Ill Health Notification

Telling us about an illness

There are only a few steps, it should take a few minutes to complete.

It’s important to know:

Please check the definitions that apply to your policy in your Policy Provisions or Terms & Conditions booklet before completing the claim form.
If you don’t have a copy of the Policy Provisions or Terms & Conditions booklets, you can contact us to request a copy.
Once you have completed this form, we will call you and go through any additional information we require.
If you would like to know more about how we’ll manage this claim, you can find more information on the Health Claim webpage.

To understand more about how we process your personal information and the rights you have, please read our Privacy Statement.

Get started

These details need to match your policy documents

First name

Last name

Date of birth

Enter postcode and search for address

Mobile phone number We'll use this number to keep you updated on progress

Email address We will use this email address to keep you updated on progress (if you have not entered a mobile number)

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Policy number You can find this on your annual benefit statement or policy schedule

What is your claim in connection with?

Date first absent from work due to disability or illness

Voicemail preference Please tell us if we can leave a voicemail if we cannot get through to you

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Please check your details are correct before submitting the form.

First name: ##firstname##

Last name: ##lastname##

Date of birth: ##dateofbirth##

Address: ##address1##
##address2##
##address3##
##address4##
##postcode##

Mobile number: ##mobilephonenumber##

Email address: ##email##

Edit your details

Policy number: ##policynumber##

What is your claim in connection with: ##connection##

Date first absent from work due to disability or illness: ##datefirstabsent##

Leave a voicemail: ##voicemailpreference##

Edit your details

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