Ill Health Notification

Telling us about an illness


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

You’ll need:

  • Your details
  • Your policy number

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.

 

Step 1 (of 3): Confirm your details

These details need to match your policy documents


 

Your address
 

Address:

##add1##

##add2##

##add3##

##add4##

##postcode##


 

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

Step 2 (of 3): Your claim details

You can find this on your annual benefit statement or policy schedule
Please tell us if we can leave a voicemail if we cannot get through to you

Step 3 (of 3): Check your details

Please check your details are correct before submitting the form.


Your details:

First name:                              ##firstname##

Last name:                               ##lastname##

Date of birth:                           ##dateofbirth##

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

Mobile number:                       ##mobilephonenumber##

Email address:                         ##email##

 

 


Your claim details:

Policy number:                                                                                 ##policynumber##

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

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

More details:

Leave a voicemail:                                                                          ##voicemailpreference##