Please make your online claim using the form below.
For Hospital Stays, we require a signature from the hospital or a stamp. Discharge papers can also be provided.
All receipts must include the name of the person claiming together with details of the treatment/goods received and the name of the practitioner performing the treatment.
Claims must be submitted within 6 months of the date of any treatment/goods received and inline with the terms & conditions of your policy.
All claims will now be paid directly to your chosen bank account, please complete the appropriate section of the claim form with your bank account details. We will pay all future claims into this bank account unless you tell us otherwise.
For more information on how to claim or to check your benefit levels please contact us at:
Email email@example.com or call 01204 522775 (Monday to Friday 9am-5pm).
Should you wish to submit your claim by post, please use either of the claim forms below, depending on the benefit you’d like to claim.
‘Right Click’ and ‘Save As’ On the forms below to download them in PDF format