Employees claim notification

Get your claim started

To make a claim, just fill in the form below and our claims team will be in touch to let you know what happens next.

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Employee details

Title

First name

Last name

Phone number

Email address

Confirm Email address

Date of birth

Address line 1

Address line 2 (optional)

Town/City (optional)

Postcode

Name of the company you work for

Enter your staff number if you know it

When did you join your Employers Group Critical Illness Policy (optional)

What is your condition or diagnosis?

Date when symptoms first started

Have you suffered with this condition before?

Please give us the contact details for your GP

Please give us the contact details for your consultant

Do you have any medical information that we can get from you that may help support your claim?

Any other comments (optional)

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Online claim form for employees

Get your claim started

Employee details

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