We aim to make the claiming process as simple and stress free as possible.

The insured member is required to complete the following claim form and attach all the original medical bills and supporting documentation. A separate form must be completed for each medical condition, each currency and each member. All sections must be completed.

Please click here to download the claim form as a pdf – you will need page 2 to give to your doctor.

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SECTION A: PATIENT DETAILS TO BE COMPLETED BY INSURED MEMBER


If the person named above is not the patient, please complete details

SECTION B: SETTLEMENT DETAILS

We settle all eligible claims by bank transfer (EFT), therefore it is important that you confirm your correct bank details every time you make a claim. Due to new regulation in the banking sector, we also need you to provide us with your residential address (registered to your bank account) so that we can pay claims directly into your bank.

Bank Transfer – All fields in the box below are MANDATORY:

PLEASE NOTE:

• It is important that you complete the bank details section in full. Any missing or unclear information may result in payments being delayed. • Bank charges may apply when making bank transfers • Payments are not made directly to any clinic, physician or medical provider


SECTION C: PATIENT DETAILS TO BE COMPLETED BY TREATING DOCTOR

Note: If there are multiple doctors, this section is to be completed by the last attending physician.

6. Doctors previously consulted by the patient for the above condition:


SECTION D: UPLOAD SECTION

Please upload your documents below, failure to do so will delay your claim

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      “Giving you confidence in everything we do.”