You can download three types of Claim Form via this service.

Please note that once downloaded the relevant form should be completed in full by you and your doctor and posted to the address shown.

On receipt of the completed form, your claim and policy coverage will be reviewed and assessed and we will contact you confirming if benefits are payable.

To download a CLAIM FORM please click on one of the following options:

CLAIM FORM for a new claim

CONTINUATION CLAIM FORM for a current or previous ACCIDENT claim

CONTINUATION CLAIM FORM for a current or previous SICKNESS claim

Click here to download the FREE Adobe Acrobat viewer required to view these forms