Health Cash Plan Benefit Application Form

You can claim for all benefits here except for Hospital Benefits – including Parental Hospital Stay and Birth/Adoption of a child as we need original documents to be sent in to us in the post, for this you would need to complete the paper claim form, which can be printed here.

  1. Personal Details
  2. Employment Details
  3. Claim Details
  4. Bank Account Details
  5. Consent & Declaration

THE SOCIETY RESERVES THE RIGHT TO DEDUCT ALL ARREARS ON THIS POLICY FROM ANY BENEFITS PAYABLE OR MAY DECLINE COVER IN CASE OF SIGNIFICANT ARREARS.

PLEASE ENSURE THAT YOU COMPLETE ALL THE INFORMATION BELOW ACCURATELY AS FAILURE TO DO SO MAY LEAD TO THE REJECTION OR DELAY TO THE PAYMENT OF YOUR CLAIM.