Get Interglobal Claim Form

Filing a claim can seem daunting, but with the right guidance, you can navigate the Interglobal Claim Form online smoothly. This guide provides clear, step-by-step instructions tailored to your needs, ensuring your submission is complete and accurate.

Follow the steps to fill out the form correctly:

1. Press the 'Get Form' button to access the Interglobal Claim Form and open it in the designated editor.
2. Begin with section A where you will provide patient details. Complete all fields accurately using block capitals, including title, family name, first name(s), date of birth, sex, group name (if applicable), member number, plan number, correspondence address, email, and telephone.
3. If the main member is different from the patient, fill out section B with the main member's details.
4. In section C, answer the questions regarding other insurance policies that may cover medical costs and specify if you are claiming from a third party.
5. Section D addresses the hospital cash benefit claim. Indicate whether you are claiming this benefit and provide required details if applicable.
6. In section E, disclose if you have personally paid any costs for treatment and select your preferred reimbursement method, completing bank details for bank transfers.
7. Fill out section F, detailing the treatment date, invoice date, invoice reference, and the total amount (includiing currency) you are claiming.
8. Review section G and ensure you sign the declaration, confirming that all provided information is truthful and accurate.
9. If applicable, have your medical or dental practitioner complete sections H or I, providing their contact information, diagnosis, treatment details, and relevant signatures.
10. Finally, save your completed form. You can download, print, or share it as needed. Make sure to gather and attach original invoices and any supporting documents before submission.

Start filling out your Interglobal Claim Form online now to ensure a smooth claims process.