Thank you for submitting your claim online. Please note that the declaration at the end of this online form must be read and accepted by each policy owner and the claimant (or their parent/guardian if under 16) before it's submitted. The policy owner(s) will be notified about this claim.

Attachment hints

Single file size can not exceed 3MB. Total file size for all attachments can not exceed 20MB. Only file of type: PDF, DOC/DOCX, JPG/JPEG or PNG is allowed as attachment.

Please only attach JPEG, jpg or png image files from your photo gallery. If you have a PDF or any other document, please take a photo and upload. Thank you.

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Detail

Please complete the following to ensure we have all the necessary information to process your claim as quickly as possible.


Please select one (or more) of the boxes to explain what you are applying for

Is your treatment within the next 5 days?

Please select an answer

Need help with your claim?

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