Get Cern Health Insurance Scheme Chis/f02 2019-2026

This guide will assist you in completing the CERN Health Insurance Scheme CHIS/F02 form online. Follow the step-by-step instructions to ensure that you fill out the necessary sections accurately and efficiently.

Follow the steps to complete the form accurately.

1. Press the ‘Get Form’ button to access the CERN Health Insurance Scheme CHIS/F02 form and open it in your preferred online editing tool.
2. Begin by filling in the main member's information. In the designated fields, enter your surname and first name(s). Provide your CHIS ID, ensuring the format is correct.
3. If the patient is not the main member, fill in their surname, first name(s), and CHIS ID. Include the home address of the patient if it differs from the main member's address.
4. Indicate whether there is other insurance covering the patient's medical expenses related to the accident. If yes, provide the name of the insurance and the policy number.
5. Record the date and time of the accident using the specified Day/Month/Year and Hours:Minutes formats.
6. Describe the location and circumstances of the accident in clear detail. If necessary, attach additional documentation or sketches.
7. Choose the method of transport after the accident: if an ambulance was used, specify the service provider; if you used your own transport, select that option. Provide the name of your care provider and any relevant reports.
8. Fill out the section regarding involvement of third parties. Indicate if applicable, and if so, enter the third party's surname, first name(s), and home address.
9. If a vehicle was involved, note the type and registration number. Additionally, provide information on the civil liability insurance, including the company name and policy number.
10. If witnesses are available, fill their details as required. Include at least their names and contact information.
11. Confirm the subrogation agreement, providing your signature, name, and date as required.
12. Review all filled information for accuracy. Once confirmed, follow through by saving changes, downloading, printing, or sharing the form as necessary.

Complete the CERN Health Insurance Scheme CHIS/F02 form online today to ensure a smooth reimbursement process.