Claim notification

If you need to make a claim, you can get the process started online

To start the claim process, just fill in this form and a member of our claims team will be in touch to let you know what happens next.

Your data and rights

We collect and use personal information so we can assess a claim. For more details about how we use personal information, see our Privacy Policy.

You need to enable JavaScript to use this form. If you are unable to do this, please go to our contact us page to find the relevant contact details.

Policy number

Policy numbers are normally between 8-10 characters long and are made up of letters and numbers.

Policy numbers are normally between 8-10 characters long and are made up of letters and numbers.

Please enter the date in the format dd/mm/yyyy

What type of claim are you looking to make?
Who are you claiming for?

Please give us a brief description of the condition you’re claiming for. For example: Lung cancer.

Please provide the GP's details

To assess the claim, we may need to obtain information from the GP or another medical practitioner about the condition being claimed for. If this information is required, we’ll need a completed ‘Access to Medical Reports Act (AMRA) consent and authorisation form’ so that we can request it. We won’t contact the medical practitioner without this, but if it isn’t provided, we may be unable to assess or pay the claim. You’ll need to provide both the GP’s and Consultant’s Name and Address to start the claims process. If you don't have this information to hand at the moment, you'll need to get this before you can submit this form.

Please provide the consultant's details

Please tell us a brief description of the condition you’re claiming for. For example: Lung cancer.

Please provide your GP's details

To assess the claim, we may need to obtain information from the GP or another medical practitioner about the condition being claimed for. If this information is required, we’ll need a completed ‘Access to Medical Reports Act (AMRA) consent and authorisation form’ so that we can request it. We won’t contact the medical practitioner without this, but if it isn’t provided, we may be unable to assess or pay the claim. You’ll need to provide both the GP’s and Consultant’s Name and Address to start the claims process. If you don't have this information to hand at the moment, you'll need to get this before you can submit this form.

Please provide your consultant's details

Please tell us a brief description of the condition you’re claiming for.

Please enter the date in the format dd/mm/yyyy

Does your injury stop you from being able to work?

We’ll check if the cover you have with us can help with lost earnings.

Preferred method of contact

Additional Support

Do you have any additional support requirements you would like to make us aware of?
Please let us know the additional support requirements you would like to make us aware of?

If there's nothing else, please skip this question

Customer declaration

Please enter the date in the format DD/MM/YYYY

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